The highest paying paramedic jobs on our board right now are in flight and critical care transport and in fire departments. Both post a median $38 an hour for paramedics, across 48 and 80 US listings with pay on November 8, 2026. 911 and municipal EMS comes next at $35. The highest paying EMT jobs are in fire departments and 911, at a median $34 each. Travel and contract, industrial and site, and wildland crew work all post $32 to $33. Offshore, event and tactical gigs rarely post a rate, so we can’t rank them yet.
The gap between types of work is small: $6 an hour from top to bottom. Location and hours move pay more. Paramedic listings in Washington post a median $49 an hour. And at 40 hours a week, only the top 10% of paramedic listings reach about $100,000 a year. Below that rate, six figures takes overtime or a long schedule.
What each type of EMS work pays on our board
Flight and CCT paramedic work pays the most, and industrial and wildland crew work the least. Every type with enough posted pay sits between $32 and $38 an hour at the median.
| Work type | Median (middle half) | Listings with pay | What it takes | Where to look |
|---|---|---|---|---|
| Flight and CCT paramedic | $38 ($34–$44) | 48 | Paramedic license, 3+ years of busy 911, FP-C or CCP-C | Flight paramedic and critical care jobs |
| Fire department EMT and paramedic | $37 ($34–$44) | 96 | Firefighter I and II, a hiring test | Paramedic jobs, EMT jobs |
| 911 and municipal EMS | $35 ($32–$41) | 159 | A state license | Paramedic jobs, EMT jobs |
| Interfacility transport (IFT) | $34 ($31–$35) | 10 | A state license | Paramedic jobs |
| Travel, contract and per diem | $33 ($31–$35) | 51 | A license valid where you work; a year on the truck for travel | Travel, contract and per diem EMS jobs |
| Industrial and site medic | $32 ($31–$35) | 55 | EMT or paramedic license; OSHA 10 or 30 helps | Industrial and site medic jobs |
| Wildland crew and engine | $32 ($29–$35) | 14 | NWCG basics, the pack test, a Red Card | Wildland fire jobs |
| Tactical, federal and overseas contract | Too few post pay | 3 | Years of busy 911 first | See below |
| Offshore and oil rig | Too few post pay | 0 | Paramedic license, BOSIET and HUET | Offshore medic guide |
| Event and VIP | Too few post pay | 1 | A license valid in the event’s state | Event medic guide |
Rates are hourly, in whole dollars, from US listings that post pay, with each posting counted once (November 8, 2026). The middle half is the range the middle 50% of those listings post. “Too few” means fewer than 5 listings post usable pay, so we don’t print a median.
Highest paying paramedic jobs and EMT jobs, by license
Paramedic listings post a median $35 an hour and EMT listings $33. On our board the license moves the median by about $2 and the top end by about $10.
| Work type | Paramedic (n) | EMT and AEMT (n) |
|---|---|---|
| Flight and CCT | $38 (48) | Paramedic jobs only |
| Fire department | $38 (80) | $34 (15) |
| 911 and municipal EMS | $35 (138) | $34 (16) |
| Travel, contract and per diem | $35 (26) | $32 (20) |
| Industrial and site | $31 (27) | $32 (25) |
| Top 10% of all listings | $48+ (302) | $38+ (62) |
Each figure is the median posted hourly rate, with the number of US listings with pay in brackets. The best paying EMT jobs here are in fire departments and 911. Fewer than 5 AEMT-level listings post pay, so AEMT rates sit with EMT here. Listings open to AEMTs, including the EMT jobs an AEMT license covers, post a median $33 across 66.
In the Bureau of Labor Statistics (BLS) 2025 wage data, the national median is $29.13 an hour for paramedics and $21.38 for EMTs, a gap of about $8. The gap on our board is smaller because the board leaves out the lowest paying jobs. The paramedic license matters most for access: flight, offshore and most international medic jobs hire paramedics. Weighing the AEMT first? AEMT vs EMT compares the two, and AEMT jobs shows what’s open.
What each type of work takes, from highest paying down
Flight asks the most and pays the most. Industrial, contract and wildland crew work asks less to get in and pays $32 to $33 an hour.
Flight and critical care transport: $38
Flight ties with fire departments as the highest paying paramedic work on our board: a median $38 an hour across 48 US listings with pay (November 8, 2026). That’s $3 above ground 911 paramedics on the same board ($35, 158 listings), and the top 10% of flight paramedic listings post $50 or more. Programs usually want three or more years of busy 911, and 49% of flight listings name the FP-C. See flight paramedic and critical care jobs and how to become a flight paramedic.
Fire department EMT and paramedic: $37
Fire department jobs post a median $37 an hour across 96 listings with pay (November 8, 2026): $38 for paramedics and $34 for EMTs. They post pay more often than any other type of work here, at 96% of listings, and they usually ask for Firefighter I and II and a hiring test. 72 of the 96 post a yearly salary, which reads high per hour on a 24-hour schedule; the overtime section below explains why. Fire jobs list on paramedic jobs and EMT jobs.
911, municipal EMS and IFT: $35
911 and municipal EMS listings post a median $35 an hour across 159 with pay (November 8, 2026): $35 for paramedics and $34 for EMTs. Interfacility transport posts $34 across 10. 911 is the biggest share of the board and isn’t the bottom of the pay table, partly because our board leaves out the lowest paying jobs. See paramedic jobs and EMT jobs.
Travel, contract and per diem: $33
Travel and contract work posts a median $33 an hour across 51 US listings with pay (November 8, 2026): $35 for paramedics and $32 for EMTs and AEMTs. Most of it is per diem or PRN shifts (65% of these listings); true travel postings are 6%. Travel contracts usually want a year or more on the truck and a license valid where you’ll work, and they often add housing and meal stipends on top of the rate. See travel, contract and per diem EMS jobs and contract EMT work, explained.
Industrial and site medic: $32
Industrial and site medic jobs post a median $32 an hour across 55 US listings with pay (November 8, 2026): $33 at plants and remote sites, $32 in occupational clinics. It’s one of the few types of work where EMTs earn about what paramedics do, $32 against $31. Sites want a current license and the tickets the site needs, such as OSHA 10 or 30, HAZWOPER or a TWIC. See industrial and site medic jobs.
Wildland fire: $32 for crew, $42 for supervisors
Wildland crew and engine jobs post a median $32 an hour across 14 listings with pay (November 8, 2026), and supervisor and specialist jobs $42 across 33. In a big fire year, overtime is where the money is. No fireline EMT or paramedic listings were live on November 8; fireline medical contractors hire before the season, so apply early. Fireline jobs need the NWCG basics, the arduous pack test and a Red Card; see wildland fire jobs and how to get a wildland firefighter job.
Federal jobs: public pay scales
Federal EMS and fire jobs pay on public pay tables, and entry rates are modest: wildland entry crew pay starts at $21.14 an hour before overtime. That’s GW-3, step 1, on the Office of Personnel Management’s 2026 table (Rest of US locality). Our board doesn’t count federal jobs as their own type: federal wildland crews list with wildland, and federal fire departments with fire. Primary federal firefighter jobs have a maximum entry age, with exceptions for veterans and prior service.
Tactical and overseas contract work: too few rates to rank
Tactical, federal and overseas contract jobs are a small group on our board: 10 live listings, and only 3 post usable US pay. Tactical employers want years of busy 911 first. Tactical medics on Reddit (October 2026) say full-time tactical jobs are scarce and most SWAT medic work is part time. Medics who’ve worked overseas contracts say the easy money has dried up.
Offshore and oil rig: too few rates to rank
Offshore and maritime medic jobs rarely post a rate: 18 of the 19 live listings state no pay at all, and 10 are outside the US. The tickets they name most often are BOSIET (offshore safety and emergency training) and HUET (helicopter underwater escape training). Like flight, offshore wants years of busy 911 first. The offshore medic guide covers rotations, tickets and how people get on.
Event and VIP: too few rates to rank
Event, festival and VIP medic jobs are the thinnest group on our board: 8 live listings, 1 with usable pay. A lot of event work runs as per diem shifts, so check travel, contract and per diem EMS jobs too. You need a license valid in the state the event is in. The event medic guide covers how event staffing works.
How to get to the top end of EMS pay
Most high paying EMS jobs ask for some mix of four things: the paramedic license, the ticket the work needs, years on a busy truck, and a willingness to move.
- Get the paramedic license if you can. The top 10% of paramedic listings post $48 an hour or more, against $38 for EMT listings. 46 paramedic listings post $45 or more. If you go AEMT first, ask whether it changes the rate before you count on it.
- Add the ticket the work asks for.
- Flight: the FP-C or CCP-C. The International Board of Specialty Certification (IBSC) only requires a current, unrestricted paramedic license to sit either.
- Fire: Firefighter I and II.
- Industrial sites: OSHA 10 or 30, HAZWOPER (hazardous waste and emergency response training) or a TWIC (the TSA’s card for secure port and maritime areas).
- Wildland: the National Wildfire Coordinating Group (NWCG) basics, S-130 and S-190, and the pack test: 3 miles with a 45-pound pack in 45 minutes or less.
- Offshore: BOSIET and HUET.
- Put in the years. Flight programs usually want three or more years of busy 911, and tactical and offshore employers want years of 911 too. Travel contracts usually want at least one.
- Be willing to move. On our board, paramedic listings in Washington post a median $49 an hour, against $35 board-wide. Listings in Oregon post $43, and in California and New Jersey $42. In BLS’s 2025 wage data the median paramedic in Washington earns $50.15 an hour ($104,310 a year), the most of any state. The EMS Compact lets EMTs, AEMTs and paramedics licensed in a member state work in other member states through an EMS agency there. See best states to be an EMT.
- Compare base rates, not “up to” figures. Ask for the base rate and the overtime separately, and ask whether the job is W-2 or 1099. A 1099 rate has to cover your own taxes and insurance.
Overtime vs base pay: why posted rates can mislead
A posted rate is a base rate. It understates jobs that pay through overtime, stipends or day rates, and it overstates salaried jobs on 24-hour schedules.
Where posted rates understate pay
- Overtime. At $35 an hour, $100,000 a year takes about 2,860 hours: 55 hours a week, every week. At the BLS national median of $29.13 it takes about 66. That’s a second part-time job on top of the first.
- Stipends. Travel packages often add housing and meal stipends on top of the rate. They’re only tax-free if you keep a tax home and work away from it (IRS Publication 463).
- Day rates. We leave day rates out of every median, because a 16-hour fireline day doesn’t convert cleanly to an hourly rate. Jobs that pay by the day don’t show in these medians at all.
- Fire seasons. In a big fire year, wildland overtime does the heavy lifting. In a quiet one, it doesn’t.
Where posted rates overstate pay
- Salaries on 24-hour schedules. We count a yearly salary at 2,080 hours, a 40-hour year. A 24-on, 48-off schedule averages 56 hours a week, about 2,912 hours a year. So a $75,000 salary reads as $36 an hour here but works out to under $26 on that schedule. Our fire listings show it: those posting a salary have a median $37 an hour (72 listings), those posting an hourly rate $35 (16).
- “Up to” ranges. The top of a posted range can be years of steps away, so we count each listing at the middle of its range.
A rate that only works with 20 hours of overtime a week isn’t a better job. It’s the same rate with less sleep.
From the field: what medics say about where the money is
The medics who report six figures in these threads mostly work 911 in a high paying area. They’re blunt about the gigs that don’t pay.
- 911 in the right place. A 911 paramedic on r/Paramedics (October 2026) said it’s “all about location”, after reporting $110,000 the year before on a 24-on, 72-off schedule. Others reported about $113,000 in the Pacific Northwest, and $145,000 in the Bay Area from a medic who “Didn’t work much OT”.
- The overtime catch. A reply in the same thread: “You just work 500 to 1,000 in OT. It ain’t the flex you think it is.”
- Flight’s pay cut. “Flight keeps paying less because people line up to do it,” a paramedic wrote on r/Paramedics (October 2026). Another said the move to flight cost “an $8/hr paycut”.
- Fire’s medic premium. Firefighters on r/Firefighting (October 2026) said the medic premium is small. One department pays “12% over the FF of the same grade”; another, “$2.00 an hour more for being on the ambulance”.
- Overseas contracts. “You’ve missed the gravy train of easy high paying contract work,” a paramedic told someone asking for leads on r/Paramedics (September 2026).
- Offshore reels. Rig workers on r/oilandgasworkers (October 2026) pushed back on six-figure offshore reels: “Don’t buy into the ‘DM if you’re interested’.”
- Wildland day rates. An EMT-firefighter on r/NewToEMS (October 2026) reported “$750 a day” on a wildland rope-rescue support team.
- The hours. On r/ems (November 2026), a commenter described shifts rostered at 12 hours that regularly ran 17. In a summer 2026 thread, the answer to “how do you afford to do this” was “Either 2 jobs or lots of overtime.”
Each of these is one person’s account, not data. Still, the 911 reports point the same way as our listings and BLS: toward the Pacific Northwest and California.
How we count these numbers
These are posted rates from live US listings, counted the way our category pages count them.
- Snapshot: every live listing on our board on November 8, 2026: 1,232 listings, or 1,024 distinct postings. The category pages update live, so their numbers will drift from this snapshot.
- What counts as pay: US listings only, each posting counted once (same title, same place), at the middle of its posted range. Yearly salaries count as 2,080 hours. Day rates and rates outside $8 to $250 an hour are left out, and cents are dropped.
- When we hide a number: pay needs at least 5 listings with usable pay, and a percentage needs at least 15 listings behind it.
- Work types: flight, industrial, travel and contract, and wildland follow their category pages. The other types count listings open to an EMT, AEMT or paramedic in that work setting.
- What it isn’t: our board leaves out the lowest paying jobs, so these medians run above what all EMS work pays. BLS figures are its 2025 wage data, as published on O*NET OnLine by the US Department of Labor.
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