50-State Practice Authority Map
CRNA practice authority varies dramatically across the United States. Click any state for detailed practice requirements, licensure info, CE requirements, and average salary data.
Click any state for detailed practice requirements, licensure, and salary data.
CAA practice authority — states to watch
CAA practice authority is the most active legislative front in anesthesia. 24 jurisdictions currently authorize practice (23 states + DC). Here's what we're tracking for 2026:
Recently added
- • Tennessee — licensure signed May 2025 (23rd state)
- • Virginia — licensure expanded 2025
- • Washington — WMC rulemaking finalized 2024–2025
- • Indiana — licensure enacted 2023
Active legislation
- • New York — A01072 (2025–2026 session) proposes CAA licensure
- • South Carolina — supervision ratio expanded 2025
- • Additional states with pending bills — see AAAA for the latest
Sources: AAAA Practice Map · ASA · NCCAA. Last verified April 2026.
New to practice authority?
Read our comprehensive guide covering all 50 states, legislative trends, and what it means for your career.
Alabama
Physician Supervision Required
Alabama requires physician supervision for CRNAs. CAAs are licensed and actively practicing — one of the long-standing...
Alaska
Full Practice Authority
Alaska grants CRNAs full practice authority with independent prescriptive authority. One of the first states to opt out.
Arizona
Full Practice Authority
Arizona provides full practice authority for CRNAs with no physician supervision requirement.
Arkansas
Opt-Out / Collaborative
Arkansas has opted out of federal supervision requirements. CRNAs practice under collaborative agreements.
California
Physician Supervision Required
California requires physician supervision for CRNAs. Has not opted out of the CMS requirement. One of the most...
Colorado
Full Practice Authority
Colorado grants full practice authority to CRNAs. CAAs (Certified Anesthesiologist Assistants) are licensed by the...
Connecticut
Full Practice Authority
Connecticut provides full practice authority for CRNAs with no supervision requirement.
Delaware
Opt-Out / Collaborative
Delaware has opted out of the federal supervision requirement. CRNAs work under collaborative agreements.
District of Columbia
Full Practice Authority
DC grants full practice authority to CRNAs. Both CRNAs and CAAs are authorized to practice.
Florida
Physician Supervision Required
Florida requires physician supervision. Active legislation (HB 375/649) to expand CRNA practice authority. CAAs are...
Georgia
Physician Supervision Required
Georgia requires physician supervision for CRNAs. One of the largest CAA populations in the country.
Hawaii
Opt-Out / Collaborative
Hawaii has opted out of federal supervision. CRNAs practice under collaborative agreements.
Idaho
Full Practice Authority
Idaho grants full practice authority to CRNAs with independent prescriptive authority.
Illinois
Opt-Out / Collaborative
Illinois requires collaborative agreements between CRNAs and physicians. CAAs do not currently have practice authority...
Indiana
Opt-Out / Collaborative
Indiana has opted out of federal supervision. CRNAs practice under collaborative agreements. CAAs gained licensure...
Iowa
Full Practice Authority
Iowa grants full practice authority to CRNAs.
Kansas
Full Practice Authority
Kansas grants full practice authority to CRNAs with independent practice. CAAs practice under delegatory authority...
Kentucky
Opt-Out / Collaborative
Kentucky has opted out of federal supervision. CRNAs practice under collaborative agreements. CAAs authorized.
Louisiana
Opt-Out / Collaborative
Louisiana has opted out of federal supervision. CRNAs work under collaborative practice agreements.
Maine
Full Practice Authority
Maine grants full practice authority to CRNAs.
Maryland
Opt-Out / Collaborative
Maryland requires collaborative agreements. Has not opted out of CMS supervision requirement. CAAs do not currently...
Massachusetts
Physician Supervision Required
Massachusetts requires physician supervision for CRNAs. Has not opted out of federal requirement.
Michigan
Opt-Out / Collaborative
Michigan has opted out of federal supervision. CRNAs practice under collaborative agreements. CAAs authorized.
Minnesota
Full Practice Authority
Minnesota grants full practice authority to CRNAs with no supervision requirement.
Mississippi
Opt-Out / Collaborative
Mississippi has opted out of federal supervision. CRNAs work under collaborative agreements.
Missouri
Opt-Out / Collaborative
Missouri has opted out of federal supervision. CRNAs practice under collaborative agreements. CAAs authorized.
Montana
Full Practice Authority
Montana grants full practice authority to CRNAs. Strong rural CRNA presence.
Nebraska
Full Practice Authority
Nebraska grants full practice authority to CRNAs.
Nevada
Full Practice Authority
Nevada grants full practice authority to CRNAs. CAAs are licensed to practice in Nevada.
New Hampshire
Full Practice Authority
New Hampshire grants full practice authority to CRNAs.
New Jersey
Physician Supervision Required
New Jersey requires physician supervision for CRNAs.
New Mexico
Full Practice Authority
New Mexico grants full practice authority to CRNAs. Critical for rural healthcare access. CAAs are licensed to practice...
New York
Physician Supervision Required
New York requires physician supervision for CRNAs. One of the most restrictive states. CAAs do not currently have...
North Carolina
Opt-Out / Collaborative
North Carolina has opted out of federal supervision. CRNAs work under collaborative agreements. CAAs authorized.
North Dakota
Full Practice Authority
North Dakota grants full practice authority to CRNAs.
Ohio
Opt-Out / Collaborative
Ohio requires collaborative agreements. Has not opted out of CMS requirement. Large CAA population.
Oklahoma
Opt-Out / Collaborative
Oklahoma has opted out of federal supervision. CRNAs practice under collaborative agreements. CAAs authorized.
Oregon
Full Practice Authority
Oregon grants full practice authority to CRNAs with independent prescriptive authority.
Pennsylvania
Physician Supervision Required
Pennsylvania requires physician supervision for CRNAs. Has not opted out of federal requirement. CAAs practice under...
Rhode Island
Opt-Out / Collaborative
Rhode Island has opted out of federal supervision. CRNAs practice under collaborative agreements.
South Carolina
Opt-Out / Collaborative
South Carolina has opted out of federal supervision. CRNAs work under collaborative agreements. CAAs authorized.
South Dakota
Full Practice Authority
South Dakota grants full practice authority to CRNAs.
Tennessee
Physician Supervision Required
Tennessee requires physician supervision for CRNAs. CAAs are authorized.
Texas
Physician Supervision Required
Texas requires physician supervision for CRNAs. Active advocacy for practice authority expansion. CAAs authorized.
Utah
Opt-Out / Collaborative
Utah has opted out of federal supervision. CRNAs practice under collaborative agreements. CAAs are licensed to practice...
Vermont
Full Practice Authority
Vermont grants full practice authority to CRNAs. CAAs are licensed to practice in Vermont.
Virginia
Opt-Out / Collaborative
Virginia has active legislation (SB33) to expand CRNA practice authority. CAAs authorized.
Washington
Full Practice Authority
Washington grants full practice authority to CRNAs with independent practice. CAA licensure rules were finalized by the...
West Virginia
Opt-Out / Collaborative
West Virginia has opted out of federal supervision. CRNAs work under collaborative agreements.
Wisconsin
Opt-Out / Collaborative
Wisconsin has opted out of federal supervision. CRNAs practice under collaborative agreements. CAAs authorized.
Wyoming
Full Practice Authority
Wyoming grants full practice authority to CRNAs. Critical for rural access.