Quick Links to FEDERAL & STATE  -Rules, Regulations, Statutes, and Hospital/ASC Licensure Regs. 

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CMS Hospitals

CMS-HOSPITALS-State Operating Manual (SOM) Hospitals


CMS-ASC-Conditions for Coverage-Appendix L (Rev. 200, 02-21-20)


Certified Registered Nurse Anesthetists (CRNAs) Qualifications and Billing Guidelines 

Chapter 12 of the Medicare Claims Processing Manual-Physicians and Non-Physicians (Rev. 10356, 09-18-20)

CMS Sec. 50 and 140-Regs and Guid Ans-implemented May 15, 2017-R3747CP

Missouri-Regulations/CRNAs/Hospitals and ASCs

MO Code of State Regulations

Mo ASCs-Chapter 30-Ambulatory Surgery Centers 

Mo HOSPITALS Now Refer to CMS-Hospitals-State Operating Manual (SOM) Hospitals (Rev. 200, 02-21-20) 

Mo-Nurse Practice Act (NPA)-Chapter 335

Mo Rules Code of State Regulations-Division 2200—State Board of Nursing Chapter 4—General Rules

Mo Rev. Statutes Chapter 334.104-Collaborative Practice Arrangements: 334.104.7.  Notwithstanding any law to the contrary, a certified registered nurse anesthetist as defined in subdivision (8) of section 335.016 shall be permitted to provide anesthesia services without a collaborative practice arrangement provided that he or she is under the supervision of an anesthesiologist or other physician, dentist, or podiatrist who is immediately available if needed.  Nothing in this subsection shall be construed to prohibit or prevent a certified registered nurse anesthetist as defined in subdivision (8) of section 335.016 from entering into a collaborative practice arrangement under this section, except that the collaborative practice arrangement may not delegate the authority to prescribe any controlled substances listed in Schedules III, IV, and V of section 195.017, or Schedule II – hydrocodone.

Kansas- Regulations/CRNAs/ Hospitals and ASCs

Kansas Hospital Regulations-28-34-17a. Anesthesia services. p.28

Kansas ASC Regulations-28-34-56a. Anesthesia services.pg.19

Kansas Nurse Practice Act (Ks NPA)

65-1130. Advance practice registered nurse; standards and requirements for licensure; rules and regulations; roles, titles and abbreviations; prescription of drugs authorized; licensure of currently registered individuals.

CRNAs in Kansas are exempt from protocol and collaborative practice agreements in Kansas when providing anesthesia services.  65-1130(d) An advanced practice registered nurse certified in the role of registered nurse anesthetist while functioning as a registered nurse anesthetist under K.S.A. 65-1151 through 65-1164, and amendments thereto, shall be subject to the provisions of K.S.A. 65-1151 through 65-1164, and amendments thereto, with respect to drugs and anesthetic agents and shall not be subject to the provisions of this subsection. For the purposes of this subsection, “responsible physician” means a person licensed to practice medicine and surgery in Kansas who has accepted responsibility for the protocol and the actions of the advanced practice registered nurse when prescribing drugs.

Ks Nursing Statutes-Article 11-Chapter 65

KS CRNAs-65-1158

65-1158.Duties of registered nurse anesthetists. (a) Upon the order of a physician or dentist requesting anesthesia or analgesia care, each registered nurse anesthetist shall be authorized to:

(1) Conduct a pre- and post-anesthesia and pre- and post-analgesia visit and assessment with appropriate documentation;

(2) develop a general plan of anesthesia care with the physician or dentist;

(3) select the method for administration of anesthesia or analgesia;

(4) select or administer appropriate medications and anesthetic agents during the peri-anesthetic or peri-analgesic period;

(5) order necessary medications and tests in the peri-anesthetic or peri-analgesic period;

(6) induce and maintain anesthesia or analgesia at the required levels;

(7) support life functions during the peri-anesthetic or peri-analgesic period;

(8) recognize and take appropriate action with respect to patient responses during the peri-anesthetic or peri-analgesic period;

(9) manage the patient’s emergence from anesthesia or analgesia; and

(10) participate in the life support of the patient.

(b) Each registered nurse anesthetist may participate in periodic and joint evaluation of services rendered, including, but not limited to, chart reviews, case reviews, patient evaluation and outcome of case statistics.

(c) A registered nurse anesthetist shall perform duties and functions in an interdependent role as a member of a physician or dentist directed health care team.

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