Practice Authority

CRNA Practice Authority in Washington

Washington gives CRNAs full practice authority. No physician supervision is required.

Full Practice Authority
No physician supervision required
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Washington opted out of the Medicare supervision rule in 2003, and state rules recognize CRNAs as licensed independent practitioners (WAC 246-840-300). As of October 2026, 16 of the 50 states and D.C. give CRNAs full practice authority, 10 give partial authority, and 25 require physician supervision, direction or collaboration.

Reviewed October 2026 against state statutes and rules and the AANA state opt-out fact sheet. Hospitals and surgery centers can set stricter terms in their bylaws. This summary is general information, not legal advice.

What does this mean for you?

What the rules say

  • • No physician supervision required by state law
  • • State has opted out of the Medicare supervision rule
  • • Facility bylaws can still add supervision terms

Before you accept a role

Practice terms vary by facility. Confirm the care team model and any supervision terms with each employer in Washington before you accept an offer.

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