NCSL has added certified registered nurse anesthetists to its Scope of Practice Policy Resource Center.
Certified registered nurse anesthetists, or CRNAs, are highly trained registered nurses who specialize in anesthesia, and many hold master’s degrees or higher in nursing. This new section provides scope of practice information on CRNA across all 50 states, Washington, D.C., and the territories.
State of the States: CRNA Scope of Practice
Eleven states, the district and two territories allow CRNAs to practice and prescribe without a physician relationship. Seventeen states and three territories do not allow CRNAs to prescribe medications independently beyond routine anesthesia services, and 17 states do not allow prescriptive authority. Some states have exceptions. For example, Maine allows full practice and prescriptive authority if the CRNA is practicing at critical access and rural hospitals. Several states allow full practice or prescriptive authority after the CRNA completes a specified transition period.
Nearly every state includes CRNAs under the umbrella of advanced practice registered nurses. Some states, including Iowa and Washington, may refer to CRNAS as advanced registered nurse practitioners. In New York, CRNAs are not explicitly recognized in the nursing statute and have distinct licensure processes, education and training requirements, and scope of practice. CRNAs are not required to have prescriptive authority to provide anesthesia care. Prescriptive authority refers to prescription drugs beyond perioperative and routine anesthesia services defined within CRNA scope of practice.
For more detailed information on CRNAs and the scope of practice for other health care professionals, visit the NCSL Scope of Practice Policy website. For tracking on health workforce legislation across the 50 states, the territories and Washington, D.C., please visit NCSL’s Health Workforce Legislation Database. For historical legislation on scope of practice policy from 2015-2024, please visit NCSL’s Scope of Practice Legislation Database.
Razan Badr is a policy analyst with NCSL’s Health Program.