AANA Continued Professional 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 (Continued Professional Certification, formerly CPC) is the 4-year recertification requirement for all practicing CRNAs. Requirements: 60 Class A CE credits (anesthesia-specific, peer-reviewed), 4 Core Modules (Airway / A&P / Pharm / Equipment + Pain Mgmt), various Class B activities, and the recert fee. Each 4-year cycle is itself one half of an 8-year cycle ending in the simulated-practice assessment in year 8.
MAC vs the old recert model
MAC (Continued Professional Certification) replaced the older CPC program in 2023, with terminology updated to 'MAC' for 'Maintenance of Anesthesia Certification' in 2024+ communications. The 8-year cycle is split into two 4-year sub-cycles. Year 4 = mid-cycle audit + Class A CE proof. Year 8 = simulated-practice assessment + full audit.
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 — the 4 mandatory topics
Every 4-year cycle, you must complete 4 Core Modules covering: (1) Airway Management, (2) Applied Clinical Pharmacology, (3) Human Physiology + Pathophysiology, (4) Equipment + Technology. Each module = ~15-20 Class A credits when completed through NBCRNA-approved providers. Pain Management is a 5th core topic added in 2026 cycles. Modules can be combined for partial credit if you take them from the same provider.
Class B — softer activities
Class B activities don't count toward the 60 Class A minimum but contribute to the broader MAC requirement. Examples: clinical practice hours documented at your employer, leadership roles (department chair, committee), teaching SRNAs in clinical, peer-review service, professional society membership, publications. Each cycle requires a minimum Class B documentation.
Fees + timeline
Recert fee: $110 every 4 years for AANA members ($210 non-members). 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 Class A 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. Front-load the Core Modules in year 2-3 of each cycle so years 1 and 4 are buffer. 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.
Track your MAC progress →Related reading
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Last reviewed 2026-05-19. Spot something inaccurate? Email hello@gasguide.app.