CRNA · Kentucky
Supervision Agreement for Certified Registered Nurse Anesthetists in Kentucky
No. Certified Registered Nurse Anesthetists practice independently here. Kentucky does not require one.
Uniquely among the states on file: KY exempts CRNAs from any CAPA requirement when delivering anesthesia care (KRS 314.042(12)), and KY opted out of the federal Medicare physician-supervision requirement in April 2012 (AANA). Outside the anesthesia-care context (e.g. pain management), CRNAs fall under the same CAPA framework as other APRNs — see prescriptiveAuthority.
What the supervision must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
No proximity requirement
No state-law physician-supervision or proximity standard exists for CRNA anesthesia delivery, and KY opted out of the federal Medicare supervision requirement in April 2012. Individual facilities/hospital bylaws may still impose their own supervision requirement regardless — the opt-out doesn't bind private facility credentialing.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
delivering anesthesia care: Covered by the practice agreement · controlled substances permitted
No CAPA required (KRS 314.042(12)); individual DEA registration still required to prescribe/administer controlled substances as part of anesthesia care.
prescribing outside anesthesia care (e.g. pain management): Separate prescribing terms required · controlled substances permitted
Same CAPA-NS/CAPA-CS framework as general APRNs applies once prescribing is broader than delivering anesthesia care.
Written agreement
Not required
Unconditional only within anesthesia care itself: no CAPA is required to deliver anesthesia care (KRS 314.042(12)). A CRNA prescribing outside that context — pain management is explicitly called out as broader than anesthesia delivery — needs the same CAPA-NS/CAPA-CS agreements as any other APRN, absent the 4-year exemption.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional LLC (KRS Ch. 275) or PSC (KRS Ch. 274) — CRNAs, as nurses, are explicitly eligible independent owners; no physician ownership required.
What a supervising physician costs here
Typical monthly cost in Kentucky
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.