or podiatrist) varies with state law. Some states use the term collaboration to define a relationship where the supervising physician and the CRNA work together to provide the anesthetic. Other states require the consent or order of a physician or other qualified licensed provider to administer the anesthetic. The licensed CRNA is legally authorized to deliver care under the particular Nurse Practice Act of each state. Scope of CRNA practice is commonly further defined by the practice location's clinical privilege and credentialing process, anesthesia department policies, or practitioner agreements. Clinical privileges are based on the scope and complexity of the expected clinical practice, CRNA qualifications, and CRNA experience. This allows the CRNA to provide core services and activities under defined conditions with or without supervision. In 2001, the Centers for Medicare and Medicaid Services (CMS) published a rule in the Federal Register that allows a state to be exempt from Medicare's physician supervision requirement for nurse anesthetists after appropriate approval by the state governor. To date, 22 states and Guam have opted out of the federal requirement, instituting their own individual requirements instead. Salary According to the U.S. Bureau of Labor Statistics, a CRNA salary is around $225,555. Salaries within the US vary by state. Connecticut is the highest-paying state for CRNAs at an average salary of $276,540. It is followed by New Jersey ($263,850), Illinois ($250,280), and West Virginia ($247,650). Overall employment for nurse anesthetists and other medical professions is projected to grow 45 percent from 2020 to 2030. Duties CRNAs typically work in healthcare settings such as emergency rooms, intensive care units, and operating rooms. Their environment is with medical and surgical teams with procedures that can occur anytime. Some partnerships they work with are dentists, surgeons, podiatrists and other healthcare providers in serving patients who need of receiving anesthesia. Nurse anesthetists are an essential part of everyday medical facilities. The need of CRNAs is anticipated to grow. Skills and procedures Nurse anesthetists practice independently (depending on the state law) or they practice in collaboration with anesthesiologists, surgeons, and doctors to supply anesthetics to patients. CRNAs are responsible to communicate with the surgeon or team of the patient's health history and designing a plan for anesthesia. The procedures that nurse anesthetists offer include: Evaluation of the patient prior to anesthesia Physical assessment and teaching before the anesthesia Administering patients' anesthesia Administering regional anesthesia/analgesia such as spinals and epidurals