EMS Clinician Guide
This guide applies to all EMS Compact Member States where the Compact is enacted as state law.
Practice in 25 States with One Credential
The EMS Compact gives you immediate practice privileges across member states. No extra applications. No additional fees. Just verified credentials and proper local affiliation.
This guide is valid in these EMS Compact Member States
Find Your Home State on EMSCompact.govTo view your state’s EMS Compact law, click on your Home State.
What is the EMS Compact?
The Recognition of EMS Personnel Licensure Interstate CompAct (REPLICA) is an interstate agreement that allows EMS clinicians to practice across state lines without obtaining multiple licenses. In each Member State, it is enacted in state law and requires immediate recognition of a qualified EMS license from another Compact state when the clinician is properly affiliated with a local EMS agency.
How It Works: 3 Simple Steps
Hold Your Home State License
Obtain and maintain your EMS license in a Compact Member State (your “Home State”).
Verify Your Privilege to Practice
Use the official tool on EMSCompact.gov with your 12-digit EMS ID. Your status must display Valid with a green outline.
Status key: Valid indicates active and recognized in all Compact states.
Affiliate with a Local Agency
Be properly rostered with a receiving-state EMS agency (or an agency authorized to operate there). Once affiliated, practice is recognized immediately.
For EMS Clinicians
If you hold a Home State EMS license with a valid Privilege to Practice, your credential is recognized in all 25 EMS Compact Member States (with proper local affiliation).
Practice in any Compact state by verifying your status and affiliating with a local EMS agency. No additional applications or fees required.
Key Benefits
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Immediate recognition: Start practicing as soon as you are properly affiliated—no waiting period
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No fees: The Privilege to Practice is free and does not require an application
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Full state authority: Receiving states maintain complete regulatory and disciplinary oversight
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Multi-state mobility: Practice in all 25 Member States with one Home State license and a valid PTP
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No set time limit: Your PTP remains valid so long as your Home State license is active and Compact requirements are met; if you relocate, consider obtaining a license in your new Home State
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Disaster response ready: Enables rapid mutual aid and emergency response across state lines
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Recruitment & retention: Agencies can leverage a workforce of 400,000+ qualified clinicians for lateral transfers, relocations, surge operations, temporary staffing, and education
Required: Local Affiliation and Compliance
All clinicians must be properly affiliated with a local EMS agency before providing patient care. This means being on the roster, using approved local protocols, and operating within the local scope of practice.
When practicing in a Remote Compact state:
- Follow the protocols and procedures of your EMS agency and local medical director
- Operate within the Remote State’s EMS regulations and scope of practice
- Complete any required local orientation or training
- Identify and address any gaps in knowledge or education before patient care
- Maintain a current Home State license and a valid Privilege to Practice
In some states, you may need to request an account from the state EMS office to access a statewide ePCR system, or you may be required to complete a local protocol examination. These are not licensure requirements, but local operational requirements established by the receiving EMS agency or state system.
Interstate Patient Transports
When transporting a patient from one Compact state to another, your Privilege to Practice is recognized if:
Your EMS Agency has proper authorization to operate in the relevant jurisdictions, and your PTP is Valid. During the transport, you follow your Home State agency protocols unless otherwise directed by applicable law.
Example: An air ambulance based in one Member State delivering a patient to a hospital in another Member State remains under their Home State agency protocols while PTP is recognized during the transport.
Pre-Practice Checklist
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Verified my Privilege to Practice shows “Valid” on EMSCompact.gov
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Confirmed my Home State license is current and in good standing
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Affiliated with a receiving-state EMS agency, or with an out-of-state agency authorized to operate in that state
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Reviewed local protocols and scope of practice
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Completed any required local orientation or training
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Met with the medical director or designee if required
Contact
Each Member State has a Governor-appointed EMS Compact Commissioner responsible for implementation.
Find Your CommissionerWhere Can I Practice?
25 Member States Nationwide
Your Privilege to Practice is recognized across all participating states.
View All Member States