Healthcare Recruiting
Missouri CRNA License 2026: APRN Requirements, Practice Protocol, Salary
Missouri CRNAs are licensed as APRNs by the Missouri State Board of Nursing. Missouri is a reduced practice state — a written collaborative practice protocol with a physician is required. Missouri has NOT opted out of the federal Medicare CRNA supervision requirement. St. Louis and Kansas City are large two-anchor markets with both ACT and CRNA-independent models; rural Missouri and the Ozarks region rely heavily on CRNA-only anesthesia at Critical Access Hospitals.
Practice Model
- Written collaborative practice protocol with licensed Missouri physician required
- Missouri has NOT opted out of federal Medicare CRNA supervision requirement
- ACT model: Barnes-Jewish / Washington University, Children's Mercy (Kansas City), Saint Luke's Health System
- CRNA-independent (with protocol): Mercy Health, Cox Health (Springfield), rural CAH facilities statewide
- Rural Ozarks and Southern Missouri: CRNA-only anesthesia at many community and CAH facilities
Application Requirements
- Active Missouri RN license (compact or MO-issued)
- Current NBCRNA certification
- Official nurse anesthesia program documentation
- Completed pr.mo.gov/nursing application + $75 fee
- Criminal background check via Missouri State Highway Patrol
Processing Timeline
Missouri State Board of Nursing processes APRN applications in 6–8 weeks from complete submission. Missouri's online portal is efficient and the $75 fee reflects a lean process; timely submission of background check results is the most common rate-limiting factor.
CRNA Salary in Missouri (2026)
| Market | Avg CRNA Salary | Notes |
|---|---|---|
| St. Louis | $190,000–$222,000 | BJC / Wash U, Mercy, Ascension; major academic and community market |
| Kansas City | $192,000–$222,000 | Saint Luke's, Children's Mercy, HCA Midwest; dual-metro market |
| Springfield | $185,000–$212,000 | Cox Health, Mercy Springfield; Ozarks regional hub |
| Columbia | $185,000–$210,000 | University of Missouri Health Care; academic ACT model |
| Rural / Ozarks / CAH | $188,000–$220,000 | CRNA-only; persistent vacancies; signing bonuses $20K–$35K |
Top Employers in Missouri
- BJC HealthCare / Barnes-Jewish — St. Louis; Washington University academic affiliation; ACT model; major CRNA employer
- Mercy Health — St. Louis + Springfield + statewide; large Catholic health system; CRNA-independent at most community sites
- Saint Luke's Health System — Kansas City; CRNA-independent model; Level II trauma
- Cox Health — Springfield; Ozarks regional system; CRNA-independent throughout Southern Missouri
- University of Missouri Health Care — Columbia; academic medical center; ACT model; training partnerships
What We See at Ava Health
Missouri's two major metro markets (St. Louis and KC) operate at competitive Midwest salary levels with strong cost-of-living ratios. The Ozarks and rural Southern Missouri have consistent CRNA shortages at Cox Health affiliate facilities, Mercy's rural network, and independent Critical Access Hospitals — these positions often go unfilled for months and offer signing bonuses that partially compensate for remote location. CRNAs who accept rural Missouri positions frequently find the combination of higher total compensation and dramatically lower housing costs delivers outsized real income.
Related: CRNA Salary by State 2026, NP License Missouri 2026, CRNA License Kansas 2026.
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