CRNA Independent Practice States

The demand for Certified Registered Nurse Anesthetists continues to grow as healthcare systems respond to the nationwide shortage of anesthesiologists. The most recent data from the U.S. Bureau of Labor Statistics projects CRNA employment will grow by nearly 35% percent by 2034, reflecting increased surgical volume and the need for expanded anesthesia coverage across care settings.

According to the American Association of Nurse Anesthesiology. There are currently about 57,000 CRNAs practicing in the United States and administering more than 50 million anesthetics to patients each year. CRNAs play a central role in maintaining access to anesthesia services, particularly in rural and underserved areas. They represent more than 80% of anesthesia providers in rural U.S. counties, helping ensure that essential surgical and procedural care remains available. As reliance on CRNAs continues to grow, questions surrounding independent practice, scope of practice by state, and regulatory flexibility have become increasingly relevant.

CRNA's scope of practice varies by state. Some states allow CRNAs to practice independently without physician supervision, which can greatly improve access to anesthesia care in rural and underserved areas. 

Listed below are the states where CRNAs can practice independently:

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Hawaii, Idaho, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington D.C., Washington State, West Virginia, Wisconsin, and Wyoming.

For more details about your state’s scope of practice, visit the practice in your state resource from the American Association of Nurse Anesthesiology.

As of 2023, 75% of certified registered nurse anesthetists reported practicing independently without collaboration from physicians.

Working independently can give CRNAs more control over how they practice. This may include greater flexibility with scheduling, more involvement in clinical decisions, and the ability to work in a wider range of settings, such as rural hospitals and outpatient surgery centers.

Independent practice can also open up additional career options. Some CRNAs choose to work directly with healthcare facilities, join CRNA-led groups, or take on roles where they serve as the primary anesthesia provider.

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