Paramedic Salary in Tennessee 2026,
$57,690 Median | BLS Data by City

The published Tennessee figure is $57,690 a year, or $27.74 an hour, per BLS OEWS May 2025, with a band from $41,410 at the 10th percentile to $80,190 at the 90th. That is 4.8% below the national median of $60,600, though Tennessee takes no state income tax from it. The state employs 3,710 paramedics at a location quotient of 1.75.

Memphis at $66,830, by a wide margin — then Nashville-Davidson--Murfreesboro--Franklin $63,450, Clarksville $60,330, Chattanooga $53,220 and Jackson $51,550. The near-30% spread from top to bottom is the widest metro range in this unit, and it maps onto employer type: fire-based and hospital-based metro systems against rural county and private ambulance services.

Yes. The Tennessee Department of Health's Board for Licensing Emergency Medical Services issues a state licence to paramedics — this is a licence, not merely recognition of a national certification. The route runs through an accredited paramedic programme, National Registry certification and then Tennessee licensure, with continuing education at renewal. A paramedic relocating into Tennessee must hold the state licence before working; no employer can waive it.

Because the employing services are different institutions. Memphis's EMS provision is weighted toward municipal fire-based and large hospital-based systems, which pay on structured public-service scales with defined steps, benefits and overtime rules. Chattanooga's $53,220 and Jackson's $51,550 reflect a heavier mix of county and private ambulance provision, where budgets are tighter and pay scales flatter. The licence is identical; the employer is not.

The work is abundant and the pay depends entirely on the employer. Tennessee employs paramedics at 1.75 times the national rate, retention is a chronic problem so posts come open often, and there is no state income tax on the wage or on the overtime. Against that, the state median of $57,690 is 4.8% under the national figure and the rural services at the bottom of the band pay close to the $41,410 tenth percentile. The strategy that works is getting into a metro fire-based or hospital-based system.

Geography and system design. Tennessee has a dispersed rural population spread across a long state, transport distances to definitive care that are substantial in the eastern and western ends, and a hospital network that relies heavily on ambulance transfer between facilities. All three generate paramedic demand that a compact urban state does not have. A location quotient of 1.75 across 3,710 paramedics is the result — a large workforce sustained by need rather than by wage attraction, which is also why the median sits below the national figure.

It is an annual number for work whose hours are unusual. Paramedic schedules commonly run 24-hour shifts and substantial mandatory and voluntary overtime, so the annual figure reflects a working pattern rather than a salary — two paramedics on the same hourly rate can be thousands apart depending on shifts worked. The published hourly median of $27.74 is the more comparable figure, and with no Tennessee income tax on the overtime, the annual total responds more directly to hours here than in most states.

Employer type first, credential second. Moving from a rural county or private ambulance service to a metropolitan fire-based or hospital-based system is the single largest step available and accounts for much of the distance from the $48,510 twenty-fifth percentile to the $76,570 seventy-fifth. On top of that, critical care transport and flight paramedic credentials narrow the competing pool sharply, and field training officer or supervisory responsibility reaches the $80,190 top decile. Overtime, untaxed by the state, magnifies all of it.