---
kind: "section"
citation: "42 C.F.R. § 410.69"
title: "42"
number: "410.69"
heading: "Services of a certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions."
url: "https://uscodex.org/cfr/42/410.69"
---

# §410.69. Services of a certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions.

- (a) **Basic rule.** Medicare Part B pays for anesthesia services and related care furnished by a certified registered nurse anesthetist or an anesthesiologist's assistant who is legally authorized to perform the services by the State in which the services are furnished.
- (b) **Definitions.** For purposes of this part—

  Anesthesia and related care means those services that a certified registered nurse anesthetist is legally authorized to perform in the state in which the services are furnished.

  Anesthesiologist's assistant means a person who—

  - (1) Works under the direction of an anesthesiologist;
  - (2) Is in compliance with all applicable requirements of State law, including any licensure requirements the State imposes on nonphysician anesthetists; and
  - (3) **Is a graduate of a medical school-based anesthesiologist's assistant educational program that—**
    - (A) Is accredited by the Committee on Allied Health Education and Accreditation; and
    - (B) Includes approximately two years of specialized basic science and clinical education in anesthesia at a level that builds on a premedical undergraduate science background.

      Anesthetist includes both an anesthesiologist's assistant and a certified registered nurse anesthetist.

      Certified registered nurse anesthetist means a registered nurse who:

      - (1) Is licensed as a registered professional nurse by the State in which the nurse practices;
      - (2) Meets any licensure requirements the State imposes with respect to non-physician anesthetists;
      - (3) Has graduated from a nurse anesthesia educational program that meets the standards of the Council on Accreditation of Nurse Anesthesia Programs, or such other accreditation organization as may be designated by the Secretary; and
      - (4) **Meets the following criteria—**
        - (i) Has passed a certification examination of the Council on Certification of Nurse Anesthetists, the Council on Recertification of Nurse Anesthetists, or any other certification organization that may be designated by the Secretary; or
        - (ii) Is a graduate of a program described in [paragraph (3)](#b-3) of this definition and within 24 months after that graduation meets the requirements of paragraph (4)(i) of this definition.
      - (5) For certified registered nurse anesthetist services, the certified registered nurse anesthetist may review and verify (sign and date), rather than re-document, notes in a patient's medical record made by physicians; residents; nurses; medical, physician assistant, and advanced practice registered nurse students; or other members of the medical team, including, as applicable, notes documenting the certified registered nurse anesthetist's presence and participation in the service.

## Notes

### Amendments

[57 FR 33896, July 31, 1992, as amended at 77 FR 69363, Nov. 16, 2012; 84 FR 63190, Nov. 15, 2019]

### Authority

Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.

### Source

Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.

### Amendments

[57 FR 33896, July 31, 1992, as amended at 77 FR 69363, Nov. 16, 2012; 84 FR 63190, Nov. 15, 2019]