CRNA · North Dakota
Collaborative Practice Agreement for Certified Registered Nurse Anesthetists in North Dakota
No. Certified Registered Nurse Anesthetists practice independently here. North Dakota does not require one.
CRNA is one of ND's four APRN roles (NDAC § 54-05-03.1-02) with no CRNA-specific supervision statute — same full-authority framework as NP. Separately, ND is reported (secondary-sourced only — the primary CMS opt-out letter wasn't located) to have opted out of Medicare's federal physician-supervision Condition of Participation for CRNA anesthesia services.
What the collaboration 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
Same general APRN prescribing regime (NDAC §§ 54-05-03.1-09 to -11) as other APRN roles — no anesthesia-specific carve-out found.
Written agreement
Not required
Unconditional under state law — no collaboration agreement required. The Medicare CoP opt-out (if confirmed) is a federal reimbursement-conditions question layered on top of this state-law baseline, not a state scope-of-practice requirement.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry — N.D. Cent. Code ch. 10-31 professional-organization framework, no CRNA-specific ownership statute.
Legal sources for these rules (2)
- N.D. Admin. Code § 54-05-03.1-02 — APRN roles
- Secondary reporting (Becker's ASC, AANA/industry summaries) on ND's Medicare CRNA supervision opt-out — not independently verified against a primary CMS opt-out letter
What a collaborating physician costs here
Typical monthly cost in North Dakota
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.
About North Dakota's rules
H.B. 1175 (2019, eff. 2020) and a 2022 rule amendment repealed ND's old PA supervision-contract/ratio/countersignature model — PAs are now CONDITIONAL only below 4,000 practice hours or outside a qualifying facility. All four APRN roles (NP, CRNA, CNM, CNS) are FULL independent practice with no collaboration agreement of any kind.
Other clinicians in North Dakota: see the state overview.