Licensing

CRNA Recertification: How the NBCRNA MAC Program Works

How NBCRNA recertification works now: the MAC program replacing CPC, 60 Class A and 40 Class B credits, MAC Check, fees, and rules for 2026-2027 renewals.

Updated October 2026 · Reviewed by Nelson, CRNA · Checked against official sources

CRNAs recertify with NBCRNA every four years. The Maintaining Anesthesia Certification (MAC) program has replaced the older Continued Professional Certification (CPC) program. NBCRNA says all CRNAs will be enrolled in MAC by 2026.

Each four-year MAC cycle needs 60 Class A credits, 40 Class B credits and participation in MAC Check. If your credential renews in 2026 or 2027, you still finish your CPC renewal requirements first.

At a glance

Requirement What NBCRNA asks for
Cycle length Four years, with a two-year check-in
MAC Ed 60 Class A credits
MAC Dev 40 Class B credits
MAC Check Quarterly questions in at least 13 of 16 quarters
Licensure Current unrestricted RN license, with authority to practice nurse anesthesia where granted
Practice Engagement in nurse anesthesia practice in the four years before you apply
Fee $445 per four-year cycle
Core Modules No longer required under MAC

If you renew in 2026 or 2027

NBCRNA calls CPC its legacy program. CRNAs renewing in 2026 or 2027 must still complete CPC renewal requirements, even while enrolled in the Modified MAC Check program.

For those renewals, the required pieces are 60 MAC Ed credits and 40 MAC Dev credits. The MAC handbook says Modified MAC Check participation runs 2 to 5 quarters, depending on your expiration date.

NBCRNA emails you when your CPC renewal window opens, typically five months before your cycle ends. You join MAC after you complete your CPC cycle and renew. You cannot be in both programs at once.

Your personal timeline is in the NBCRNA portal. Check it now, since dates depend on when you were certified.

MAC Ed: 60 Class A credits

Class A credits come from continuing education with prior approval from AANA, ANCC or ACCME. Each activity must include an assessment and relate to nurse anesthesia practice.

Examples include online courses, webinars and workshops. Extra Class A credits beyond 60 count toward your Class B total.

NBCRNA has no internal appeal if it denies an activity as Class A. Choose activities clearly labeled as approved for Class A credit.

MAC Dev: 40 Class B credits

Class B credits come from professional development. They need no prior approval and no assessment.

Each activity must meet at least one aim: better anesthesia knowledge, patient safety, or understanding of the wider health care system. Examples include teaching, publishing, research, morbidity and mortality conferences, and mission trips.

You report details only if you are audited. Keep records as you go anyway, using NBCRNA's MAC Dev credits table.

MAC Check

MAC Check replaces the old CPC Assessment (CPCA). It is a longitudinal assessment: short sets of questions spread over your cycle, with feedback on each answer.

How it works

  • You answer 25 questions in your first quarter and up to 30 in later quarters.
  • Questions you missed come back in later quarters, up to five per quarter.
  • You can answer on a phone or computer and stop and resume within the quarter.
  • It covers four domains: airway management, applied clinical pharmacology, applied physiology and pathophysiology, and anesthesia equipment, technology and safety.

Time off quarters

You get three time off quarters in each four-year cycle. One is fixed in the final three months before your renewal date. You choose when to use the other two.

That leaves 13 quarters to complete. If you miss a quarter without choosing it as time off, NBCRNA assigns one of your time off quarters. Once those are used up, the missed questions are forfeited.

Is it pass/fail?

No. MAC Check has a performance standard, but missing it does not cost you your certification.

If you fall short in a domain, you must earn five extra Class A credits in each weak domain before your renewal date. Failing to complete that extra education, or failing to take part in MAC Check, can lead to loss of certification.

The two-year check-in

Midway through each four-year cycle, you complete a short online check-in. You validate your licensure, confirm you are still practicing, update contact details and review your progress.

Fees

NBCRNA charges $445 per four-year MAC cycle. That covers $160 for MAC Check access and a $285 renewal application fee, an average of $111 a year.

CE costs are separate and depend on the provider. NBCRNA says CE credit transfer comes with full AANA membership, and extra fees apply without it. Check the current fee schedule.

If you miss your deadline

If you do not finish requirements or apply by your deadline, you lose certification until you catch up. Costs rise the longer you wait:

Time after deadline Extra requirements (plus missing items and the application fee)
Up to 31 days No late fee
Day 32 to 60 $100 late fee
Day 61 to 182 5 extra Class A credits, prorated requirements, $100 late fee
Day 183 to 1 year 5 extra Class A credits, prorated requirements, $250 late fee
1 to 2 years 15 extra Class A credits, prorated requirements, $500 late fee
2 to 3 years 25 extra Class A credits, prorated requirements, $750 late fee
3 to 4 years 35 extra Class A credits, prorated requirements, $1,000 late fee

After more than four years, you must complete NBCRNA's Reentry Program. Losing certification can also affect your state APRN authority and facility privileges, so do not let it lapse.

Pain management (NSPM) holders

If you hold NBCRNA's Nonsurgical Pain Management credential (NSPM-C), maintenance is changing. From October 2026, you answer extra NSPM questions in your MAC Check dashboard. This replaces a point-in-time exam every eight years. See CRNA fellowships for new NSPM eligibility rules.

Tips to stay on track

  • Log in to the NBCRNA portal and note your renewal date and MAC start date.
  • Set a quarterly reminder for MAC Check.
  • Spread Class A credits over the cycle instead of cramming at the end.
  • Ask your employer for a CME allowance (see CRNA contract negotiation).
  • Keep your licenses current in every state where you hold one.

Certification is one part of staying credentialed. For licensing, NPI, DEA and privileges, see APRN credentialing.

FAQ

Is the CPC program over?

CPC is NBCRNA's legacy program, replaced by MAC. If you renew in 2026 or 2027, you still complete CPC renewal requirements first.

Do I still take the CPCA exam?

Not under MAC. MAC Check replaces the CPCA with quarterly questions. Check the portal for what your current cycle requires.

Do I still need Core Modules?

Not under MAC. NBCRNA removed Core Modules as a requirement.

Does a state board accept MAC?

NBCRNA says MAC meets APRN regulatory standards across all state boards of nursing. Check your own board's renewal rules too.

This page is general information. Always confirm your requirements and dates in the NBCRNA portal.

Sources

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