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How Much Do Paramedics Make?

Paramedics' salaries vary by location, training, and other factors. But generally, it is less than you think.
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You rely on their rapid "first response" to an emergency medical call to 9-1-1. You rely on their training, knowledge, and experience in first aid and ability to stabilize a patient -- possibly a love one -- to rush them to a hospital for more precise care. But how much do paramedics make? 

What Is the Average Salary of a Paramedic?

Paramedics' salaries vary depending on their state, their training, employer, and a host of other factors. But generally, it is less than you think -- and far less than, say, a plumber. According to, which has broken down average salaries by state and hourly wage, the average salary nationwide across all 50 states is $40,374.34, or $19.41 per hour. Average salaries range among the 50 states between $25,000 to $63,500, with the majority being between $35,500 and $47,500.

Also, according to ZipRecruiter, the average pay range between paramedics varies by only about $12,000, suggesting not many opportunities exist even nationally for advancement or higher pay, even with multiple years of experience.

A year ago, the U.S. Department of Labor's Occupational Outlook Handbook listed the average emergency medical technician and paramedic salary as $34,320, suggesting the average salaries have risen 18% in the past year, which is significant. Also in 2018, according to the BLS, the EMT and paramedic job outlook through 2028 was expected to grow 7%, faster than average.

What Factors Determine a Parademic's Salary?

A paramedic's or EMT's salary is determined by a number of factors, including location and work setting, training, and education.

By work setting, EMTs or paramedics work in ambulance services, for local government (excluding education and hospitals) and for state, local and private hospitals.

The most primary factors determining salary are location and experience or certification level of the EMT.

Because demand for EMTs and paramedics varies by state, city and county, and cost of living also varies, the best way for paramedics to improve their salaries is to get more experience and attain more certifications.

States That Pay the Highest and Lowest Paramedic Salaries

As might be imagined, the more populous states pay the highest average salaries for paramedics, with New York at the top paying $46,494 on average, followed by Massachusetts, New Hampshire and Maryland, according to a survey by ZipRecruiter.

Next come states with less population, led by Nebraska, with an average salary of $42,861 per year, followed by Connecticut, Hawaii, North Dakota and Nevada.

According to ZipRecruiter, North Carolina pays the least to its paramedics, or an average annual salary of $32,839, followed in increasing salary by Florida, Mississippi and Missouri, while Michigan, Illinois, New Mexico and Alabama pay more, but significantly less than the highest.


According to the BLS, to be qualified to train in emergency medical technology, a high school diploma and cardiopulmonary resuscitation (CPR) certification are both required. Most EMT programs are non-degree award programs, and can be completed in less than a year. Others last up to two years.

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A paramedic, however, may need an associate's degree. EMT programs are offered by technical institutes, community colleges, universities, and places that specialize in emergency care training.

The BLS notes some states may have emergency medical responder positions that don't require national certification -- but such workers, who are not allowed to administer advanced techniques for first aid because they aren't trained to, typically require state certification.

The Commission on Accreditation of Allied Health Education Programs offers a list of accredited programs for EMTs and paramedics by state.

EMT programs include instruction in assessing patients' conditions, dealing with trauma and cardiac emergencies, clearing obstructed airways, using field equipment, and handling emergencies. Formal courses offer about 150 hours of specialized instruction, and some instruction may be in a hospital or at least ambulance setting.

At the advanced EMT level, programs typically require about 400 hours of instruction, and candidates learn EMT-level skills as well as more advanced ones, like using complex airway devices, intravenous fluids, and some medications.

Paramedics have the most advanced level of education in administering emergency medical attention. An aspiring paramedic must be already EMT-certified. Community colleges and universities may offer paramedic programs, which include about 1,200 hours of instruction and may lead to an associate's or bachelor's degree. Paramedics' broader scope of skills and practice may include stitching wounds or administering medications intravenously.

If you're seriously interested in becoming an EMT or paramedic, you should take courses in anatomy and physiology in high school and consider becoming certified in CPR.

To become licensed, certified, and registered as an EMT and paramedic on the national level, you have to complete a certified education program and pass the national exam. The national exam includes both practical and written parts. Some states have first-level state certifications that don't require national certification, but the National Registry of Emergency Medical Technicians (NREMT) certifies EMTs and Paramedics on the national level.

In the U.S., all states require EMTs and paramedics to be licensed; requirements to obtain such a license varies by state. However, in most states, if you have NREMT certification, you are qualified for licensure. In other states, you may have to pass an equivalent state exam. Most applicants for licensure must be over 18, and many states require a background check and won't give a licenses to someone who has a criminal history.

While some emergency medical services hire separate drivers, most EMTs and paramedics have to take a course requiring about eight hours of training before being allowed to drive an ambulance.

Payment Outlook

As mentioned, a year ago, the BLS listed the average EMT's and paramedic's salary as $34,320, suggesting the average salaries have risen 18% in the past year, which is significant. Also in 2018, according to the BLS, the EMT and paramedic job outlook for to 2028 was expected to grow 7%, faster than average for all occupations.

This is because EMT and paramedics' skills will continue to be needed for emergencies such as car crashes, natural disasters, and acts of violence, the BLS noted, as will the need for volunteer EMTs and paramedics in rural and smaller metropolitan areas.

The BLS also noted that the need for EMTs and paramedics will continue to grow as the population of middle-aged and older people grows, and leads to an increase in age-related emergencies like heart attacks and strokes.