Privilege To Practice & FAQs

Multi-state Privilege to Practice

EMS Personnel with an EMS license issued by a Compact Member State are granted a Privilege to Practice in the other Compact states. As outlined in Section 4 of the REPLICA legislation, the requirements for an individual to use the Privilege to Practice, the EMS provider (individual) must:
  • Be at least 18 years of age;
  • Have a current unrestricted license as an EMT, AEMT, Paramedic (or a state recognized and licensed level with a scope of practice and authority between EMT and paramedic) issued by an EMS Compact Member State
  • Practice under the supervision of a physician medical director.
* NOTE: For the purposes of the EMS Compact, an "EMS certification" issued by a state is equivalent to a EMS license.

Scope of Practice in a Remote State

EMS Providers providing patient care in a remote state under the privilege to practice shall function within the Scope of Practice authorized by the home state unless and until the scope of practice is modified by an appropriate authority in the remote state.

Generally, EMS Providers are encouraged to adhere to their home state scope of practice. The adage, 'Train like you fight.' - used across high stress and high risk professions - certainly applies to EMS professionals.  However, there are many situations where a modified scope of practice may be required. For example, in extended deployments, special events, and surge personnel staffing, a physician medical director or state may require out of state EMS personnel to use local and/or state protocols.  EMS personnel should be properly oriented to the local protocols and only perform procedures or administer medications that have been trained on. 

Restricted License or Restricted Privilege to Practice

As outlined in Section 8 of the REPLICA legislation, the Privilege to Practice is a privilege granted to EMS Providers, and the privilege can be restricted by any Compact State.
  • Only the state that suspended or revoked the Privilege to Practice can edit or remove the restriction. EMS Providers with questions about a suspended or revoked Privilege to Practice should contact the EMS Office that placed the discipline action. 
  • The suspension of a Privilege to Practice by one state removes the Privilege to Practice in ALL Compact states. 
  • Individuals with a suspended EMS Compact Privilege to Practice may seek licensure in any state (Privilege to Practice restrictions do NOT prohibit licensure by other states.)     

Frequently Asked Questions

Is there an application or fee for the EMS Compact Privilege to Practice?

No.  The Privilege to Practice is granted automatically to qualified EMS Personnel. No additional applications, fees, paperwork or administrative processes are required.

Is the Privilege to Practice the same as reciprocity?

No.  EMS personnel must obtain and maintain a license in their home state of practice.  The EMS Compact extends a privilege to practice under authorized circumstances to EMS personnel based on their home license.  To remain active under the EMS Compact, EMS personnel must follow their home state rules for licensure, license renewals (recertification), and maintain a relationship with an authorized physician medical director.

Does the EMS Compact cover EMS Agencies, Ambulances, Employers? 

The EMS Compact only applies to qualified EMS Personnel. The EMS Compact DOES NOT apply to EMS Agencies, Ambulances, or Employers.  EMS agencies, ambulances, and employers are required to meet all applicable state and local laws and regulations. 

Are Emergency Medical Responders (EMRs) covered by the EMS Compact?

No. The EMS Compact does not provide a multistate privilege to practice for Emergency Medical Responders.

Are EMT-Intermediates covered by the EMS Compact?

Yes.  The EMS Compact applies to EMS personnel licensed as an EMT, Paramedic, or a level between EMT and Paramedic (including Advanced-EMT, EMT-Intermediates, or similar levels) in at least one Compact member state. All EMS personnel must practice under the supervision of a physician medical director.  

Is National Registry required for the EMS Compact Privilege to Practice?

No. There is not a requirement for individual EMS Personnel to have or maintain National Registry certification. However, states participating in the EMS Compact are required to use the National Registry certification as a prerequisite for applicants seeking initial (new) state EMS licensure. 

I live in a non-Compact state. How do I get a compact Privilege to Practice?

Only EMS personnel who have a license issued by an EMS Compact state are eligible for the multistate Privilege to Practice. 

What are the requirements for the Privilege to Practice?

EMS Personnel are required to meet the following eligibility requirements:

  • Licensed, in good-standing, as an EMT, an AEMT (or a level between EMT and Paramedic), or a Paramedic in a Compact state
  • Have an EMS Medical Director
  • At least 18 years old

What is the difference between a Home State and a Remote State?

  • A Home State is a state that has passed and enacted the REPLICA Legislation where an individual is licensed by that State EMS Office or authority to practice emergency medical services. 
  • A Remote State is a state that has passed and enacted the REPLICA Legislation in which the individual is NOT licensed by that State EMS Office or authority to practice emergency medical services.  

Can I have more than one Home State license?

Yes. EMS Personnel are permitted to be licensed in multiple states.  For the purpose of the EMS Compact, a Home State is any EMS Compact Member State which issues you an EMS license. When practicing or working in a Home State, the EMS provider is working on the basis of their State EMS license. When working in a Remote State (an EMS Compact Member State in which the EMS provider is not licensed), they are working under the EMS Compact's a Privilege to Practice. 

Can a Remote State investigate or discipline an EMS Provider in that state working under the Privilege to Practice?

Yes. Under the authority granted by the EMS Compact legislation, Remote States have the ability to fully investigate EMS Personnel complaints originating in their state, even if the individual under investigation is no longer in their state. Remote States also have the authority to suspend an individual's Privilege to Practice. If the Privilege to Practice is suspended by one state, the Privilege to Practice is immediately suspended in all Compact states.

Can a Remote State suspend or revoke my EMS license?

No, a Remote State can not suspend or revoke a license issued by your Home State. However, Remote States can investigate complaints and suspend an individual's Privilege to Practice.