How do you renew an EMS certification in Missouri?
Missouri offers two cycles. On the NREMT path you recertify every two years with 40, 50 or 60 hours by level. On the five-year state path, under 19 CSR 30-40.342, an EMT needs 100 hours (48 core plus 52 elective), an AEMT 144 (72 core plus 72 elective) and a paramedic 144 (96 core plus 48 elective). The rule addresses EMT, AEMT and paramedic relicensure only; it sets no EMR continuing-education figure.
NREMTNREMT is one pathway; a state CE alternative exists
Cycle2 years (NREMT path) or 5 years (state path)
Renewal pageEMT and Paramedic Licensing Information
Open the official Missouri renewal page
What each level needs
| Level | Requirement |
|---|---|
| EMT | 100 hours over 5 years (48 core, 52 elective), or 40 on the NREMT path |
| AEMT | 144 hours over 5 years (72 core, 72 elective), or 50 on the NREMT path |
| Paramedic | 144 hours over 5 years (96 core, 48 elective), or 60 on the NREMT path |
What else Missouri requires
- Apply 30 to 120 days before expiration through the ImageTrend portal.
- Governed by 19 CSR 30-40.342.
How this relates to NREMT
In Missouri the National Registry is one way to renew; the state CE route above is the other. See the NREMT requirements by level.
Sources
- Missouri official renewal page: EMT and Paramedic Licensing Information
- 19 CSR 30-40 (PDF)
- EMT core requirements (PDF)
- Paramedic core requirements (PDF)
- Missouri EMT and paramedic licensing information
Compiled from these sources, retrieved September 2026. Renewal rules change; confirm with the issuing agency before you rely on any figure here.