Certified Registered Nurse Anesthetist Cheat Sheet for Missouri
Requirements for Supervising Physician agreements in Missouri, plus a free agreement builder tailored to Missouri law.
Provider supervision requirements in Missouri
Updated 2026-09-03
Provided for educational and research purposes only — this is not legal advice. Laws and regulations change frequently, and this content may contain errors or omissions. Always confirm current requirements with a licensed attorney before relying on this for compliance decisions.
PA/APRN collaboration is governed by nearly-identical §§ 334.104/334.735: a 6-FTE combined ratio cap, 10%/20% chart-review every 14 days, biweekly physician presence, and a 120-hour controlled-substance Rx cap. A pre-2024 numeric 75-mile proximity rule was reportedly rescinded by both boards — current text uses an undefined 'geographic proximity' standard; verify with counsel before relying on any specific mileage figure.
Certified Registered Nurse Anesthetist
CRNAs practice under direct physician/dentist/podiatrist supervision ('immediately available if needed') rather than the full § 334.104 collaborative practice arrangement — a lighter mechanism, but still no independent-practice pathway. No written collaborative practice arrangement is required for CRNAs.
Proximity
On-site presence required
Supervising anesthesiologist/physician/dentist/podiatrist must be 'immediately available if needed' — a traditional direct-supervision standard rather than a written-agreement proximity clause. No numeric mile/minute radius found. Confirmed only via secondary synthesis of § 334.104's anesthesia catch-line, not a full verbatim fetch — verify exact statutory text before relying on it.Chart review
Not codified — left to the practice agreement
Prescriptive authority
Covered by practice agreement · controlled substances permitted
CRNAs administer anesthesia-related drugs (including controlled substances) as part of anesthesia care under physician/dentist/podiatrist supervision rather than under the general APRN collaborative-practice Rx framework; not authorized to prescribe outpatient controlled substances for sedation purposes outside anesthesia care.Practice ownership (CPOM)
Licensee-only ownership required — As for other APRNs: RSMo Chapter 356 professional corporations
Supervision ratio
Not codified — left to the practice agreement
Meeting cadence
Not codified — left to the practice agreement
Written agreement
Not required
CRNAs are exempt from the written collaborative-practice-arrangement requirement that applies to general APRNs and PAs; they practice instead under direct physician, dentist or podiatrist supervision as defined in § 334.104's anesthesia carve-out. Confirm the subsection text before relying on it.$500–$700/mo
Estimated CRNA supervision cost in Missouri
Available Supervising Physicians in Missouri
Browse supervising physicians open to new collaborations near you.