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CRNA Supporting Documentation Requirements

To Maintain CRNA status:

  • To maintain its eligibility for reasonable cost payment under paragraph (c)(2)(1) must demonstrate prior to January 1 of each respective year that for the prior year its volume of surgical procedures requiring anesthesia service did not exceed 800 procedures.

Supporting Documentation:

  • A signed statement by each CRNA/AA agreeing that he/she will not bill on a fee schedule basis for patient care services. This statement must include the current review period.
  • Supporting documentation to define the total number of hours spent at the facility, whether performing anesthesia or other services.
  • Copies of CRNA/AA contracts. If the CRNA/AA is employed by the hospital/CAH, the CRNA exemption request submitted by the facility should indicate that the CRNA/AA is an employee of the hospital/CAH.
  • A surgical log with dates of procedures that were performed between January 1st and September 30th of the current year. The long must include:

    Dates (surgical)
    Patient Name
    Surgeon Name
    Anesthetists’ name (CRNA/AA)
    Type of Anesthesia
    Type of Surgical Procedure

Reviewed: 12.02.22


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