A Physician, a Certified Registered Nurse Anesthetist (CRNA) or Anesthesiologist Assistant
under the medical supervision of a physician, may provide anesthesia services.
Physician – Anesthesiologist
Physician is defined as a doctor of medicine who is legally authorized to practice in the State in
which he/she performs services. The issuance of a license by a State to practice constitutes legal
authorization. If the State licensing law limits the scope of practice of a particular type of medical
practitioner, only the services within these limitations are covered.
Anesthesiologist Assistants and Certified Registered Nurse Anesthetists
For payment purposes, qualified anesthetists are Anesthesiologist Assistants and Certified
Registered Nurse Anesthetists (CRNAs).
An Anesthesiologist Assistant is a person who:
• Is permitted by state law to administer anesthesia; and
• Has successfully completed a six (6) year program for Anesthesiologists Assistants of which
two (2) years consist of specialized academic and clinical training in anesthesia.
A CRNA is a registered nurse who is licensed by the state in which the nurse practices and who:
• Is currently certified by the Council on Certification of Nurse Anesthetists or the Council on
Recertification of Nurse Anesthetists; or
• Has graduated within the past 18 months from a nurse anesthesia program meeting the
standards of the Council of Accreditation of Nurse Anesthesia Educational Programs and
awaits initial certification.
CRNAs and AAs may bill Medicare directly for their services or have payment made to an
employer or an entity under which they have a contract. This could be a hospital, physician or
Ambulatory Surgical Center.
NOTE: Locum Tenens Arrangements do not apply to CRNAs and Anesthesiologist Assistants.