42 CFR §410.69
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Basic rule. Medicare Part B pays for anesthesia services and related care furnished by a certified registered nurse anesthetist or an anesthesiologist's assistant who is legally authorized to perform the services by the State in which the services are furnished.
- (b)Definitions. For purposes of this part—
- (1)Works under the direction of an anesthesiologist;
- (2)Is in compliance with all applicable requirements of State law, including any licensure requirements the State imposes on nonphysician anesthetists; and
- (3)Is a graduate of a medical school-based anesthesiologist's assistant educational program that—
- (A)Is accredited by the Committee on Allied Health Education and Accreditation; and
- (B)Includes approximately two years of specialized basic science and clinical education in anesthesia at a level that builds on a premedical undergraduate science background.
- (1)Is licensed as a registered professional nurse by the State in which the nurse practices;
- (2)Meets any licensure requirements the State imposes with respect to non-physician anesthetists;
- (3)Has graduated from a nurse anesthesia educational program that meets the standards of the Council on Accreditation of Nurse Anesthesia Programs, or such other accreditation organization as may be designated by the Secretary; and
- (4)Meets the following criteria:
- (i)Has passed a certification examination of the Council on Certification of Nurse Anesthetists, the Council on Recertification of Nurse Anesthetists, or any other certification organization that may be designated by the Secretary; or
- (ii)Is a graduate of a program described in paragraph (3) of this definition and within 24 months after that graduation meets the requirements of paragraph (4)(i) of this definition.
- (5)For certified registered nurse anesthetist services, the certified registered nurse anesthetist may review and verify (sign and date), rather than re-document, notes in a patient's medical record made by physicians; residents; nurses; medical, physician assistant, and advanced practice registered nurse students; or other members of the medical team, including, as applicable, notes documenting the certified registered nurse anesthetist's presence and participation in the service.
Anesthesia and related care means those services that a certified registered nurse anesthetist is legally authorized to perform in the state in which the services are furnished.
Anesthesiologist's assistant means a person who—
Anesthetist includes both an anesthesiologist's assistant and a certified registered nurse anesthetist.
Certified registered nurse anesthetist means a registered nurse who: