CRNA · Pennsylvania
Supervision Agreement for Certified Registered Nurse Anesthetists in Pennsylvania
Yes, a written supervising-physician agreement is required. Pennsylvania does not name a specific instrument.
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.
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
Not codified — left to the agreement
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
Covered by the 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.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same physician/licensee-only ownership regime as the general `pa`/`np` entries — no CRNA-specific independent-ownership statute was found in this research pass.
Legal sources for these rules (2)
What a supervising physician costs here
Typical monthly cost in Pennsylvania
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.
About Pennsylvania's rules
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.
Other clinicians in Pennsylvania: see the state overview.