How to Become a Certified Registered Nurse Anesthetist (CRNA)

Pathways to Become a Certified Registered Nurse Anesthetist (CRNA)

Nurse anesthesia education has changed over time. COA requires students accepted into accredited entry-level nurse anesthesia programs on or after January 1, 2022 to graduate with a doctoral degree, according to the COA accreditation standards. Current entry therefore runs through an accredited nurse anesthesia program that awards a doctoral degree, after you earn your RN license and critical care experience. The degrees below describe general nursing education and earlier routes. None of them alone qualifies a new applicant for the NCE, and the requirement does not apply retroactively to CRNAs who were already certified.

Master of Science in Nursing (MSN)

A master’s in nursing may help prepare you for advanced practice nursing roles in general. A general MSN does not by itself meet the current entry requirements for nurse anesthesia. You can explore online MSN programs for general advanced practice preparation.

RN to MSN

The RN to MSN program route is a general nursing education pathway for practicing RNs who are working toward a master’s degree. Like the MSN, it does not by itself qualify a new applicant for nurse anesthesia practice. COA admission standards require a baccalaureate or graduate degree in nursing or an appropriate major, a registered nurse and/or APRN license and critical care experience.

Post-Grad Certificate

Post-master’s certificate programs are designed for nurses who already hold a graduate degree. Before applying to any certificate program, confirm that it is COA-accredited for nurse anesthesia and that it meets the doctoral requirement for students accepted on or after January 1, 2022.

Doctor of Nursing Practice

COA standards identify the Doctor of Nursing Practice (DNP) and the Doctor of Nurse Anesthesia Practice (DNAP) as the degrees that nurse anesthesia programs award. A general DNP program is not the same as an accredited nurse anesthesia program: to be eligible for the NCE, you must complete a nurse anesthesia program accredited by COA, according to the NBCRNA NCE handbook.

Nurse anesthesia programs are approved to award doctoral degrees for entry into practice, according to AANA.

BSN to DNP

Nurses who hold a BSN can pursue a doctoral nurse anesthesia program through a BSN-to-DNP program. For CRNA entry, the program must be an accredited nurse anesthesia program. COA standards set a minimum of three years of full-time study for postbaccalaureate nurse anesthesia programs, with shorter programs considered only with supporting rationale, and a minimum of 2,000 clinical hours, according to the COA accreditation standards. Check each program to see which degrees it awards.

What Is a Nurse Anesthetist?

CRNAs are advanced practice registered nurses educated at the graduate level in nurse anesthesia, and NCSBN identifies the CRNA as one of four APRN roles, according to NCSBN. Under the federal hospital rule at 42 CFR 482.52, a CRNA is generally supervised by the operating practitioner or an immediately available anesthesiologist, unless the hospital is exempted because the governor of its state has submitted an opt-out letter to CMS that is consistent with state law. An opt-out is a federal facility exemption and does not by itself define a CRNA’s legal scope of practice: state law and facility policies still govern how CRNAs practice.

All CRNAs are board-certified by the NBCRNA.

Should I Become a Nurse Anesthetist?

Becoming a CRNA takes considerable time, depending on your career path.

CRNAs practice in many settings, including hospital surgical suites, obstetrical delivery rooms and the offices of dentists, according to AANA. AANA also says many rural hospitals are critical access hospitals, which often rely on independently practicing CRNAs.

Salary

Compensation for a CRNA will vary by location and the institution for which they work. According to the Bureau of Labor Statistics (BLS), the median annual wage for nurse anesthetists was $236,590 in May 2025, and the median hourly wage was $113.75. BLS estimated that 51,840 nurse anesthetists were employed in the United States in May 2025.

By industry, offices of physicians employed the most nurse anesthetists (an estimated 26,270), with a median annual wage of $222,530. Hospitals employed an estimated 17,250, with a median annual wage of $260,060. Here are the five states where CRNAs had the highest median annual wages in May 2025:

^{State figures are BLS May 2025 estimates for Alaska, New York, Massachusetts, California and New Jersey. BLS did not publish wage estimates for Colorado, Indiana and Rhode Island, so those states are not ranked.}

Roles and Responsibilities

CRNAs are educated to provide anesthesia and related care before, during and after procedures. COA’s crosswalk of the AANA Scope of Nurse Anesthesia Practice and COA standards describes anesthetic techniques that include general, regional and local anesthesia, as well as sedation and pain management, and services that include emergency, critical care and resuscitation care. These are professional and training descriptions, not a guarantee of legal permission: the services a CRNA may actually provide depend on state law and on authorization at the facility where they work.

According to the COA crosswalk, nurse anesthesia services include:

• Preanesthesia assessment and evaluation, anesthesia care during procedures, and postanesthesia evaluation
• Anesthesia and analgesia using regional techniques for obstetric and other acute pain management
• Selecting and inserting monitoring modalities and using ultrasound, fluoroscopy and other technologies for diagnosis and care delivery
• Emergency, critical care and resuscitation services
• Acute, chronic and interventional pain management

Certified Registered Nurse Anesthetist (CRNA) Certification

Nursing certification and nursing licensure are two different processes that CRNAs must navigate. State boards of nursing or other relevant agencies manage licensure. CRNA certification, administered by NBCRNA, indicates compliance with the professional practice standards for this clinical nursing specialty, according to the NBCRNA NCE handbook.

Information below is current as of September 2026. Be sure to check with the NBCRNA for the most up-to-date information.

National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)

National Certification Examination
Eligibility Requirements: Current and unrestricted RN license, completion of a COA-accredited nurse anesthesia education program and granted eligibility status to take the NCE, according to the NBCRNA NCE handbook. This is a simplified summary, not a complete application checklist.
Fee: $1,310, which includes the $160 MAC Check enrollment fee, according to the NBCRNA 2026 fee schedule

Maintaining Anesthesia Certification (MAC)

MAC Program
Renewal: The MAC program runs on a four-year cycle. The MAC Check replaces the Continued Professional Certification Assessment (CPCA), according to NBCRNA.
Eligibility Requirements: All CRNAs will be enrolled in the MAC program by 2026, according to NBCRNA.
Fees: The MAC Check fee is $160, according to the NBCRNA 2026 fee schedule.

Certified Registered Nurse Anesthetist (CRNA) Resources

• American Association of Nurse Anesthesiology (AANA): The professional organization for nurse anesthetists. AANA reports that more than 71,000 CRNAs and residents are members.
• Council on Accreditation of Nurse Anesthesia Education Programs (COA): The COA formulates and implements standards for accrediting institutions and programs for nurse anesthesia programs at all educational levels. The COA maintains a searchable database of CRNA schools.
• Diversity in Nurse Anesthesia Mentorship Program: An organization committed to promoting diversity initiatives for the CRNA profession.
• National Board of Certification and Recertification for Nurse Anesthetists: The national certifying body for CRNAs that manages certification and recertification exams for the profession.

Related Advanced Practice Registered Nursing (APRN) Careers

Certified Nurse Midwife (CNM)

Certified nurse-midwives provide care during pregnancy, childbirth and the postpartum period, according to the American College of Nurse-Midwives. CNM candidates must have an active RN license, and a graduate degree from an accredited nurse-midwifery or midwifery program is required to be eligible to take the national certification examination from the American Midwifery Certification Board. The first step to becoming a CNM is therefore to become a registered nurse. Then a graduate-level midwifery program accredited by the Accreditation Commission for Midwifery Education may help prepare you for the AMCB certification examination. Like the CRNA, the CNM is one of four APRN roles identified by NCSBN.

Clinical Nurse Specialist (CNS)

A CNS is an advanced practice registered nurse prepared at the master’s, doctoral or post-graduate certificate level, with advanced clinical expertise in a specialized area of nursing practice, according to the National Association of Clinical Nurse Specialists (NACNS). In most states, CNSs must obtain certification based on a population area, and NACNS lists adult/gerontology, pediatrics and neonatal certifications. NACNS also describes CNS work as including leading evidence-based practice and optimizing organizational systems. Learn more about how to become a clinical nurse specialist.

Nurse Practitioner

Nurse practitioners complete a master’s or doctoral degree program, undergo national certification and are licensed in all states and the District of Columbia, according to the American Association of Nurse Practitioners (AANP). AANP says NPs provide a full range of primary, acute and specialty health care services. NCSBN identifies the certified nurse practitioner as one APRN role, educated and certified in both the role and a population focus. You can explore a nurse practitioner program. The CRNA is a different APRN role, focused on anesthesia.

Nurse Educator

A nurse educator prepares nurses for practice. The National League for Nursing (NLN) says its Certified Nurse Educator (CNE) credential recognizes the key role academic nurse educators play in preparing the nation’s nursing workforce, and that nurse educators work across higher education and in affiliated health and hospital systems, according to the NLN.

Family Nurse Practitioner

To become a family nurse practitioner, you could complete an on-campus or online FNP program. An FNP is a nurse practitioner whose population focus is family/individual across the life span, according to NCSBN and AANP. FNPs and CRNAs are both APRNs, but they are different roles: the CRNA role focuses on anesthesia.