Certified Registered Nurse Anesthetist Cheat Sheet for Pennsylvania

Requirements for Supervising Physician agreements in Pennsylvania, plus a free agreement builder tailored to Pennsylvania law.

Provider supervision requirements in Pennsylvania

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.

Pennsylvania has no independent-practice pathway for CRNPs — SB 25-style full-practice-authority bills have been introduced every session without passing. PA (physician assistant) reform via Acts 78/79 of 2021 removed prior Board pre-approval of written agreements and the flat 100%-countersignature rule after the first year, but a written agreement and supervision remain mandatory. PA is a CPOM state: only licensed physicians may own a medical professional corporation.

Certified Registered Nurse Anesthetist

Supervision required

CRNAs practice 'in cooperation with' a physician, dentist, or podiatrist under Act 60 (S.B. 416, 2021), which formally recognized CRNAs in the Professional Nursing Law. No independent-practice pathway exists. Pennsylvania has not opted out of the CMS Medicare physician-supervision requirement for anesthesia services.


Proximity

Not codified — left to the practice agreement

Chart review

Not codified — left to the practice agreement

Prescriptive authority

Covered by practice agreement · no controlled-substance authority

CRNAs administer anesthesia-related drugs under standing orders/protocols in cooperation with a supervising physician/dentist/podiatrist rather than under independent DEA prescriptive authority; Act 60 does not grant CRNAs a separate prescriptive-authority statute the way it does for CRNPs.

Practice ownership (CPOM)

Licensee-only ownership required — Same physician and licensee-only ownership regime as PAs and NPs; no CRNA-specific provision

Supervision ratio

Not codified — left to the practice agreement

Meeting cadence

Not codified — left to the practice agreement

Written agreement

Required

Free Supervising Physician Agreement for Pennsylvania

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$500–$700/mo

Estimated CRNA supervision cost in Pennsylvania

Medium supervisor liability complexity

Available Supervising Physicians in Pennsylvania

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