Paramedic
State-by-state licensing requirements, salary data, and career ROI
What Is a Paramedic?
Paramedics deliver advanced emergency medical care beyond what EMTs can provide — administering IV medications, intubating airways, reading EKGs, and performing advanced cardiac life support. They work on ambulances and in emergency departments. Becoming a paramedic requires completing a 1–2 year accredited program (typically after EMT-Basic) and passing the NREMT Paramedic exam.
The Landscape
While all states require licensing, the path to obtaining and maintaining it varies, impacting a paramedic's mobility and initial entry. Most states rely on National Registry of EMTs (NREMT) certification for renewal, simplifying continued education across borders. However, states like New York and Illinois utilize their own state exams for initial certification, creating an additional hurdle, and California and Nevada delegate actual practice licensure to local authorities, which can introduce local regulatory nuances beyond state-level certification.
Paramedic by State
Click any state for detailed requirements, salary percentiles, and ROI analysis.
| State | License Required | Median Salary | vs. National | Time to Complete |
|---|---|---|---|---|
| Alabama | Yes | $36,260 | -12.3% | 1-2 years |
| Alaska | Yes | $56,900 | +37.6% | 1-2 years |
| Arizona | Yes | $38,110 | -7.8% | 1-2 years |
| Arkansas | Yes | $31,710 | -23.3% | 12-18 months |
| California | Yes | $45,680 | +10.5% | 1-2 years |
| Colorado | Yes | $43,950 | +6.3% | 1-2 years |
| Connecticut | Yes | $47,550 | +15.0% | 1-2 years |
| Delaware | Yes | $45,310 | +9.6% | 1-2 years |
| District of Columbia | Yes | $45,920 | +11.1% | 1-2 years |
| Florida | Yes | $40,420 | -2.2% | 1-2 years |
| Georgia | Yes | $39,250 | -5.1% | 1-2 years |
| Hawaii | Yes | $61,310 | +48.3% | 1-2 years |
| Idaho | Yes | $39,430 | -4.6% | 1-2 years |
| Illinois | Yes | $40,780 | -1.4% | 1-2 years |
| Indiana | Yes | $39,850 | -3.6% | 1-2 years (including EMT prerequisite) |
| Iowa | Yes | $39,260 | -5.0% | 1-2 years |
| Kansas | Yes | $34,650 | -16.2% | 1-2 years |
| Kentucky | Yes | $36,050 | -12.8% | Approximately 1.5-2 years |
| Louisiana | Yes | $33,990 | -17.8% | 1-2 years |
| Maine | Yes | $45,720 | +10.6% | 1-2 years |
| Maryland | Yes | $47,390 | +14.6% | 1-2 years |
| Massachusetts | Yes | $45,970 | +11.2% | 3-4 weeks (online application processing) |
| Michigan | Yes | $38,890 | -5.9% | 1-2 years |
| Minnesota | Yes | $45,690 | +10.5% | 1-2 years |
| Mississippi | Yes | $35,980 | -13.0% | 1-2 years |
| Missouri | Yes | $38,580 | -6.7% | 1-2 years |
| Montana | Yes | $34,900 | -15.6% | 1-2 years |
| Nebraska | Yes | $39,370 | -4.8% | 1-2 years |
| Nevada | Yes | $38,980 | -5.7% | 1-2 years (program length varies, plus application/processing time) |
| New Hampshire | Yes | $45,170 | +9.3% | 1-2 years |
| New Jersey | Yes | $49,500 | +19.7% | 1-2 years |
| New Mexico | Yes | $36,850 | -10.9% | 1-2 years |
| New York | Yes | $46,000 | +11.3% | 1-2 years |
| North Carolina | Yes | $40,530 | -2.0% | 1-2 years |
| North Dakota | Yes | $37,670 | -8.9% | 1-2 years |
| Ohio | Yes | $38,140 | -7.7% | 1-2 years (program length varies, typically 1100.5 hours over 14-20 months) |
| Oklahoma | Yes | $32,420 | -21.6% | 1-2 years |
| Oregon | Yes | $48,070 | +16.3% | Approximately 1 year for education program; license valid for up to 30 months initially. |
| Pennsylvania | Yes | $38,580 | -6.7% | 1-2 years |
| Rhode Island | Yes | $49,500 | +19.7% | 1-2 years |
| South Carolina | Yes | $38,670 | -6.5% | 1-2 years |
| South Dakota | Yes | $39,520 | -4.4% | 1-2 years |
| Tennessee | Yes | $37,630 | -9.0% | 1-2 years |
| Texas | Yes | $37,000 | -10.5% | Varies (typically 1-2 years for education, plus application processing time) |
| Utah | Yes | $36,940 | -10.6% | 1-2 years |
| Vermont | Yes | $39,520 | -4.4% | 1-2 years |
| Virginia | Yes | $45,060 | +9.0% | 1-2 years |
| Washington | Yes | $48,850 | +18.2% | 1-2 years |
| West Virginia | Yes | $35,060 | -15.2% | 1-2 years |
| Wisconsin | Yes | $43,340 | +4.8% | 1-2 years |
| Wyoming | Yes | $41,330 | -0.0% | 1-2 years |
Highest-Paying States for Paramedics
| # | State | Median Salary | Employment |
|---|---|---|---|
| 1 | Hawaii | $61,310 | 550 |
| 2 | Alaska | $56,900 | 290 |
| 3 | New Jersey | $49,500 | 5,630 |
| 4 | Rhode Island | $49,500 | 520 |
| 5 | Washington | $48,850 | 3,280 |
| 6 | Oregon | $48,070 | 1,760 |
| 7 | Connecticut | $47,550 | 2,100 |
| 8 | Maryland | $47,390 | 2,970 |
| 9 | New York | $46,000 | 14,350 |
| 10 | Massachusetts | $45,970 | 4,270 |