CRNA · South Dakota
Supervision Agreement for Certified Registered Nurse Anesthetists in South Dakota
No. Certified Registered Nurse Anesthetists practice independently here. South Dakota does not require one.
SD opted out of the CMS Medicare physician-supervision requirement for CRNAs in March 2005. SDCL 36-9-3.1 requires only that a CRNA 'collaborate' (communicate/consult) with a physician, dentist, podiatrist, NP, CNM, or PA when providing anesthesia — no written agreement or physical-presence standard, unlike most non-opt-out states in this dataset.
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 · controlled substances permitted
SDCL 36-9-3.1(4): may prescribe/administer/furnish over-the-counter, legend, and controlled substances 'listed on Schedule II in chapter 34-20B' in connection with anesthesia/pain-management practice. The SD Board of Nursing's own CRNA practice guidance describes Schedule II–IV authority under implementing board rules (the statute directs the board to promulgate rules for prescriptive-authority implementation) — this entry follows that guidance, but the underlying board rule text was not independently reviewed in this pass.
Written agreement
Not required
No SD statute was found requiring a written practice/collaborative agreement document for CRNAs — 'collaborate' is defined (SDCL 36-9-1(7)) as a communication duty, not a document or supervisory gate.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — SD professional-corporation statute for nursing services was not directly confirmed in this research pass — flagged as an open item.
What a supervising physician costs here
Typical monthly cost in South Dakota
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.
About South Dakota's rules
SD is unusually permissive: NP/CNM need only 1,040 practice hours (or a collaborative agreement with ANY physician OR already-independent NP/CNM) to become fully independent (SDCL 36-9A), and a 2025 reform (SL 2025, ch 149) gives PAs the same kind of pathway after 6,000 hours plus NCCPA certification. Older sources citing a fixed PA-per-physician ratio are now outdated — that cap was repealed.
Other clinicians in South Dakota: see the state overview.