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.

Full Practice Authority (21)
Opt-Out / Collaborative (20)
Supervision Required (10)
AlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyoming

Click any state for detailed practice requirements, licensure, and salary data.

New to practice authority?

Read our comprehensive guide covering all 50 states, legislative trends, and what it means for your career.

Read the Guide

Alabama

Physician Supervision Required

AL
NLC Compact$220,000

Alabama requires physician supervision for CRNAs. The state has not opted out of the CMS supervision requirement.

Alaska

Full Practice Authority

AK
CMS Opt-Out$290,000

Alaska grants CRNAs full practice authority with independent prescriptive authority. One of the first states to opt out.

Arizona

Full Practice Authority

AZ
CMS Opt-OutNLC Compact$245,000

Arizona provides full practice authority for CRNAs with no physician supervision requirement.

Arkansas

Opt-Out / Collaborative

AR
CMS Opt-OutNLC Compact$230,000

Arkansas has opted out of federal supervision requirements. CRNAs practice under collaborative agreements.

California

Physician Supervision Required

CA
$275,000

California requires physician supervision for CRNAs. Has not opted out of the CMS requirement. One of the most...

Colorado

Full Practice Authority

CO
CMS Opt-OutNLC Compact$260,000

Colorado grants full practice authority to CRNAs. Strong independent practice environment.

Connecticut

Full Practice Authority

CT
CMS Opt-Out$255,000

Connecticut provides full practice authority for CRNAs with no supervision requirement.

Delaware

Opt-Out / Collaborative

DE
CMS Opt-OutNLC Compact$240,000

Delaware has opted out of the federal supervision requirement. CRNAs work under collaborative agreements.

District of Columbia

Full Practice Authority

DC
CMS Opt-OutAA Authorized$250,000

DC grants full practice authority to CRNAs. Both CRNAs and AAs are authorized to practice.

Florida

Physician Supervision Required

FL
NLC CompactAA Authorized$230,000

Florida requires physician supervision. Active legislation (HB 375/649) to expand CRNA practice authority. AAs are...

Georgia

Physician Supervision Required

GA
NLC CompactAA Authorized$235,000

Georgia requires physician supervision for CRNAs. One of the largest AA populations in the country.

Hawaii

Opt-Out / Collaborative

HI
CMS Opt-Out$240,000

Hawaii has opted out of federal supervision. CRNAs practice under collaborative agreements.

Idaho

Full Practice Authority

ID
CMS Opt-OutNLC Compact$255,000

Idaho grants full practice authority to CRNAs with independent prescriptive authority.

Illinois

Opt-Out / Collaborative

IL
AA Authorized$240,000

Illinois requires collaborative agreements between CRNAs and physicians. AAs are authorized to practice.

Indiana

Opt-Out / Collaborative

IN
CMS Opt-OutNLC Compact$235,000

Indiana has opted out of federal supervision. CRNAs practice under collaborative agreements.

Iowa

Full Practice Authority

IA
CMS Opt-OutNLC Compact$250,000

Iowa grants full practice authority to CRNAs.

Kansas

Full Practice Authority

KS
CMS Opt-OutNLC Compact$245,000

Kansas grants full practice authority to CRNAs with independent practice.

Kentucky

Opt-Out / Collaborative

KY
CMS Opt-OutNLC CompactAA Authorized$230,000

Kentucky has opted out of federal supervision. CRNAs practice under collaborative agreements. AAs authorized.

Louisiana

Opt-Out / Collaborative

LA
CMS Opt-OutNLC Compact$225,000

Louisiana has opted out of federal supervision. CRNAs work under collaborative practice agreements.

Maine

Full Practice Authority

ME
CMS Opt-OutNLC Compact$240,000

Maine grants full practice authority to CRNAs.

Maryland

Opt-Out / Collaborative

MD
AA Authorized$245,000

Maryland requires collaborative agreements. Has not opted out of CMS supervision requirement. AAs authorized.

Massachusetts

Physician Supervision Required

MA
$250,000

Massachusetts requires physician supervision for CRNAs. Has not opted out of federal requirement.

Michigan

Opt-Out / Collaborative

MI
CMS Opt-OutAA Authorized$240,000

Michigan has opted out of federal supervision. CRNAs practice under collaborative agreements. AAs authorized.

Minnesota

Full Practice Authority

MN
CMS Opt-Out$255,000

Minnesota grants full practice authority to CRNAs with no supervision requirement.

Mississippi

Opt-Out / Collaborative

MS
CMS Opt-OutNLC Compact$220,000

Mississippi has opted out of federal supervision. CRNAs work under collaborative agreements.

Missouri

Opt-Out / Collaborative

MO
CMS Opt-OutNLC CompactAA Authorized$235,000

Missouri has opted out of federal supervision. CRNAs practice under collaborative agreements. AAs authorized.

Montana

Full Practice Authority

MT
CMS Opt-OutNLC Compact$260,000

Montana grants full practice authority to CRNAs. Strong rural CRNA presence.

Nebraska

Full Practice Authority

NE
CMS Opt-OutNLC Compact$250,000

Nebraska grants full practice authority to CRNAs.

Nevada

Full Practice Authority

NV
CMS Opt-OutNLC Compact$255,000

Nevada grants full practice authority to CRNAs.

New Hampshire

Full Practice Authority

NH
CMS Opt-OutNLC Compact$245,000

New Hampshire grants full practice authority to CRNAs.

New Jersey

Physician Supervision Required

NJ
$250,000

New Jersey requires physician supervision for CRNAs.

New Mexico

Full Practice Authority

NM
CMS Opt-OutNLC Compact$245,000

New Mexico grants full practice authority to CRNAs. Critical for rural healthcare access.

New York

Physician Supervision Required

NY
AA Authorized$260,000

New York requires physician supervision for CRNAs. One of the most restrictive states. AAs authorized.

North Carolina

Opt-Out / Collaborative

NC
CMS Opt-OutNLC CompactAA Authorized$240,000

North Carolina has opted out of federal supervision. CRNAs work under collaborative agreements. AAs authorized.

North Dakota

Full Practice Authority

ND
CMS Opt-OutNLC Compact$260,000

North Dakota grants full practice authority to CRNAs.

Ohio

Opt-Out / Collaborative

OH
NLC CompactAA Authorized$235,000

Ohio requires collaborative agreements. Has not opted out of CMS requirement. Large AA population.

Oklahoma

Opt-Out / Collaborative

OK
CMS Opt-OutNLC CompactAA Authorized$235,000

Oklahoma has opted out of federal supervision. CRNAs practice under collaborative agreements. AAs authorized.

Oregon

Full Practice Authority

OR
CMS Opt-Out$260,000

Oregon grants full practice authority to CRNAs with independent prescriptive authority.

Pennsylvania

Physician Supervision Required

PA
$240,000

Pennsylvania requires physician supervision for CRNAs. Has not opted out of federal requirement.

Rhode Island

Opt-Out / Collaborative

RI
CMS Opt-Out$245,000

Rhode Island has opted out of federal supervision. CRNAs practice under collaborative agreements.

South Carolina

Opt-Out / Collaborative

SC
CMS Opt-OutNLC CompactAA Authorized$235,000

South Carolina has opted out of federal supervision. CRNAs work under collaborative agreements. AAs authorized.

South Dakota

Full Practice Authority

SD
CMS Opt-OutNLC Compact$255,000

South Dakota grants full practice authority to CRNAs.

Tennessee

Physician Supervision Required

TN
NLC CompactAA Authorized$230,000

Tennessee requires physician supervision for CRNAs. AAs are authorized.

Texas

Physician Supervision Required

TX
NLC CompactAA Authorized$235,000

Texas requires physician supervision for CRNAs. Active advocacy for practice authority expansion. AAs authorized.

Utah

Opt-Out / Collaborative

UT
CMS Opt-OutNLC Compact$245,000

Utah has opted out of federal supervision. CRNAs practice under collaborative agreements.

Vermont

Full Practice Authority

VT
CMS Opt-OutNLC Compact$240,000

Vermont grants full practice authority to CRNAs.

Virginia

Opt-Out / Collaborative

VA
NLC CompactAA Authorized$240,000

Virginia has active legislation (SB33) to expand CRNA practice authority. AAs authorized.

Washington

Full Practice Authority

WA
CMS Opt-Out$270,000

Washington grants full practice authority to CRNAs with independent practice.

West Virginia

Opt-Out / Collaborative

WV
CMS Opt-OutNLC Compact$225,000

West Virginia has opted out of federal supervision. CRNAs work under collaborative agreements.

Wisconsin

Opt-Out / Collaborative

WI
CMS Opt-OutNLC CompactAA Authorized$245,000

Wisconsin has opted out of federal supervision. CRNAs practice under collaborative agreements. AAs authorized.

Wyoming

Full Practice Authority

WY
CMS Opt-OutNLC Compact$265,000

Wyoming grants full practice authority to CRNAs. Critical for rural access.