Maryland Institute for
Emergency Medical Services Systems

Reciprocity is a process by which individuals who possess pre-hospital Clinician certifications/licenses from other states may transfer their certification/license to Maryland. For the specific processes involved with each level of Maryland certification/licensure, please select a Clinician level from the list below:

Emergency Medical Responder (EMR)
Emergency Medical Technician (EMT)
Paramedic

EMR Reciprocity

To initiate the Emergency Medical Responder reciprocity process, an applicant must:

1. Be at least sixteen (16) years of age.
2. Have an equivalent state EMS license or certificate, based upon the National Standard Scope of Practice.
3. Complete and submit the reciprocity application at miemsslicense.com. This application should be accompanied by:
   • A copy of all current EMS certificates, licenses, or registrations. These documents should be uploaded at the time you complete your reciprocity application.
   • If unaffiliated with any Maryland EMS Service or a Maryland Licensed Commercial Service, a non-refundable money order or company check, in the amount of $35, made payable to MIEMSS and mailed to the Office of EMS Clinician Services (NO PERSONAL CHECKS ARE ACCEPTED). You may call the office at (410) 706‑3666 to pay the fee over the phone.
4. Must be familiar with the Maryland Medical Protocols.

Upon submission of the above information:
You will be notified by MIEMSS, in writing, that your application has been received and that you may enroll in and successfully complete a minimum of a six-hour Maryland Emergency Medical Responder Skills Refresher Course, as approved by MIEMSS.

Upon completion of all of the above requirements, and verification of out-of-state credentials, a reciprocity applicant may be eligible for initial certification as a Maryland Emergency Medical Responder for a period not to exceed 42 months.

EMT Reciprocity

To begin the EMT reciprocity process, you must:

1. Be at least sixteen (16) years of age
2. Hold current EMS credentials based on the National Standard Scope of Practice:
   • EMT, AEMT, or Paramedic certification from another state, OR
   • National Registry (NREMT) registration as an EMT, AEMT, or Paramedic
3. Complete and submit the application on the EMS Board's required form and include:
   • Evidence of current out-of-state certification or National Registry registration
4. Affiliate with a Maryland EMS operational program providing at least the service level you're seeking
   • Exception: Emergency medical responder applicants do not need affiliation

Maryland-Specific Requirements
Before receiving certification, you must successfully complete:

1. MIEMSS-approved protocol orientation
2. MIEMSS-approved technical proficiency verification Certification Period

Certification Period
Once all requirements are completed and credentials are verified, you will receive:

• Maryland EMT certification

Paramedic Reciprocity

To initiate the Paramedic reciprocity process, an applicant must:

1. Be 18 years old or older.
2. Have a valid National Registry Paramedic card.
3. Complete and submit the application for ALS reciprocity at miemsslicense.com.
4. Complete the Maryland Medical Protocol Orientation for ALS Clinicians. 

• • If unaffiliated with any Maryland EMS Service or a Maryland Licensed Commercial Service, the application must be accompanied by a non-refundable money order or company check, in the amount of $35, made payable to MIEMSS and mailed to the Office of EMS Clinician Services (NO PERSONAL CHECKS ARE ACCEPTED). You may call the office at (410) 706‑3666 to pay the fee over the phone.

Upon submission of the all of the above information:
You will be notified by MIEMSS, in writing, that your application has been received.

Upon completion of all of the above requirements, a reciprocity applicant may be eligible for licensure as a Maryland Paramedic until April 30^th of the year the individual’s National Registry expires.