TLDR
CRNA jobs in Massachusetts pay an average of $242 per hour and $271,825 per year, the highest hourly average among populous east-coast states. Massachusetts opted out of the CMS physician supervision requirement in June 2024, joining the full practice authority map after decades as a supervision-required state. The Bay State now combines top-tier pay, full practice authority, and the densest academic medical center concentration in the country.
CRNA jobs in Massachusetts averaged $242 per hour and $271,825 per year in 2026, with full practice authority statewide as of the June 2024 CMS opt-out. Boston metro pays the highest gross rates ($235 to $265 per hour for permanent staff), the state applies a flat 5 percent income tax, and the cost-of-living difference between Boston and Western Massachusetts changes the net-take-home math more than the gross hourly rate suggests.
At 5:55 a.m. on a Monday in February, a CRNA in Worcester walks into a 380-bed community teaching hospital and reads the schedule for the third time. She is paid $232 an hour, runs three twelve-hour shifts a week, and grosses about $362,000 a year on call-heavy weeks. Across the state, in a Berkshires critical access hospital that opted into a CRNA-only model after the June 2024 opt-out, a classmate of hers covers a four-room rural OR at $258 an hour with a $25,000 annual call stipend. Same NBCRNA. Same Massachusetts license. Different practice models, both legal in the same state for the first time in their careers.
That sentence was not true in May 2024. It is true now. Massachusetts is the most recent large-population state to opt out of the CMS physician supervision requirement, joining the full practice authority map roughly 18 months ago. The decision changed the structure of CRNA work in a state that already paid among the highest hourly rates in the country.
The hourly rate, the annual figure, and how they compare
RxRooster aggregated salary data for Massachusetts puts CRNA pay at $242 per hour and $271,825 per year. The Bureau of Labor Statistics has cited Massachusetts as one of the top-paying states for nurse anesthetists, with prior reports placing the state average near $292,000. The two numbers describe overlapping but not identical samples: BLS uses occupational survey data across employer types, while the RxRooster aggregated figure pulls from a broader cross-section of employment forms including academic, community, ASC, and locum work.
The $242 hourly average is the highest among populous east-coast states. New York averages $199 per hour. New Jersey $196 per hour. Connecticut and Rhode Island sit between $215 and $230. Vermont, an FPA peer with a smaller market, averages $230 per hour. Among large markets, only the rural-coverage FPA states like New Mexico ($271 per hour) and Nebraska ($267 per hour) post higher hourly averages than Massachusetts.
Locum CRNA rates in Massachusetts run notably higher than the W-2 average. Boston academic centers, including Massachusetts General, Brigham and Women's, Beth Israel Deaconess, Tufts Medical Center, and Boston Children's, pay $260 to $310 per hour for short assignments, with cardiac, neuroanesthesia, OB, and pediatric subspecialty work commanding additional premiums. Regional locum rates outside the Boston orbit run $230 to $280 per hour.
Practice scope after June 2024: full practice authority, statewide
Massachusetts opted out of the CMS physician supervision requirement in June 2024, joining roughly 30 other states and Washington, D.C. on the full practice authority map. The opt-out removed the federal Medicare condition that had required physician supervision of CRNAs at participating hospitals and ambulatory surgical centers. State law followed the opt-out structure, allowing CRNAs to practice to the full scope of their training without a written supervision arrangement.
For a CRNA evaluating a Massachusetts offer in 2026, FPA has three practical effects. The first is that solo-coverage and CRNA-only models became structurally possible at Massachusetts ASCs, critical access hospitals, and rural facilities for the first time. The second is that bill-rate ceilings opened upward in those settings, because facilities can now run a CRNA-only model without the medical-direction modifier framework cap. The third is that case-mix flexibility expanded: a Massachusetts CRNA can now take an autonomous OB shift at a regional hospital that previously required an anesthesiologist on the unit for billing compliance.
Most large Boston academic centers continue to operate the medical direction model with anesthesiologists supervising CRNAs in care teams. The opt-out did not force any facility to change its staffing model. It did open new staffing options at facilities that wanted them, particularly in Western Massachusetts, the Cape, and the Berkshires.
For more on what FPA changes for CRNA work, see the full practice authority guide. For how FPA shapes anesthesia billing, see our anesthesia reimbursement breakdown.
The Massachusetts tax stack: simpler than New York, costlier than the no-tax states
Massachusetts applies a flat 5 percent state income tax on most personal income. A 4 percent surtax on income above $1 million applies to filers in the top earnings band, but does not touch a CRNA at the $272,000 to $310,000 salary range. Massachusetts imposes no municipal or city personal income tax. Boston, Cambridge, Worcester, and Springfield residents pay the same flat 5 percent that a CRNA in Pittsfield or North Adams pays.
For a CRNA earning $271,825 in Massachusetts, the state tax line is roughly $13,591 per year. A Texas CRNA earning the same gross keeps that $13,591. A Florida CRNA keeps it. A New Hampshire CRNA, working an hour north of Boston without crossing into Vermont, keeps it. Across a 30-year career, the gap compounds: $13,591 per year for 20 years is roughly $272,000 in pre-investment dollars, and the figure grows by approximately the wage inflation rate.
The Massachusetts stack lands lighter than the New York City resident stack, where state plus city tax can run 9.5 to 10 percent for five-borough residents. A New York CRNA at the same gross loses roughly $25,000 to the state-and-city stack. A Massachusetts CRNA loses roughly $13,591 to the state-only stack. The $11,000 net-pay advantage to Massachusetts at equal gross is one reason Boston-area CRNAs commonly outearn New York City peers in net terms despite the two metros sitting on the same Northeast corridor.
Metro-level rates and where the math actually changes
Five regions describe most CRNA employment in Massachusetts: Greater Boston, the Worcester corridor, the Cape and Islands, the North Shore and Merrimack Valley, and Western Massachusetts including the Pioneer Valley and Berkshires.
Greater Boston is the highest-pay, highest-cost cluster. Mass General Brigham, the Beth Israel Lahey Health network, Tufts Medicine, Boston Medical Center, and Boston Children's anchor academic and tertiary anesthesia volume. Permanent W-2 base rates run $235 to $265 per hour. Locum rates run $260 to $310, with cardiac, neuroanesthesia, OB, and pediatric subspecialty premiums. Boston rents on a one-bedroom in 2026 average roughly $3,200 to $3,800; Cambridge runs slightly higher; Brookline, Newton, and Somerville fall between Boston and Cambridge. The cost-of-living adjustment is the dominant net-pay variable in the region.
Worcester and the central corridor covers UMass Memorial, Saint Vincent Hospital, and Heywood Hospital. Base rates run $215 to $245 per hour. Worcester rents run roughly half of Boston's, and the Pike commute to Boston for occasional locum or per-diem work is one to one-and-a-half hours each way. Worcester is often the highest net-take-home zone in eastern Massachusetts for CRNAs willing to live one ZIP outside the I-495 ring.
The Cape and Islands includes Cape Cod Hospital, Falmouth Hospital, Martha's Vineyard Hospital, and Nantucket Cottage Hospital. Year-round base rates run $215 to $245 per hour, with seasonal locum premiums driving Cape coverage to $260 to $290 per hour during the May-to-September peak. Year-round housing is affordable in winter and expensive in summer; many Cape CRNAs live off-island and work seasonal blocks.
The North Shore and Merrimack Valley includes the Beth Israel Lahey footprint at Lahey Hospital and Medical Center in Burlington, Salem Hospital, and Anna Jaques Hospital in Newburyport. Base rates run $220 to $250 per hour. The region offers Boston-adjacent gross pay without Boston-level rents in towns like Andover, Reading, and Beverly.
Western Massachusetts covers Springfield, Northampton, Greenfield, and Pittsfield. Baystate Health anchors the Pioneer Valley; Berkshire Health Systems anchors the Berkshires. Base rates run $200 to $235 per hour. Cost of living is among the lowest in any New England metro. Western Massachusetts produces the highest net-take-home math in the state once rent, taxes, and commute costs are stacked, and the region was one of the first to expand CRNA-only and solo-coverage staffing models after the June 2024 opt-out.
Locum and per-diem in Massachusetts
Massachusetts is a top-ten locum destination by volume. Boston academic centers run frequent short-term and weekend coverage requests. Cape Cod runs heavy seasonal locum demand from May through September. Western Massachusetts and the Berkshires expanded post-opt-out into CRNA-only and solo-coverage rural locum models that did not exist before June 2024.
Locum work in Massachusetts requires a Massachusetts Board of Registration in Nursing APRN authorization with prescriptive practice prefix before the first case. The state recognizes nurse anesthetist as a defined APRN role; the June 2024 opt-out removed the federal supervision condition for Medicare billing, and state regulations followed in subsequent rule-making to align scope with the opt-out structure. Most CRNAs working locum in Massachusetts maintain compact-state RN licensure plus the Massachusetts-specific APRN authorization.
For more on how locum economics work nationally, see our locum rates breakdown and the hybrid W-2 plus 1099 portfolio guide.
Credentialing in Massachusetts: the runway and the dollar cost
Massachusetts requires APRN authorization through the Board of Registration in Nursing before the first day of clinical work. Initial authorization takes four to ten weeks depending on whether the applicant holds an existing Massachusetts RN license, whether the NBCRNA file transfers cleanly, and whether the chosen employer's privileging file requires additional supplements such as CME logs, prior case logs, or supervisor attestation letters from previous employers.
For a CRNA earning the Massachusetts hourly average of $242, every week of credentialing runway represents about $9,680 in lost gross income at full-time hours. Ten weeks of runway is roughly $96,800 in deferred earnings. A 14-day automated credentialing pipeline lowers that runway to roughly $19,360 at the same hourly rate, a difference of about $77,400 per accepted offer.
For more on how automated credentialing reduces this runway, see our credentialing automation post.
Who fits Massachusetts, and who should keep looking
Massachusetts is the right state for a CRNA who values academic medicine, dense subspecialty case mix, and the highest hourly pay among populous east-coast markets. It is the right state for a CRNA who wants to practice with full practice authority on the east coast, particularly outside the Mass General Brigham orbit where smaller community and rural facilities have begun building CRNA-only and solo-coverage staffing models. It is the right state for a CRNA willing to accept a flat 5 percent income tax in exchange for top hourly pay and a denser academic concentration than any single metro outside New York City.
It is the wrong state for a CRNA prioritizing zero state tax exposure. New Hampshire sits one hour north of Boston with FPA and no income tax. Texas and Florida are no-tax peers in supervision-required and FPA-recent geographies, respectively. A CRNA whose top priority is annual gross at minimum tax exposure should compare Massachusetts directly against the nine no-income-tax states.
For broader state-by-state comparison see the Massachusetts CRNA salary page, the New York CRNA guide, the Texas CRNA guide, the California CRNA guide, and the Florida CRNA guide. Together they cover the largest US states with the most distinct pay-and-tax structures.
The Takeaway
Massachusetts is the highest-paying east-coast state by hourly rate, the most recent large state to expand into full practice authority, and the densest academic medical concentration in the country outside New York City. The June 2024 opt-out turned Massachusetts from a supervision-only market into a state where solo-coverage and CRNA-only staffing models are now legal and growing.
See live rates for Massachusetts on RxRooster. Every metro, every facility type, every credential verified before the first call.
Frequently Asked Questions
How much does a CRNA make in Massachusetts?
CRNAs in Massachusetts earn an average of $242 per hour and $271,825 per year as of 2026, the highest hourly average among populous east-coast states. Boston-area locum rates run $260 to $310 per hour at major academic centers, with subspecialty premiums on top.
Does Massachusetts have full practice authority for CRNAs?
Yes. Massachusetts opted out of the CMS physician supervision requirement in June 2024, joining roughly 30 other states and Washington, D.C. on the full practice authority map. State regulations align with the opt-out structure to allow autonomous CRNA practice.
What state income tax do CRNAs pay in Massachusetts?
Massachusetts applies a flat 5 percent income tax on most personal income. A 4 percent surtax applies to income above $1 million but does not affect a CRNA at the $272,000 to $310,000 salary range. There is no city or municipal income tax anywhere in Massachusetts.
Where in Massachusetts pays CRNAs the most net take-home?
Western Massachusetts and the Worcester corridor generally produce the highest net-take-home math for permanent CRNA staff. Both regions pair $200 to $245 per hour with rents roughly half of Greater Boston, and both have expanded CRNA-only and solo-coverage staffing options after the June 2024 opt-out.
Is Massachusetts a good state for locum CRNAs?
Massachusetts is a top-ten locum destination by volume. Boston academic centers pay $260 to $310 per hour, Cape Cod pays seasonal premiums of $260 to $290 per hour from May through September, and Western Massachusetts and the Berkshires now offer post-opt-out CRNA-only and solo-coverage rural locum work that did not exist before 2024.