Certification Process Handbook.

Copyright © 2024 – 2026

National Commission for Certification of Anesthesiologist Assistants, Inc., All Rights Reserved

No part of this publication may be reproduced, transmitted, or stored in any form or by any means — electronic, mechanical, or otherwise (including but not limited to photocopying, photographing, scanning, recording, facsimile transmission) — without permission in writing from the National Commission for Certification of Anesthesiologist Assistants, Inc.

NCCAA Overview

The National Commission for Certification of Anesthesiologist Assistants (NCCAA) is a not-for-profit corporation organized under the laws of the state of Georgia. NCCAA certification provides assurances to the public that Certified Anesthesiologist Assistants (CAA) possess the knowledge, skills and competency to practice as CAAs.

While individual states provide the legal credential for the practice of anesthesiologist assistants, private voluntary certification with the NCCAA indicates compliance with the professional standards for practice as an anesthesiologist assistant. The certification credential for anesthesiologist assistants has been adopted by many health care facilities, practice groups and health systems as a requirement for practice. The certification credential for anesthesiologist assistants has also been recognized in state medical practice acts as well as state administrative rules and regulations.

NCCAA Mission

The mission of the NCCAA is to promote patient safety through certification programs which assess the knowledge, skills and competency of the anesthesiologist assistant and to instill lifelong learning through continuing education requirements.

History

In 1989, a group of five anesthesiologists, two anesthesiologist assistants and one member of the public formed the National Commission for Certification of Anesthesiologist Assistants (NCCAA). Anesthesiologist Assistants had been in practice for a couple of decades. The need for independent credentialing of anesthesiologist assistants was deemed important to:

• Ensure the public of the training, knowledge and skill of anesthesiologist assistants.
• Protect the anesthesiologist assistants in practice by developing and ensuring standards for practice as an anesthesiologist assistant.

Purpose

The purpose of the NCCAA is to ensure that CAAs have the necessary knowledge and skills to practice safely and effectively. In so doing, the NCCAA also protects the value of the CAA credential. The NCCAA is responsible for:

• Establishing and maintaining criteria for the earning of designation as a Certified Anesthesiologist Assistant, including requirements for initial a certification and continued certification.
• Adopting and confirming compliance of initial and continued certification eligibility requirements for certified anesthesiologist assistants.
• Formulating, adopting, and confirming compliance of the requirements for eligibility for admission to NCCAA-administered examinations or assessments including, but not limited to, the NCCAA Certification Exam (CERT) and the NCCAA Continued Demonstration of Qualifications (CDQ) Exam.
• Developing, administering, scoring, and analyzing the NCCAA examination to establish proficient applicants for the credential of Certified Anesthesiologist Assistant.
• Formulating, adopting, and administering NCCAA-created examinations or assessments to candidates who have met all requirements for examination or assessment and have been found eligible.

No national organization can expect to determine the specific procedures that any individual CAA is qualified to perform. Nor can any national organization adequately determine whether an individual CAA may have developed an impairment that could interfere with the proper administration of anesthesia. Ultimately, these judgments must be entrusted to the individual CAA, to those with whom they work, and those that provide state licensing for CAAs. The NCCAA seeks to protect the public’s interest by enacting a plan of certification and recertification on evidence of continued competence in providing anesthesia as indicated by participation in continuing medical education, substantiation of satisfactory performance, and undergoing periodic re-examination to confirm maintenance of current medical knowledge.

Structure

The NCCAA Board of Directors is composed of certified anesthesiologist assistants who hold the NCCAA issued credential of CAA, board certified physician anesthesiologists and representatives of the public.

Communications

Five mechanisms are available for communicating with the National Commission:

• Website: www.nccaa.org
• Email: [email protected]
• US Postal Service:

NCCAA
Box # 160
8459 US HWY 42

Florence, KY 41042

• Phone: 859-903-0089
• Direct Message through NCCAA Mobile Application

Change of Address

The NCCAA maintains on file the mailing address of each applicant/candidate/practitioner as they submit it via the practitioner portal of the NCCAA application. It is the responsibility of the applicant/candidate/practitioner to maintain accurate contact information, including address, email, and telephone number, with the NCCAA by use of the practitioner portal available on the NCCAA application.

The NCCAA will not make changes of address based on letterheads, return addresses on envelopes, plain text email requests, etc. The NCCAA will not be responsible for lost or missed communications due to failure by the applicant/candidate/ practitioner to update the NCCAA of a change of address or contact information.

Change of Name

NCCAA maintains on file the name of each applicant/candidate/practitioner as they submit it via the practitioner portal of the NCCAA application. The name on file is used for communications, verification of certification, entrance to testing center, and other documents. It is the responsibility of the applicant/ candidate/practitioner to maintain accurate name information with the NCCAA by use of the practitioner portal available on the NCCAA application.

A name change is a two-step process within the NCCAA application. Upon changing a name within the practitioner account, notification must be made via email to [email protected] before the change of name will appear on the certificate of certification.

The NCCAA will not make changes of names based on letterheads, return addresses on envelopes, plain text email requests et cetera. NCCAA will not be responsible for lost or missed communications due to failure by the applicant/candidate/ practitioner to update the NCCAA of a change of name or contact information.

Notification

Communication from the NCCAA via telephone, email or US postal service shall be considered valid notification. The NCCAA will not be responsible for loss of communications by the US Postal Service, facsimile, email, or electronic communication via the NCCAA application.

Confidentiality Policy

Any information or material that is received or generated by the NCCAA in connection with examinations, the certification of a candidate, the continued certification of a CAA, or any NCCAA review, disciplinary or appeal proceeding will be kept confidential and will not be released except where release is authorized by the individual or required by law. However, the following information may be disclosed:

• Name of the anesthesiologist assistant
• Educational program attended, dates of attendance, and completion date
• Certification eligibility status
• Initial certification date
• Certification status
• Reportable disciplinary actions

The NCCAA may use de-identified information from an application and any subsequent examination(s) for the purpose of statistical analysis.

The NCCAA shares CAA name, address and certification status with individual state boards of medicine and similar for licensing of CAAs. In addition, the NCCAA will disclose any information that may, in the opinion of the NCCAA, have an impact on patient safety to individual state boards of medicine and similar state boards responsible for CAA licensing.

Consent to Investigation

Submission of an application for certification or continued certification constitutes consent to investigation and verification by the NCCAA, or its designee, of the applicant’s:

• License status
• Reported activities completed to maintain or demonstrate certification
• Record of practice
• Other matters that may impact on the applicant’s compliance with the requirements for certification.

Investigation and/or verification may be conducted either on a random basis or if, at the sole discretion of the NCCAA, such investigation and/or verification is warranted by the facts presented by a specific situation. Failure to cooperate with an NCCAA investigation may result in denial, suspension, or revocation of NCCAA certification.

NCCAA Reporting Responsibility

The NCCAA may consider, investigate and evaluate any information which, in its judgment, may affect an individual’s compliance with initial certification or continued certification. Such information may also be referred to an appropriate outside body for further investigation. The NCCAA shall have no obligation to investigate the professional standing of any anesthesiologist assistant applying for certification or continued certification. Further, the NCCAA has no obligation to refer any information to an outside body.

Code of Conduct

CAAs and those in the process of certifying must protect the integrity and reputation of the certified credential offered by the NCCAA and the processes by which those credentials are earned, awarded and maintained. CAAs and those in the process of certifying:

• Shall not engage in deceptive behavior that violates the integrity of the NCCAA application process, examination process (including but not limited to unauthorized reproduction, distribution or sharing of exam content) or misrepresentation of themselves as holding the credential of Certified Anesthesiologist Assistant.
• Shall behave in a manner that is lawful, ethical and upholds acceptable standards of professional practice as a CAA.

Anesthesiologist Assistants who have earned the certified credential, CAAs, expressly agree to conduct themselves in accordance with the policies of the NCCAA. The NCCAA may, at its discretion:

• Deny or revoke a CAA’s eligibility for certification or continued certification permanently or for such time as may be determined by the NCCAA
• Issue a reportable letter of censure
• Issue a non-reportable letter of concern
• Take such other actions as may be deemed appropriate if it determines the CAA is in violation of NCCAA code of conduct or NCCAA policy.

The NCCAA will automatically deny, suspend or revoke a CAA’s certification or continued certification for any of the following reasons:

• Adjudication by a court or regulatory authority that the CAA is mentally or physically incompetent.
• Suspension or termination from participation in a federal health care program for reasons relating to the unsafe, unlawful or unethical anesthesiologist assistant practice.
• Conviction of or pleading no contest to a crime which, in the judgment of the NCCAA, relates to the CAA’s safe or ethical practice as an anesthesiologist assistant.
• Failure to maintain NCCAA compliance with respect to requirements for certification.
• Falsification of application materials, intentional misstatement of material fact or deliberate failure to provide relevant information on an NCCAA application, or to the NCAAA at any time, or assisting another person to do any of the above.
• Cheating or assisting another person to cheat on an NCCAA examination or assessment, or otherwise engaging in dishonest or other improper behavior at any time in connection with any NCCAA examination or requirement to gain and maintain NCCAA certification.
• Dishonest or deceptive behavior related to any NCAAA examination or assessment, database, or intellectual property, cheating on an examination or assessment administered by the NCAAA, inappropriate use of examination or assessment questions, or assisting another individual to engage in any such conduct.
• Unauthorized use of any NCCAA-certified credential or other health professional designation or false claim of certification or other professional designation.
• Documented evidence of retention, possession, copying, distribution, disclosure, discussion or receipt of any NCAAA examination or assessment question, in whole or in part, by written, electronic, oral or other form of communication, including but not limited to emailing, posting online or through social media application, copying or printing of electronic files, and reconstruction through memorization and/or dictation before, during or after an NCAAA examination or assessment.
• Violation of any NCCAA policy or failure to cooperate with an NCCAA investigation or audit.
• Any other conduct that, in the judgment of the NCCAA, calls into question the ability of the anesthesiologist assistant to serve patients in an honest, competent and professional manner.

Nonstandard Examination Administration (Accommodation)

The NCCAA complies with the Americans with Disabilities Act (ADA) and is committed to providing appropriate accommodations for exam candidates with documented physical or mental impairments that substantially limit one or more major life activities. The NCCAA may also approve and provide accommodations for exam candidates with documented medical conditions that may be temporary or are not covered by the ADA.

The NCCAA has established a process to consider requests from applicants that a Certifying Examination or a CDQ Examination be administered to them under nonstandard conditions because of medical, religious, or other reasons. The steps include:

1. Initiate the request by contacting the NCCAA at [email protected].
2. Provide clear legible copies of all supporting documentation for your request including documentation of prior exam accommodations.

Supporting Documentation Requirements:

Appropriate supporting documentation of a disability or qualifying temporary medical condition from a qualified medical professional must be submitted to the NCCAA. A qualified medical professional is defined as an individual with the education, training, and expertise to diagnose the reported disability. The relationship of the attesting professional to the individual must be that of a treating medical professional to a patient. there must be no familial, intimate, supervisory, or other close relationship between the qualified professional and the individual requesting the accommodation.

Further the documentation must:

• Be on letterhead, signed, dated, and include the name, title, and professional licensing credentials of the qualified medical professional providing the report.
• Contain contact information including address, telephone number and email address of each professional providing documentation.
• Include the date of assessment upon which each professional’s report is based and any relevant follow up dates.
• Include a detailed description of the medical, psychological, educational, and/or cognitive functioning tests that were conducted, the results of those tests, and a comprehensive interpretation of the results.
• Provide the name of the specific disability or medical condition and a description of the specific impact on daily life activities and day-to-day functional limitations to major life activities including a history of the impact of the disability on academic functioning if the disability is due to a learning disability or attention deficit/hyperactivity disorder.
• Indicate the specific examination accommodations that are recommended and how each will compensate for those limitations and reduce the impact of the identified limitations.
• After the NCCAA has received and reviewed the documentation, the applicant must comply with any additional requests for documentation of support including prior exam accommodations utilized by the applicant. If accommodation is approved, the NCCAA will provide the details of the accommodation and instructions for scheduling exam with Pearson.
• The NCCAA will notify the exam vendor of the accommodation and work with the applicant to complete the application and scheduling process.
  

The NCCAA must receive written notification of the requested special accommodations for examination administration and the rationale at the time of exam registration. The NCCAA reserves the right to request further information from the applicant’s physician, Program Director, or other persons concerning the reason and requirements for nonstandard conditions for examination administration. The NCCAA decision to accommodate a request that is not covered by the ADA remains at the sole discretion of the NCCAA.

CAA Credential

Each anesthesiologist assistant who fulfills the NCCAA requirements for certification may continue to use “CAA” after their name. The term stands for Certified Anesthesiologist Assistant.

Unauthorized use of any NCCAA credential or false claim of certification, may result in denial, suspension or revocation of certification.

CAA Verification

By applying to enter the certification process (via the Certifying Examination for Anesthesiologist Assistants) or to continue in the certification process via the CDQ Examination and registration of CME credit, the applicant agrees NCCAA may provide to those agencies, organizations, and other parties who shall so inquire information regarding that individual’s application status (including but not limited to approved, not approved, withdrawn) and certification status (including but not limited to certified or decertified).

Complete information regarding verification of certification is available on the NCCAA homepage of the website at www.nccaa.org and within the mobile app. The official certificate may be printed and shall act as the official proof of certification for all agencies, organizations and parties.

The NCCAA assumes each anesthesiologist assistant is aware of their certification status. The NCCAA will respond to all requests for verification of certification whether or not the anesthesiologist assistant is certified.

Appeal Process

The NCCAA will review and rule on a practitioner’s appeal of decertification. The appeal must be made in writing and must be received via email to [email protected] within 30 days of notification of decertification to the practitioner by the NCCAA. The written appeal must include a complete explanation of the basis for appealing the decertification. Should the NCCAA grant an appeal, administrative fees may apply.

Initial Certification Overview

The Certification Examination for Anesthesiologist Assistants is the entry point into the certification process for anesthesiologist assistants in the United States. The Certification Examination is designed to test entry-level cognitive and deductive skills of the anesthesiologist assistant. Eligibility to sit for the NCCAA Certification Exam includes graduation from an approved educational program and completion and documentation of NCCAA Standards of Clinical Experience. The process is outlined in detail within the NCCAA Certification Examination Handbook, available on the NCCAA website or within the NCCAA mobile application.

Continued Certification Process Overview

The ongoing certification process administered by the NCCAA involves:

1. Initial certification after successful completion of the Certifying Examination (CERT) for Anesthesiologist Assistants
2. Registration of credit for continuing medical education (CME) and successful completion of any applicable CME audits
3. Successful completion of Examination for Continued Demonstration of Qualifications (CDQ). The certification process operates on a continuous ten-year cycle following the 4-year check-in CDQ:
   

YEAR	CERTIFICATION REQUIREMENT
0	Successful Passing of the Certification Exam
1	No required submissions or examination
2	Successful CME Registration & Compliance with audit as applicable
3	No required submissions or examination
4	Successful Passing of the Continued Demonstration of Qualifications (CDQ) Exam and Successful CME Registration & Compliance with audit as applicable
5	No required submissions or Examination
6	Successful CME Registration & Compliance with audit, as applicable
7	No required submissions or Examination
8	Successful CME Registration & Compliance with audit, as applicable
9	No required submissions or Examination
10	Successful Passing of the Continued Demonstration of Qualifications Exam and Successful CME Registration & Compliance with audit as applicable
11,13,15,17,19	No required submissions or Examination
12,14,16,18	Successful CME Registration & Compliance with audit, as applicable
20	Successful Passing of the Continued Demonstration of Qualifications Exam and Successful CME Registration & Compliance with audit as applicable

*Repeat years 11-20 for 21-30

The NCCAA awards a time-limited certification to each practitioner who successfully completes the Certifying Examination and graduates from an NCCAA approved educational program. Each anesthesiologist assistant is able to maintain current certification by registering the required number and type of CME credits every two (2) years and successfully completing the CDQ examination in year 4 of certification, followed by year 10, 20, 30 and so on.

CDQ Examination

The Examination for Continued Demonstration of Qualifications of Anesthesiologist Assistants [CDQ Examination] is one component of the ongoing certification process for anesthesiologist assistants in the United States. The CDQ Examination is designed to test the knowledge and deductive skills necessary to meet the competencies of the practicing anesthesiologist assistant who has successfully entered and continues to participate in the certification process for anesthesiologist assistants administered by NCCAA.

Continuing Medical Education

Registration of CME credit is an ongoing part of the certification process. Any practitioner may have their CME submissions audited by the NCCAA at any time. Should an audit occur, compliance with the audit process is mandatory for continued certification. It is recommended that practitioners keep original records of CME credit earned in the event of an audit.

To maintain certification, an anesthesiologist assistant must keep CME registration current and up to date. If the practitioner has not registered 50 hours of CME credit with the required CME registration fee in full by the deadline of June 1st, in the given year registration is due, then that practitioner will no longer be listed as certified and shall be considered certification expired by the NCCAA.

The practitioner will have until August 31st of the CME registration year to register 50 hours of eligible CME credit and pay in full the CME registration fee as well as the administrative late fee to reactivate and maintain certification. If proper payment and registration of CMEs is not completed by August 31st of a CME registration year, the practitioner is officially decertified and can only re-establish certification by reapplying for certification.