COAAA — Hire a CAA

Bringing CAAs into your anesthesia care team

Colorado created the anesthesiologist assistant license in 2012, and licensing began in July 2013. This page covers what a CAA is, what Colorado law requires of a supervising anesthesiologist, how the work is billed, and the steps to bring CAAs into your department.

What a CAA brings to the department

CAAs are advanced practice providers who work under the direction of a licensed anesthesiologist to develop and implement anesthesia care plans. They practice exclusively within the Anesthesia Care Team.

Trained for the anesthetic

A CAA completes a premedical education and a master's degree from an accredited anesthesia program, typically 24 to 28 months. Training is extensive in the delivery and maintenance of quality anesthesia care, advanced patient monitoring techniques, life support systems and patient assessment.

Built for the care team

CAAs are dedicated to the Anesthesia Care Team concept as defined by the American Society of Anesthesiologists, and work exclusively within that environment. Delegation stays at the discretion of the anesthesiologist, within Colorado regulation and your own credentialing rules.

Certified and recertified

Certification is granted by the National Commission for Certification of Anesthesiologist Assistants, whose examination is administered with the National Board of Medical Examiners. The certificate is time limited: 50 hours of continuing medical education registered every two years, and the Continued Demonstration of Qualifications examination in year four after initial certification, then every ten years.

The COAAA strongly supports the Anesthesia Care Team approach in anesthesia management. We believe the interests of patient safety are best served with an anesthesiologist's involvement in the delivery of every anesthetic, and that anesthesiologists are most qualified in making anesthesia related perioperative medical decisions. Delegation of anesthesia care to CAAs is at the discretion of the anesthesiologist, in accordance with established state regulations and local credentialing guidelines.

COAAA position on the Anesthesia Care Team

What the law here requires

Colorado licenses anesthesiologist assistants through the Colorado Medical Board. The points below are the ones that most often decide how a department is staffed.

Licensed since
House Bill 12-1332, Concerning Licensure of Anesthesiologist Assistants, was approved by Governor Hickenlooper on 29 May 2012. The licensing provisions took effect 1 July 2013. Colorado Session Laws 2012, chapter 238; license now at C.R.S. 12-240-112
Who may supervise
A CAA performs delegated medical tasks only under the direct supervision of a physician licensed in Colorado who practices as an anesthesiologist. The patient, or the patient's representative, must be advised if a CAA is involved in the patient's care. C.R.S. 12-240-107
Supervision ratio
No physician may concurrently supervise more than four specific, individual anesthesiologist assistants at any one time. The statute set the limit at three and allowed the board to raise it to four from 1 July 2016, which the board has done by rule. 3 CCR 713-1.16, effective 15 July 2026; C.R.S. 12-240-107
Immediate availability
The supervising physician must remain immediately available throughout the anesthesia service, meaning positioned near enough to return and re-establish direct contact with the patient in order to meet medical needs. 3 CCR 713-1.16
Oversight duties
Once a CAA enters a physician order in the record, the supervising physician must review it, and cosign it in a timely manner where facility or institutional policy requires. The facility must also provide an annual performance review covering medical competency, chart review, history and examination ability, and performance records. 3 CCR 713-1.16
Scope limits
A CAA may not independently write or issue a prescription order for any drug or controlled substance, and may not issue or communicate such an order outside the hospital, facility, ambulatory surgery center or office setting reported. Identification worn while performing medical services must clearly display the term Anesthesiologist Assistant. 3 CCR 713-1.16

How the work is billed

Anesthesia delivered by a CAA within the care team is reported to Medicare with the medical direction modifiers below. Because CAAs practice under the direction of an anesthesiologist, every case is billed as medically directed.

QKMedical direction of two, three or four concurrent anesthesia procedures involving qualified individuals. Reported by the anesthesiologist.
QXQualified nonphysician anesthetist service with medical direction by a physician. This is the modifier the CAA reports.
QYMedical direction of one qualified nonphysician anesthetist by an anesthesiologist. Reported by the anesthesiologist in a one to one room.
ADMedical supervision by a physician of more than four concurrent anesthesia procedures. Colorado caps CAA supervision at four, so this should not arise with a CAA-only team.

Descriptors above follow the American Society of Anesthesiologists, citing the Medicare Claims Processing Manual, chapter 12. Commercial payer policies vary, so confirm the specifics with your billing office before you model the economics.

How to bring CAAs on board

Confirm the license

Verify the candidate's Colorado anesthesiologist assistant license through the Division of Professions and Occupations.

Set the supervision model

Decide your concurrency and coverage plan within the four-to-one limit, and name the supervising anesthesiologists.

Credential and onboard

Work the candidate through your medical staff office using the integration guide below, which covers privileging and documentation.

Ask us

COAAA can help with credentialing questions and with reaching CAAs looking for work in Colorado. Contact us.

Hiring CAAs in Colorado?

We can help with credentialing questions, supervision planning, and putting your posting in front of CAAs practicing here.

Contact COAAA

This page is general information for employers, not legal or billing advice. Confirm current requirements with the Colorado Medical Board and your own counsel and billing office. Sources: Colorado Medical Board rule 3 CCR 713-1.16, version effective 15 July 2026; C.R.S. 12-240-107 and 12-240-112; Colorado House Bill 12-1332 as enrolled; National Commission for Certification of Anesthesiologist Assistants; American Academy of Anesthesiologist Assistants; American Society of Anesthesiologists, Anesthesia Payment Basics, codes and modifiers. Accessed 18 September 2026.

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