CAA Guide

Can CAAs practice in North Carolina?

Licensed

Yes — CAAs are licensed in North Carolina.

The North Carolina Medical Board has licensed CAAs since 2007 under G.S. 90-9.4 and 90-18.5. A pending 2025-26 bill (H480/S396) would add a licensure-by-endorsement fast path for AAs licensed 5+ years in another state with an NC job offer.

Legal authority
N.C. Gen. Stat. §§ 90-9.4, 90-18.5; 21 NCAC 32W
Effective
2007
Supervision
A licensed anesthesiologist actively engaged in clinical practice and immediately available on-site; base ratio one anesthesiologist to two AAs, and since Jan 1, 2010 the Board may allow up to four concurrent AAs.
Last verified
2026-08-12

Notes

G.S. 90-18.5 enacted by S.L. 2007-146 (title protection: only licensees or enrolled students may use the AA title). H480 text verified: endorsement requires 5+ years unrestricted licensure elsewhere, employer letter, clean 5-year record, and meeting G.S. 90-9.4/21 NCAC 32W requirements; endorsement fee cap $300, initial/annual AA fee cap rises to $200; would take effect Oct 1, 2025 but the bill was still parked in Senate Rules as of Aug 2026.

Active legislation

  • H480 Passed House 115-0; in Senate Committee on Rules and Operations

    Medical Board Licensing Efficiency Act (adds G.S. 90-12.2B licensure by endorsement for physicians, PAs, and anesthesiologist assistants; raises AA fee caps)

    Last action: Referred to Senate Rules and Operations, June 25, 2025

  • S396 In Senate Committee on Rules and Operations

    Medical Board Licensing Efficiency Act (Senate companion to H480)

    Last action: Referred to Senate Rules and Operations, March 25, 2025

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