As a 1099 CRNA, no employer withholds taxes for you. You pay income tax plus self-employment tax on your net earnings, and the IRS expects payment through the year via quarterly estimated payments.
This page covers the facts: the rates, the deadlines, what is commonly deductible, and the retirement plans that exist. It is general information, not tax advice; confirm your own numbers with a CPA.
Key points
- SE tax is 15.3 percent on most net earnings; you pay both halves.
- Quarterly estimates are due April, June, September, and January 15.
- Business expenses cut both income tax and SE tax.
- Solo 401(k) and SEP IRA allow much larger retirement contributions.
Self-employment tax
Employees split Social Security and Medicare taxes with their employer. Self-employed people pay both halves, called self-employment (SE) tax:
- 12.4 percent Social Security tax on net self-employment earnings up to the annual wage base: $184,500 for 2026 ($176,100 for 2025)
- 2.9 percent Medicare tax on all net self-employment earnings, no cap
- An extra 0.9 percent Additional Medicare Tax on earnings above $200,000 (single) or $250,000 (married filing jointly)
Combined, the headline rate is 15.3 percent, though it applies to 92.35 percent of your net self-employment income, and you deduct half of the SE tax when computing adjusted gross income. SE tax is calculated on Schedule SE with your Form 1040.
Because many 1099 CRNAs earn above the Social Security wage base, the marginal SE hit above $184,500 drops to the Medicare portions only. Run your own scenario in the 1099 vs W-2 calculator and the take-home pay calculator.
Quarterly estimated payments
The US tax system is pay as you go. With no withholding, you make estimated payments with Form 1040-ES (or online via IRS Direct Pay or an IRS online account). For a calendar-year taxpayer the due dates are:
| Period | Due date |
|---|---|
| January 1 to March 31 | April 15 |
| April 1 to May 31 | June 15 |
| June 1 to August 31 | September 15 |
| September 1 to December 31 | January 15 of the next year |
When a date falls on a weekend or holiday, the deadline moves to the next business day. Underpaying through the year triggers an underpayment penalty, generally avoided by paying at least 90 percent of the current year's tax or 100 percent of last year's tax (110 percent if your prior-year AGI was over $150,000). Check the current safe harbor rules on irs.gov.
Commonly deductible business expenses
Ordinary and necessary business expenses reduce the net earnings that both income tax and SE tax apply to. For 1099 CRNAs these commonly include:
- Malpractice insurance premiums
- Licenses, DEA registration, state licensure fees, and certification costs, including recertification fees
- Continuing education, required courses, and related travel
- Professional association dues
- Business travel, lodging, and the business-use portion of mileage for locum work away from your tax home
- Health insurance premiums for yourself and family (the self-employed health insurance deduction, subject to its rules)
- Business phone, equipment, scrubs or protective clothing not suitable for everyday wear, and billing or accounting software
- Retirement plan contributions (below)
- Half of your SE tax (automatic, calculated on the return)
Commuting to a regular local workplace is not deductible, and personal expenses never are. The line between a deductible travel assignment and a new tax home is one of the most audited areas for locums, so document assignments carefully.
Retirement plans that exist for the self-employed
These are the main options; contribution limits change yearly, so verify current figures on irs.gov:
- SEP IRA
- Solo 401(k), also called an individual 401(k)
- SIMPLE IRA
- Traditional and Roth IRAs
- Defined benefit and cash balance plans, for very high savers
Self-employed plans generally allow far larger annual contributions than an employee 401(k) alone, which is one of the real financial advantages of 1099 practice.
Entity choice affects taxes too
Many 1099 CRNAs operate as sole proprietors filing Schedule C. Some form an LLC or elect S corporation treatment, which changes how SE tax applies to part of the income. That decision has trade-offs and paperwork; see LLC or S corp for CRNAs.
One line that matters: confirm your specific situation, estimates, and entity choice with a CPA before acting. Rates, thresholds, and rules change every year.
Quick answers
How much should a 1099 CRNA set aside for taxes?
It depends on your total income, state, deductions, and filing status, so there is no universal percentage. Many self-employed professionals set aside a fixed share of each payment and true it up quarterly with a CPA's estimate.
Do I pay SE tax on gross or net income?
Net. SE tax applies to 92.35 percent of net self-employment earnings after business expenses.
What if I have both W-2 and 1099 income?
W-2 wages count first toward the Social Security wage base, which reduces the 12.4 percent portion of SE tax on your 1099 income. The Medicare portion still applies to everything.
Is the QBI deduction available to CRNAs?
The qualified business income deduction exists, but health care is a specified service trade or business, so the deduction phases out above income thresholds that change annually. Ask a CPA whether you qualify.