Do I apply for an EMS compact privilege?

No, and this is where REPLICA differs from the therapy compacts. The privilege to practice attaches automatically to a qualifying home state license when you cross into a member state for a covered reason — there is no application and no separate fee. What you must hold is an unencumbered license in your home state, which has to be a member state, and you remain accountable to the remote state’s authority while practicing there.

What does the EMS Compact actually let me do?

It recognizes your home state EMS license for day-to-day practice across a member state’s borders — the cross-border transfer, the mutual aid response, the special event, the disaster deployment. It covers EMTs, Advanced EMTs and paramedics. It does not convert your license into a national one, and it does not reach states that have not adopted it.

Is the EMS Compact the same as the nursing compact?

No. They are separate agreements with separate member lists, and they work differently: a nurse applies for a multistate license, while an EMS privilege attaches automatically. The member lists also differ substantially — California and New York are outside both, but Texas recognizes EMS privileges while its position in other compacts is its own question.

CompactStates.com — https://www.compactstates.com · Always confirm license status with the issuing board of nursing.

EMS compact states

Which states recognize an EMS privilege to practice under REPLICA — and the three that passed it but have not switched it on yet.

How many states are in the EMS Compact?

28 states have adopted REPLICA. 25 recognize the privilege to practice today. The other 3 — Alaska, Arizona, Connecticut — passed the legislation in the 2025-26 session and are pending implementation, so the privilege does not reach them yet.

EMS Compact Commission (emscompact.gov) ↗Last reviewed 2026-09-22

Privilege to practice recognized (25)

Active member states. A qualifying home state license carries a privilege to practice into each of these automatically — there is no application and no separate fee.

Alabama
Arkansas
Colorado
Delaware
Georgia
Idaho
Indiana
Iowa
Kansas
Louisiana
Mississippi
Missouri
Nebraska
Nevada
North Dakota
Oklahoma
Pennsylvania
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
West Virginia
Wyoming

Passed, pending implementation (3)

These states adopted REPLICA in the 2025-26 session but have not implemented it. Until they do, the privilege does not reach them.

Alaska
Arizona
Connecticut

Not a member (23)

California
District of Columbia
Florida
Hawaii
Illinois
Kentucky
Maine
Maryland
Massachusetts
Michigan
Minnesota
Montana
New Hampshire
New Jersey
New Mexico
New York
North Carolina
Ohio
Oregon
Rhode Island
Vermont
Washington
Wisconsin

REPLICA works differently from the other compacts

In nursing a clinician applies for a multistate license, and in occupational therapy they apply to the commission for each privilege. Under REPLICA there is nothing to apply for: the privilege attaches to a qualifying home state license when you cross into a member state. What matters is that your home state is a member and your license is unencumbered — and that you remain accountable to the remote state’s authority while you are practicing there. See how the compacts compare side by side.

Frequently asked questions

28 states have adopted REPLICA. 25 recognize the privilege to practice today. The other 3 — Alaska, Arizona, Connecticut — passed the legislation in the 2025-26 session and are pending implementation, so the privilege is not yet recognized there.