CRNA Continuing Education: NBCRNA MAC Requirements

CRNA continuing education now runs through the NBCRNA’s Maintaining Anesthesia Certification (MAC) program, which replaced the older CPC program for recertifying nurse anesthetists. Here is what the MAC program asks of you over each cycle, and how to tell which courses count.

We checked these requirements against the NBCRNA’s website and the AANA’s website. Rules change, so confirm with the NBCRNA before your renewal.

The short answer

The MAC cycle is four years long, with a check-in with the NBCRNA at the midpoint.
You need 100 CE credits per cycle: 60 Class A credits (MAC Ed) and 40 Class B credits (MAC Dev).
Class A credits must come from prior-approved activities that include an assessment. Class B credits don’t need prior approval.
Core Modules are no longer required in the MAC program.
The MAC Check, a quarterly online assessment, replaces the CPCA. It isn’t pass/fail, but falling short of the performance standard means extra Class A credits.

How the MAC cycle works

The NBCRNA describes MAC as a four-year program with three parts: MAC Ed, MAC Dev, and the MAC Check. According to the MAC Program Handbook, your MAC compliance expires at the end of the four-year period unless you renew.

Halfway through the cycle, you check in with the NBCRNA to verify your licensure, practice, and contact information. Your personal timeline, including your renewal deadline, is listed in the NBCRNA portal.

MAC started on August 1, 2024, for the first groups of CRNAs. Others finished their current CPC cycle first, and the NBCRNA says all CRNAs will be enrolled in MAC by 2026. You are never enrolled in both programs at once.

CRNA continuing education credits by type

The 100-credit total breaks down like this. The details come from the NBCRNA’s MAC pages and the AANA’s guidance on reporting credits.

Requirement	MAC Ed (Class A)	MAC Dev (Class B)
Credits per four-year cycle	60	40
Assessment required	Yes	No
Prior approval required	Yes (prior or non-prior approval)	No
Examples	Online courses, workshops, meetings, journal courses	Teaching, publishing, research, M&M conferences, mission trips, life support classes
Can excess credits cross over?	Extra Class A credits can count toward Class B	No

Class A credits (MAC Ed)

The NBCRNA MAC FAQ says MAC Ed credits must come from activities with prior approval from accredited organizations, giving the AANA, ANCC, and ACCME as examples. The activity must include an assessment and be relevant to nurse anesthesia practice.

The handbook explains the purpose of the assessment: it should validate the activity’s stated learning objectives and verify that learning occurred. A lecture you attend with no test afterward generally won’t qualify as Class A.

Class B credits (MAC Dev)

MAC Dev covers professional development, and it doesn’t require prior approval. You self-report these credits through the AANA CE Portal by entering the activity name, completion date, and credits, then uploading documentation.

The AANA notes that life support credits are capped at 20 per four-year cycle. It also says all 100 credits may be earned as Class A, since excess Class A credits can fill the Class B requirement.

What happened to core modules

Under the CPC program, CRNAs had to complete four Core Modules each cycle, one in each of these domains: airway management, applied clinical pharmacology, human physiology and pathophysiology, and anesthesia equipment, technology, and safety.

The NBCRNA has removed Core Modules as a requirement in the MAC program. The Core Modules page says most CRNAs still in CPC need at least one module from each domain before they move into MAC, so check your own status if you haven’t transitioned yet.

The MAC Check assessment

The MAC Check replaces the CPCA, and you can’t choose the CPCA instead. It’s an online, self-paced assessment delivered in quarters across the cycle.

You complete 13 MAC Check quarters within the 16 quarters of your four-year cycle.
Each quarter has up to 30 questions (25 in the first quarter), with a 60-second limit per question.
Quarter 16 is a fixed time-off quarter used to deliver final results, and you get two more time-off quarters to use during the first 15. You must elect time off before answering that quarter’s questions.
The MAC Check uses a performance standard, not pass/fail. You get a preliminary progress update after four quarters.
MAC Check questions don’t count toward your MAC Ed or MAC Dev credits.

If you don’t meet the performance standard, the NBCRNA assigns five additional Class A credits in the domain or domains where you fell short. Those remedial credits must be finished before your MAC compliance period ends, and the handbook warns that missing the deadline may result in loss of certification.

The modified MAC Check for 2026 and 2027 renewals

CRNAs due to renew between June 30, 2026, and December 31, 2027, take a modified MAC Check of up to five quarters, starting August 1, 2025. Time-off quarters aren’t available in this version, and the CPCA isn’t required. Renewal for this group requires at least 60 MAC Ed credits, up to 40 MAC Dev credits or excess MAC Ed credits, and participation in the modified MAC Check.

How AANA prior approval works

Prior approval means the course provider, not you, did the paperwork. In the AANA’s words, a prior-approved program is one where the provider has already completed the accreditation application and received approval for the meeting, workshop, seminar, or online course.

Providers of prior-approved programs also handle credit reporting. The AANA’s provider responsibilities document requires them to report MAC Ed credits through the AANA CE Portal within 30 days, and certificates must carry the AANA code number, its expiration date, and a prior approval statement.

If you take a course that isn’t prior approved, you can apply for non-prior approval yourself. The AANA charges an application fee per course, and review takes about 30 business days.

One practical note: the AANA maintains CE transcripts and submits them to the NBCRNA for Active Members only. Non-members can request a transcript, but the AANA says that transcript isn’t accepted by the NBCRNA for renewal.

Checking whether a course counts

Look for an AANA prior approval statement on the course materials or certificate, including the code number and expiration date.
Confirm the course includes an assessment, such as a post-test.
Make sure the content relates to nurse anesthesia practice.
After you finish, check your AANA CE transcript. If credits from a prior-approved course are missing after 30 days, the AANA asks you to contact continuingeducation@aana.com.

Audio-Digest Anesthesiology for Class A credit

Audio-Digest Anesthesiology programs are prior-approved by the AANA for Class A CE credits, which the NBCRNA now calls MAC Ed. Through Travel Medical Seminars, the anesthesiology short course gives CRNAs 5 Class A credits and the full course gives 10. The same courses are designated for AMA PRA Category 1 Credit™ for physicians (our AMA credit explainer covers how that works).

The courses are digital, so you study at your own pace and complete testing online. Check each program’s materials for its current approval details before you count the credits toward your cycle.

If you’re building out your 60 MAC Ed credits, the anesthesiology courses are a straightforward place to start, and you can browse all TMS courses if you want to add other specialties.

CRNA continuing education: MAC program requirements