An official website of the United States EMS Compact
Display:
Seal of the Interstate Commission for EMS Personnel Practice

The United States EMS Compact

Interstate Commission for EMS Personnel Practice

The United States EMS Compact, registered trademark

One license,
valid in multiple states.

The EMS Compact, state law in 28 states and operational in 27, works like your Driver's License. If you are an EMT, AEMT, or Paramedic with a qualified license issued in any participating state, your license is recognized (as a Privilege to Practice) across ALL participating states. No Fee. No Reciprocity Paperwork. The Compact is administered by the Interstate Commission for EMS Personnel Practice, the governmental body responsible for the interstate practice of EMS in the United States.

Can I practice in another state? New here? Start with the clinician guide

There is no separate "compact license" to apply for. If your home state participates and your EMS license is current, you already have a Privilege to Practice. You just verify it.

Verification

Verify a Privilege to Practice

Confirm whether an EMS clinician holds an active Compact Privilege to Practice. Enter the clinician's National EMS ID, a 12-digit number that is different from a state license or National Registry (NREMT) number.

Can I practice in another participating state?

You may be eligible for a Privilege to Practice if all of the following are true:

  • You hold a valid, unrestricted EMS license issued by your Home State.
  • Your Home State is a participating state that is in force.
  • You are affiliated with an EMS agency authorized in the state where you intend to practice.
  • You practice under a medical director.
  • You follow the remote state's scope of practice, protocols, and laws.
  • You are not restricted, suspended, or otherwise ineligible.

Read the full clinician guide →

Participating states

Where the Compact Is Law

The Compact has been enacted in 28 states and is operational in 27, and 1 more has enacted it but is not yet operational.

Privilege to Practice recognized Participating Enacted, implementing
Not yet in force Enacted, effective date pending Legislation under consideration Not yet
Florida: Not yetMaine: Not yetMassachusetts: Not yetMinnesota: Not yetNew Jersey: Not yetNorth Carolina: Not yetIllinois: Not yetNew Mexico: Not yetCalifornia: Not yetDC: Not yetHawaii: Not yetKentucky: Not yetMaryland: Not yetMichigan: Not yetMontana: Not yetNew Hampshire: Not yetNew York: Not yetOhio: Not yetOregon: Not yetWashington: Not yetWisconsin: Not yetVermont: Not yetRhode Island: Not yetAlabama: Participating (enacted 2017)Alaska: Participating (enacted 2026)Arizona: Participating (enacted 2026)Colorado: Participating (enacted 2015)Georgia: Participating (enacted 2017)Indiana: Participating (enacted 2020)Kansas: Participating (enacted 2016)North Dakota: Participating (enacted 2019)Oklahoma: Enacted, implementingPennsylvania: Enacted, implementingSouth Dakota: Participating (enacted 2021)Texas: Participating (enacted 2015)Wyoming: Participating (enacted 2017)Connecticut: Enacted, not yet operationalMissouri: Participating (enacted 2018)West Virginia: Participating (enacted 2020)Arkansas: Participating (enacted 2025)Delaware: Participating (enacted 2017)Iowa: Participating (enacted 2019)Mississippi: Participating (enacted 2017)Tennessee: Participating (enacted 2016)Utah: Participating (enacted 2016)Virginia: Participating (enacted 2016)Nebraska: Participating (enacted 2018)South Carolina: Participating (enacted 2018)Idaho: Participating (enacted 2016)Nevada: Participating (enacted 2023)Louisiana: Participating (enacted 2020)VTNHMARICTNJDEMDDCFLMEMNNCILNMCAHIKYMIMTNYOHORWAWIALAKAZCOGAINKSNDOKPASDTXWYMOWVARIAMSTNUTVANESCIDNVLA

Hover over a state for details, or select it to open its page.

View all states as a table
EMS Compact status by state
StateStatusEnacted
AlabamaParticipating2017
AlaskaParticipating2026
ArizonaParticipating2026
ArkansasParticipating2025
ColoradoParticipating2015
DelawareParticipating2017
GeorgiaParticipating2017
IdahoParticipating2016
IndianaParticipating2020
IowaParticipating2019
KansasParticipating2016
LouisianaParticipating2020
MississippiParticipating2017
MissouriParticipating2018
NebraskaParticipating2018
NevadaParticipating2023
North DakotaParticipating2019
South CarolinaParticipating2018
South DakotaParticipating2021
TennesseeParticipating2016
TexasParticipating2015
UtahParticipating2016
VirginiaParticipating2016
West VirginiaParticipating2020
WyomingParticipating2017
OklahomaEnacted, implementing2023
PennsylvaniaEnacted, implementing2022
ConnecticutEnacted, not yet operational2026
CaliforniaNot yet–
FloridaNot yet–
HawaiiNot yet–
IllinoisNot yet–
KentuckyNot yet–
MaineNot yet–
MarylandNot yet–
MassachusettsNot yet–
MichiganNot yet–
MinnesotaNot yet–
MontanaNot yet–
New HampshireNot yet–
New JerseyNot yet–
New MexicoNot yet–
New YorkNot yet–
North CarolinaNot yet–
OhioNot yet–
OregonNot yet–
Rhode IslandNot yet–
VermontNot yet–
WashingtonNot yet–
WisconsinNot yet–

Full participating-states detail →

Scope

What the Compact Does and Does Not Do

A Privilege to Practice allows eligible EMS clinicians to practice in participating states without obtaining a separate license in each state. It does not create independent practice authority, replace medical direction, authorize agency operations, or override state scope-of-practice rules.

What the Compact Does

  • Allows a State EMS license issued by any participating state to be immediately valid in all participating states.
  • Is established in law, takes effect immediately, and carries no separate application or fee.
  • Preserves local authority and accountability, including each state's control over EMS practice, licensure, and discipline within its borders.
  • Supports interstate workforce mobility, disaster response, and cross-border EMS operations.
  • Provides a coordinated system for verifying eligibility and practice status.

What the Compact Does Not Do

  • It does not authorize independent EMS practice.
  • It does not replace state scope of practice or medical direction.
  • It does not authorize an EMS agency to operate in another state without meeting that state's requirements.
  • It does not override employer credentialing, insurance, billing, or operational requirements.
Open government

Public Meetings

As a governmental body, all meetings of the Commission and its committees are open to the public, and public comment and input are encouraged. Upcoming meetings are posted here as public notice; recent meetings link to the official record.

Upcoming

Recent

All meetings & public notices →

Documents

Official Source Documents

These are the Commission's official documents, straight from the source. Read the position papers that explain where the Compact stands on key issues, the resolutions adopted by the Commissioners, a plain-language factsheet, and the legislation states use to join. Each is here in full so you can review it, share it, or cite it with confidence.

Questions

Frequently Asked Questions

What is the United States EMS Compact?

The United States EMS Compact is an interstate compact enacted as law by participating states. It creates a legal pathway for eligible EMS clinicians to practice across state lines through a Privilege to Practice, administered by the Interstate Commission for EMS Personnel Practice.

Does the Compact give me a national EMS license?

No. The Compact does not create a national license, and no federal or national EMS license legally exists. Under the Constitution, licensing the professions is reserved to the states under their police powers, not granted to the federal government. Your EMS license remains issued by your Home State. That state-only authority is exactly why occupational licensure compacts matter: an interstate compact is the constitutional mechanism, an agreement among states under the Compact Clause (Article I, Section 10), that lets states recognize one another's licenses without surrendering their authority. The EMS Compact uses that mechanism to extend a Privilege to Practice across participating states.

Can I work in another participating state without applying for another state license?

In many cases, yes, if you are eligible for a Privilege to Practice and comply with the remote state's laws, scope of practice, protocols, and medical direction.

Do I still need to be affiliated with an EMS agency?

Yes. The Compact does not create independent practice authority. You must be affiliated with an EMS agency that is licensed or authorized in the remote state and practice under a medical director.

Does the Compact replace National Registry certification?

No. The Compact does not replace employer requirements, state requirements, or National Registry certification where required by law, employer policy, or agency credentialing.

Who controls discipline if I practice in another state?

The remote state retains authority over practice within its borders, and your Home State retains authority over the EMS license it issued. A remote state may investigate complaints arising in that state and may suspend your Privilege to Practice there.

Why is my EMS ID not found when I search?

The National EMS ID is a 12-digit number that is different from a state license number or National Registry number. If it is not found, it may be missing or unverified in your state's records, or your Home State may not yet be integrated with the database. The Compact office cannot change or add database records.

Who do I contact if my information is wrong?

Your State EMS Office. The Compact office cannot modify state licensure records; corrections must be made by the state, and updates then flow to the database.

More Privilege to Practice questions →

Governance

About the Commission

Official seal of the Interstate Commission for EMS Personnel Practice
About the official seal

The Interstate Commission for EMS Personnel Practice is the governmental body established by participating states to administer the EMS Compact. It is created by state law, not a private association. Each participating state appoints one Commissioner and holds one vote, and its work is guided by the seven legislative declarations written into the Compact.

By enacting the Compact, participating states have legislatively unified EMS licensure standards (the NREMT examination for new EMT and Paramedic licenses), required FBI background checks for initial licensure, shared discipline reporting to the national database within two business days, and State EMS Office authority over every clinician working in their jurisdiction.

The Commission Governance & rules Public meetings History of the EMS Compact Legal foundation