Here are five major changes affecting certified registered nurse anesthetists’ education, practice authority, reimbursement and workforce trends that Becker’s reported in 2025.
1. Doctoral entry requirements take effect: As of the end of 2025, all newly graduating certified registered nurse anesthetists in the U.S. are now required to hold doctorate degrees, a shift first announced in 2009. The change raises the educational standard for new CRNAs and could further strain the workforce pipeline, as providers already play a major role in delivering anesthesia care in rural communities.
2. States moved to expand CRNA practice authority: Several states advanced legislation in 2025 to change how CRNAs are able to practice. West Virginia Gov. Patrick Morrisey signed a bill allowing CRNAs to administer anesthesia in cooperation with, rather than under, the supervision of a physician. California lawmakers introduced proposals to clarify CRNA regulations, while legislation filed in Florida and introduced in Virginia sought to eliminate physician supervision requirements altogether.
3. UnitedHealthcare implemented a 15% CRNA reimbursement cut: On Oct. 1, 2025, a new UnitedHealthcare policy took effect that cut reimbursements to independently practicing CRNAs by 15% for anesthesia services billed under the QZ modifier. The reduction does not apply in Arkansas, California, Ohio, Colorado, Hawaii, Massachusetts, New Hampshire and Wyoming. The American Association of Nurse Anesthesiology criticized the move as threatening patient access, particularly in rural and underserved areas, and said the policy may violate the ACA’s provider nondiscrimination provision.
4. CRNA compensation trends began to shift: CRNAs remained among the nation’s highest-earning advanced practice providers in 2025, but their pay landscape showed signs of realignment. Average annual salaries stayed strong, around $214,200, though wage growth began slowing after steep pandemic-era increases.
Outpatient and ASC settings continued to lead compensation, with CRNAs in ASCs averaging nearly $264,000 annually. Leaders also pointed to shifting contract dynamics, with fewer rapid renewals and less “contract churn” as health systems focused more on long-term anesthesia coverage stability. Regional volatility also widened, with notable state-by-state differences in pay trends.
5. New CRNA training programs expanded nationwide: Health systems and universities continued to grow the CRNA pipeline in 2025 through newly accredited and newly launched training programs. New Castle, Del.-based Wilmington University and ChristianaCare received initial accreditation for a Delaware Nurse Anesthesiology Program, with its first cohort beginning in January 2026. The University of Nevada in Las Vegas enrolled the first students in its CRNA program, while Omaha, Neb.-based Creighton University and Peoria, Ill.-based Methodist College announced plans to launch new nurse anesthesia programs in 2027 to help address ongoing workforce shortages, particularly in rural communities.
