How to Become a Paramedic in Texas
Paramedics give advanced emergency care, from cardiac drugs to airway management, on ambulances, fire departments and air medical teams. Texas paramedic programs usually take one to two years after EMT certification, as a certificate or an associate degree, and lead to the NREMT paramedic exams and Texas DSHS certification.
Step 1: Finish an Accredited Program
Texas has 57 accredited paramedic programs: 27 associate degrees, 19 other programs, 11 certificates. The median program runs about 12 months. Of the 11 that publish a total cost, prices run from $2,442 (Tarrant County College, Northeast) to $9,641 (Weatherford College). 2
Highest reported NREMT exam rates among larger programs: Angelina College (100%), Austin Community College, Eastview (100%) and College of the Mainland (100%).
Compare every Texas paramedic program, or by area: Houston, Tyler-Longview, San Antonio, Austin, Abilene, Dallas.
Step 2: Pass the NREMT Exam
The median Texas program reports a 87.0% rate (42 programs reporting), but results range from 36.8% to 100%. Graduates who passed the National Registry (NREMT) paramedic cognitive exam, as the program reports it to CoAEMSP. Some programs report first-attempt results and some report passing within three attempts; each page says which when the program does. CoAEMSP expects at least 70.0%: the 70% NREMT pass rate threshold CoAEMSP sets for accredited programs.
Step 3: Get Credentialed
Texas requires EMS certification from the Department of State Health Services (DSHS), and you must pass the National Registry (NREMT) paramedic exam to be eligible. Course completers get EMT-Paramedic certification; those who also hold a two-year EMS degree or any four-year degree can get Paramedic Licensure instead.
| Step | Fee |
|---|---|
| Finish a DSHS-approved paramedic course, then apply to NREMT and pass the Paramedic Certification Examination.3 | $175 |
| Apply online to DSHS for initial EMT-Paramedic certification, entering your NREMT number and DSHS course approval number.4 | $96 |
| Alternative: if you hold a two-year EMS degree or a four-year degree, apply for Paramedic Licensure instead of EMT-P certification.5 | $126not counted |
| Get fingerprinted through IdentoGO using the DSHS service code from your application.6 | Not published |
Typical fees to start working: $271. Counts the NREMT paramedic exam ($175) and the DSHS EMT-Paramedic certification fee ($96). Degree holders who choose Paramedic Licensure pay $126 instead of $96, and the IdentoGO fingerprint fee is extra. Texas EMS certification runs on a four-year cycle; renewal requires a Texas EMS jurisprudence course plus continuing education, a 96-hour recertification course, current NREMT certification, or passing the NREMT assessment exam (EMT-P renewal fee $96 if filed within 12 months before expiration), and NREMT itself must be renewed every two years.
Jobs and Pay Across Texas
About 8,410 paramedics work in Texas. The middle half earn between $47,740 and $63,510 a year; new graduates usually start toward the lower end. Texas expects about 580 openings a year statewide through 2034, from new positions, retirements and people changing jobs, with the number of jobs growing 21.7% (from 8,530 to 10,370).
What Paramedics Earn by Area
The Texas median is $57,500 a year. 1 Pay is highest around Austin ($67,290), Dallas ($60,300), Houston ($60,130) and lowest around Laredo ($46,180) and Sherman-Denison ($45,230). At the median program cost, setting aside 10% of the Texas median wage pays the program back in about 0.8 years.
Sources and Dates
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, Paramedics (29-2043), May 2025 estimates.
- Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (programs accredited by CAAHEP) (CoAEMSP), checked Nov. 2026.
- NREMT Paramedic Candidate Handbook: Certification Process, checked Nov 2026.
- Texas DSHS EMS Application Fees, No effective date on page; checked Nov 2026.
- Texas DSHS EMS Application Fees, No effective date on page; checked Nov 2026.
- Texas DSHS EMS Initial Certification-Licensure, checked Nov 2026.
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, Texas and metro areas (employment and wage percentiles), May 2025 estimates.
- Texas Workforce Commission, long-term occupational projections, 2024 to 2034.
Every number was checked against its source on Nov. 4, 2026. Spot an error? Report it. Program Outcomes is independent and not affiliated with any school or CoAEMSP. Our independence policy