Physician duties · CRNA · Missouri
Signing for a Certified Registered Nurse Anesthetist in Missouri: what the physician takes on
Required in some cases; see the conditions below. Missouri does not name a specific instrument.
CRNAs practice under direct physician/dentist/podiatrist supervision ('immediately available if needed') rather than the full § 334.104 collaborative practice arrangement — a lighter mechanism, but still no independent-practice pathway. No written collaborative practice arrangement is required for CRNAs.
What you take on as the physician
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
On-site presence required
Supervising anesthesiologist/physician/dentist/podiatrist must be 'immediately available if needed' — a traditional direct-supervision standard rather than a written-agreement proximity clause. No numeric mile/minute radius found. Confirmed only via secondary synthesis of § 334.104's anesthesia catch-line, not a full verbatim fetch — verify exact statutory text before relying on it.
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
Exact statutory scope not independently confirmed via a full verbatim fetch this research pass.
Written agreement
Not required
CRNAs are exempt from the written collaborative-practice-arrangement requirement that applies to general APRNs/PAs — they instead practice under direct physician/dentist/podiatrist supervision as defined in § 334.104's anesthesia carve-out. This exact subsection's text was confirmed only via secondary synthesis in this research pass, not a full verbatim primary fetch — verify before relying on it.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same traditional corporate-practice-of-medicine framework as other APRN entries — exact section numbers not confirmed this research pass.
Not independently verified against primary source this research pass.
What physicians charge for this role
Typical monthly compensation in Missouri
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.
About Missouri's rules
PA/APRN collaboration is governed by nearly-identical §§ 334.104/334.735: a 6-FTE combined ratio cap, 10%/20% chart-review every 14 days, biweekly physician presence, and a 120-hour controlled-substance Rx cap. A pre-2024 numeric 75-mile proximity rule was reportedly rescinded by both boards — current text uses an undefined 'geographic proximity' standard; verify with counsel before relying on any specific mileage figure.
Other clinicians in Missouri: see the state overview.