Paramedic Salary in Massachusetts 2026,
$66,340 Median | BLS Data by City

Massachusetts paramedics earn a median $66,340 a year, $31.89 an hour, per BLS OEWS May 2025, with the middle half between $63,770 and $77,330 and a full range of $60,410 to $84,540. That is 9.5% above the $60,600 national median, with an unusually high floor for the occupation.

Barnstable Town at $73,570, well ahead of Boston-Cambridge-Newton at $66,460, Pittsfield at $64,750, Worcester at $64,400 and Amherst Town-Northampton at $61,890. Cape Cod paying more than seven thousand dollars above the state median, and beating Boston, is the clearest recruitment premium in this unit.

Massachusetts certifies. The Department of Public Health's Office of Emergency Medical Services issues paramedic certification on completion of an accredited programme and the National Registry examination, with recertification on a defined cycle. Massachusetts also regulates ambulance services and administers regional EMS councils that set protocols, so the medical direction a paramedic works under is a formal structure rather than an employer matter.

Geography and seasonality. Barnstable County is a peninsula with long transport times to tertiary care, a population that swells dramatically in summer, and a resident labour force too small to staff advanced life support year-round. Services there must recruit and retain paramedics who could work in the Boston market instead, and $73,570 is what that costs. Boston, by contrast, has multiple training programmes and a large pool of candidates.

A flat 5% state income tax on wages, with the additional 4% surtax applying only above one million dollars and no city or town income tax anywhere in Massachusetts. Because the rate is flat, the overtime that Massachusetts EMS runs on is taxed at the same rate as base pay rather than at a higher bracket.

Because there is no cheap paramedic. Advanced life support certification requires an accredited programme, the National Registry examination and ongoing recertification under regional medical direction, and the workforce is small — about 1,860 people statewide. Services cannot staff an ambulance at the paramedic level with anyone less qualified, and they cannot leave the truck unstaffed, so the entry rate is set by what it takes to attract someone who has completed that training. The result is a tenth percentile of $60,410, remarkably close to the median.

The annual figures reflect long-shift EMS scheduling with overtime built in, so $66,340 in a system running twelve- and twenty-four-hour tours is not equivalent to $66,340 in a forty-hour job — and the fatigue cost is real. Massachusetts housing costs also absorb much of the 9.5% premium over the national median, particularly in the Boston market where the metro figure of $66,460 is barely above the state median. The Cape premium comes with its own cost of living problem.

Employer type first. Fire-based paramedic positions are typically paid on fire department scale with the associated benefits and pension treatment, which is a materially different proposition from a private ambulance role — and that difference is a large part of the gap between the $66,340 median and the $77,330 seventy-fifth percentile. After that, critical care and interfacility transport certification, field supervision, clinical education roles and the hard-to-staff Cape and island services are what reach the $84,540 ninetieth percentile.