NBCRNA Maintaining Anesthesia Certification (MAC) — recertification deep dive
Recertify every 4 years. Miss it once and you're not a CRNA tomorrow.
TL;DR
The NBCRNA's MAC program (Maintaining Anesthesia Certification), which replaced the older CPC program in 2024, is the recertification requirement for all practicing CRNAs. Requirements per 4-year cycle: 100 CE credits (60 Class A — anesthesia-specific, peer-reviewed — plus 40 Class B), and a longitudinal 'MAC Check' assessment. MAC eliminated the Core Modules that the old CPC program required.
MAC vs the old recert model
MAC stands for 'Maintaining Anesthesia Certification.' NBCRNA launched it in 2024 to replace the older CPC (Continued Professional Certification) program. MAC streamlines recert into a single 4-year cycle and replaces the old once-per-8-years CPC Assessment (CPCA) with 'MAC Check' — a longitudinal assessment delivered in short quarterly question sets across the cycle. MAC Check is not pass/fail; missing the performance standard triggers targeted CE, not loss of certification.
Class A CE — the hardest requirement
60 Class A CE credits per 4-year cycle. Class A = peer-reviewed, anesthesia-specific, formal-format learning (live courses, journal CE, accredited modules). Class A does NOT include unstructured reading, journal clubs without CE codes, or non-anesthesia general medical CE. Most CRNAs accumulate Class A via: AANA Journal CE articles (1-2 credits each), live AANA conferences (8-10 credits each), state CRNA association meetings (4-8 credits), accredited online CE providers (varies).
Core Modules — eliminated under MAC
Heads up: the 4 Core Modules that the legacy CPC program required (Airway Management, Applied Clinical Pharmacology, Human Physiology + Pathophysiology, and Equipment + Technology) were ELIMINATED when MAC launched in 2024 — one of the main reasons MAC saves CRNAs roughly $300 per cycle. There was never a 'Pain Management' core module; pain management is a separate standalone credential (NSPM-C), not part of recert. Under MAC you meet the requirement through Class A and Class B CE plus MAC Check — no mandatory modules.
Class B — softer activities
Class B activities make up the other 40 credits of the 100-credit, 4-year cycle (60 Class A + 40 Class B). Examples: clinical practice hours documented at your employer, leadership roles (department chair, committee), teaching SRNAs in clinical, peer-review service, professional society membership, publications. They don't substitute for the 60 Class A minimum.
Fees + timeline
Recert fee: $445 for the full 4-year MAC cycle — a single upfront fee (roughly $111/year). Submit through the NBCRNA portal 6 months before your expiration date. Late submissions (post-expiration) trigger probation status and remediation. Probation means you can still practice but with reporting requirements; lose certification entirely if not remediated within the grace period.
Audit — what happens if you're picked
NBCRNA randomly audits ~5% of recertifying CRNAs each cycle. If audited, you submit CE certificates, Core Module completions, and Class B documentation. They verify against the providers. Missing documentation = recert denied + you lose certification status until corrected. Always keep digital + paper copies of every CE certificate for 6 years minimum (4-year cycle + buffer).
Common mistakes
(1) Counting non-Class-A activities as Class A — biggest audit failure. (2) Procrastinating until year 4 — then needing 60 credits in 12 months. (3) Forgetting to renew AANA membership (lapses give the non-member fee + lose some Class A options). (4) Losing CE certificates from defunct providers. (5) Missing the application window (6 months before expiration is the soft deadline; absolute deadline is the expiration date itself).
How to make MAC easy
Track your credits as you earn them in a single spreadsheet/tracker. Aim for 15-20 Class A credits per year — that's 4-5 hours/month of formal CE — and let Class B accrue from your clinical practice and any leadership/teaching. Stay ahead of MAC Check by keeping current each quarter rather than cramming. AANA conference attendance covers 8-12 Class A credits in 3 days. Live state CRNA association meetings add another 4-8. Online platforms (gasguide AANA Class A flow ships Q3 2026) make the journal-CE pieces easy to accumulate.
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Last reviewed 2026-06-19. Spot something inaccurate? Email hello@gasguide.app.