CRNA · Texas
Collaborative Practice Agreement for Certified Registered Nurse Anesthetists in Texas
Yes, a written physician agreement is required. Texas does not name a specific instrument.
CRNAs administering anesthesia in a hospital or ambulatory surgical center practice under a physician's general anesthesia order (§ 157.058), not a Prescriptive Authority Agreement — the order need not specify drug, dose, or technique. AG Opinion KP-0266 (2019, secondary-sourced) confirms a CRNA has no authority to administer anesthesia absent that delegation.
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
A CRNA practicing outside the anesthesia-delegation context (e.g., a pain-management clinic prescribing independently) would need a standard Prescriptive Authority Agreement under §§ 157.0511–.0512 like any other APRN, since 'advanced practice registered nurse' under § 157.051(1) includes CRNAs — this is this dataset's own reading of the statutory definitions, not an explicit BON/TMB statement; confirm before relying on it for non-OR/ASC CRNA practice.
Written agreement
Required
Unconditional in the sense that CRNA anesthesia practice always requires a physician's order under § 157.058, but this is a general anesthesia order, not a Prescriptive Authority Agreement — a materially lighter administrative burden than the PAA framework governing np/pmhnp/cnm/pa above (no ratio cap, chart-review quota, or monthly-meeting requirement attaches to it).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the general `np` entry — CRNAs are an APRN category not listed in § 301.012, so no statutory ownership pathway into a medical PA/PLLC exists.
Legal sources for these rules (4)
- Tex. Occ. Code § 157.058 — Delegation to Certified Registered Nurse Anesthetist
- Tex. Occ. Code § 157.0511(c)
- Tex. Occ. Code § 157.051(1) — Definitions
- Tex. Att'y Gen. Op. KP-0266 (2019) (secondary-sourced summary — primary opinion text was not directly retrievable in this research pass)
What a collaborating physician costs here
Typical monthly cost in Texas
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.
About Texas's rules
Texas has no independent-practice pathway for any APRN type (NP/PMHNP/CRNA/CNM/CNS) at any experience level — a 2025 rural 10-year/20,000-hour bill (S.B. 3055) died in committee, as did 2023's full-practice-authority S.B. 1700. No chart-review percentage is codified (the physician and provider set the number themselves) — the commonly-cited 10%/20% figures reflect a pre-2013 rule since repealed. PA is the only non-physician profession with a statutory joint-ownership pathway into a medical entity.
Other clinicians in Texas: see the state overview.