The MAC program comprises three main components: 

• MAC Ed (60 Class A Credits): Continuing education through online courses and workshops. 

• MAC Dev (40 Class B Credits): Development through professional activities. 

• MAC Check (replaces CPCA): Solidifying core knowledge through a self-paced, dynamic platform. 

As part of the enhancements with the MAC program, we are simplifying the fee schedule to ensure a consistent cost every four years and provide a streamlined path for maintaining the CRNA credential.  

CRNAs will pay a one-time, upfront fee of $445 when submitting the renewal application for the four-year certification cycle. This means no unexpected charges and an average yearly cost of $111. Although this is a $28 increase in renewal application and assessment costs over the four-year cycle, CRNAs will save $300 on average with the removal of the Core Modules requirement from the MAC Program.  

Click here for more details.  

CRNAs must complete their current CPC program cycle requirements before entering the MAC program. MAC begins August 1, 2024, for the following CRNAs:   

• CRNAs in their second cycle with a certification renewal deadline of July 31, 2024.  

• CRNAs in their first cycle who have renewed their certification between January 2024 and July 2024.  

• CRNAs who have passed the NCE and are newly certified between January 2024 and July 2024.  

CRNAs that do not fall within those dates will continue in the current program—completing your current continued certification cycle requirements—and will start MAC at a later date.  

NBCRNA will message you individually through your preferred email about requirements and timelines throughout the transition. Learn more about your personalized timing within the NBCRNA Portal and click on CPC Timeline.  

Adhering to the MAC Program requires completing knowledge checks for each quarter by the designated due date. If you're unable to answer a quarter's questions before the deadline and haven't chosen it as time off, please contact NBCRNA Support as soon as possible to discuss your options.  

We understand that unforeseen circumstances may arise. Contacting NBCRNA allows you to explain the reason for missing the deadline and explore potential solutions on a case-by-case basis. NBCRNA will advise you on the best course of action based on your specific circumstances.  

It's important to note that consistently missing quarters can negatively impact your performance and potentially jeopardize meeting MAC Program requirement for certification renewal.  

More information can be found in the MAC Program Handbook. 

No, you do not need to use external resources while answering questions. MAC Check is designed to assess your independent knowledge and critical thinking as a CRNA. Using external resources during the quarterly knowledge checks undermines this goal. 

A research study conducted by NBCRNA in 2019 found that using external resources during assessments did not improve performance. In fact, the use of external resources resulted in CRNAs spending more time on each question just to confirm an answer and demonstrated that it had minimal impact on a CRNA's ability to meet the performance standard on the CPCA. This confirms that CRNAs possess the mastery of the knowledge necessary for practice in nurse anesthesia. 

Therefore, trust your knowledge base! MAC Check emphasizes a CRNA's ability to think critically and draw upon their existing knowledge to answer the questions. This demonstrates your competency and preparedness as a qualified CRNA who can be trusted to provide care for patients and families. 

Yes! MAC Check offers flexibility by allowing you to take quarters off. This is called “time off” and no questions will be required.  

CRNAs will have three-time off quarters during their four-year cycle – one fixed time off quarter at the end of the cycle (quarter 16) and two CRNA-elected time off quarters that can be used at any time. You can elect two quarters as time off quarters anytime during the first 15 quarters of the four-year cycle at your discretion.

During the 16th quarter in the four-year cycle, you will be provided with your results and no questions are required. 

You can choose to elect time off for a quarter at any time during the four- year cycle.  The 16th quarter is a fixed time off quarter where you will be provided with your final results and no questions are required.  

However, you must elect to take time off for a specific quarter before you begin answering questions within that quarter.  

Taking time off can be a valuable way to manage your schedule at your discretion. You can elect time off from the MAC Check dashboard when you log-in under the Assessment Overview timeline by using the “Time Off” button. 

The decision to prepare or study for MAC Check in advance is ultimately yours, as it's designed to be flexible without the pressure of dedicated study sessions. Participating in the MAC Check itself offers a learning experience through provided feedback after each question. This feedback helps you identify areas where you excel, as well as areas where you might benefit from further review. 

MAC Check questions assess knowledge deemed essential for all CRNAs to demonstrate mastery in nurse anesthesia regardless of career trajectory. According to the longitudinal assessment research study, most participants reported spending zero hours per week studying compared to the traditional assessment format and found there was no significant difference in performance. 

However, if you prefer to study in advance of answering the quarterly knowledge checks, NBCRNA provides a bibliography list for CRNAs to utilize, with the sources used by item writers to support questions for MAC Check. 

No, directly participating in MAC Check does not award MAC Ed (Class A) credits, but it does empower you to identify the most impactful continuing education opportunities to enhance your knowledge as a CRNA. 

MAC Check is designed to be a valuable tool for identifying areas where you might benefit from continuing education opportunities. After each quarter, you'll receive immediate feedback on your performance. This feedback highlights areas where you answered correctly and identifies topics where you might need to strengthen your knowledge. 

By reviewing the feedback and referring to the specific content areas mentioned, you can identify relevant MAC Ed (Class A) continuing education courses that align with your learning needs. 

There are a few different types of questions you will need to answer: 

Multiple choice: These questions will ask you to select one response option. 

Multiple selection: These questions will ask you to select more than one response option. Please note that when selecting responses for questions that require more than one answer, you will need to unselect a response option if you want to change your answer. For example, if you select response options ‘A’ and ‘B’ for a multiple select question that requires two answers, you will need to unselect ‘B’ if you want to select ‘C’ instead. 

Images: These questions contain image content and will ask you to select an answer(s) based on looking at an image. Please consider whether your device screen size and resolution will be sufficient. 

Case scenario: These questions are based on a brief case scenario. Please read the scenario and answer the questions. 

Each CRNA in the MAC program will be required to participate in quarterly knowledge checks, which means answering up to 30 questions each quarter. CRNAs complete 25 multi-choice and multi-select questions in the first quarter, and in every subsequent quarter, CRNAs complete up to 30 questions. After each question, CRNAs receive immediate feedback, including supporting rationale for correct answers. CRNAs also are provided with information on improvement areas to consider as part of continuing education and professional development activities.  

Being available on mobile devices or personal computers, CRNAs can leave the assessment and come back at any time within a quarter and resume where they left off—as long as the assessment is completed within the designated three-month period.  

Answering questions in MAC Check supports adult learning principles through spaced repetition and self-assessment, which is why you may see questions that were administered in previous quarters.  

Starting in the second quarter, you may see up to 30 questions total: 25 new questions and up to five repeat questions. Repeat questions are administered to build a deeper understanding by revisiting topics, which reinforces memory of key concepts, and supports continuous learning in areas needing improvement.  

Results from the longitudinal assessment research study found that a CRNA’s performance improved when scoring the most recent responses on repeat questions previously answered incorrectly (NBCRNA, 2024). Therefore, your score on these repeat questions will be based on your most recent attempt, and not your initial incorrect answer. This provides an opportunity to improve your score by answering repeated questions correctly. Please note that there are some questions that are not eligible for retries such as case-based items. 

All questions are developed by CRNAs for CRNAs using a panel of item writers composed of active CRNAs who have been trained in best practices and industry standards established for item writing. 

MAC Check utilizes a comprehensive approach to knowledge assessment for CRNAs. This is to ensure their knowledge base stays relevant and up to date across all four core domains of nurse anesthesia practice. The topics identified in the content outline across all four core domains are determined by CRNAs through a professional practice analysis, which is conducted every five years or sooner. 

You will be asked the level of confidence in your responses after answering each question. Confidence ratings can be used as a filter to sort the rationales and references related to all questions you have previously answered in the review tab. For that reason, any question(s) that you rated highly confident but got incorrect will be prioritized and administered as a repeat question first.  

If a CRNA does not meet the performance standard in any core MAC Check domain, they must earn additional MAC Ed (Class A) credits prior to their next certification renewal.  

MAC Check is not pass/fail, and inability to meet the performance standard will not result in a loss of certification. However, completion of MAC Check is required as a part of your continued certification process.