Nonsurgical Pain Management Examination

In response to the ongoing challenges faced by many nurse anesthetists practicing nonsurgical pain management (NSPM), the NBCRNA established a voluntary subspecialty certification program for nurse anesthetists in Nonsurgical Pain Management (NSPM-C) in 2014. This program evaluates the knowledge, skills, and abilities of NBCRNA-certified registered nurse anesthetists for practice in the NSPM field. It requires advanced, subspecialty knowledge beyond the initial certification requirements. 

Currently certified nurse anesthetists who meet specific criteria are eligible to apply for NSPM certification. The initial NSPM exam is a computer-based assessment consisting of 200 questions. The total time allotted for the initial exam is 240 minutes, and it is offered annually at test centers in the United States. It’s important to note that this certification is time-limited and requires renewal. 

Individuals who meet the criteria for the NSPM subspecialty certification and wish to pursue the initial certification can apply to take the exam during the specified dates below. 

 

Application Windows for Initial NSPM Exam – 2026

If you are planning to take the initial NSPM Examination, contact NBCRNA at support@nbcrna.com or (855) 285-7762 to have an application activated.

Applications for Exam AcceptedTest Dates
3/9/2026-9/17/20269/21/2026-10/30/2026

Starting in October 2026, the ongoing maintenance of the NSPM-C will transition into a longitudinal assessment (MAC Check) format. Instead of taking a point-in-time assessment every eight years, CRNAs who hold the NSPM-C will be required to answer additional NSPM-related quarterly knowledge check questions within their MAC Check dashboard. NBCRNA will provide personalized transition details to eligible CRNAs. Additionally, after October 2026, Core Modules will no longer be required. 


Important Note: To maintain uniformity in the standards for initial certification, starting January 1, 2027, CRNAs who are seeking to obtain the initial NSPM subspecialty certification will need to complete a COA accredited post-masters Pain Management Fellowship currently offered at Texas Christian University (TCU) or University of South Florida (USF) as part of the education requirements for the NSPM Program. As new fellowship programs gain accreditation from the COA, they will also fulfill the eligibility requirement for NSPM certification.


NSPM Eligibility Rationale

  • CRNA certification and applicable continued certification compliance establish the foundational credential.
  • Unrestricted licensure addresses authority to practice.
  • Two years of clinical nurse anesthesia experience and active practice provide a clinical foundation for advanced subspecialty education and judgment.
  • Fellowship education and references provide evidence of focused preparation and observed clinical performance.
  • Attestations support professional accountability and accurate reporting.
  • The NSPM examination assesses subspecialty knowledge identified through practice analysis.

 

NSPM Certification Rationale

NBCRNA uses a four-year continued certification period to balance regular verification of continued qualifications and subspecialty knowledge with sufficient time for repeated assessment, learning, application of feedback, and remediation as pain management practice evolves. Quarterly NSPM MAC Check participation supports learning throughout the period, and renewal requires review of continued eligibility and completion of program requirements. Alignment with the MAC cycle coordinates review of primary and subspecialty credentials while retaining distinct NSPM practice and assessment requirements. This interval supports continuing competence, lifelong learning, and patient safety.

 

Total Number of NSPM Certificants

NBCRNA NSPM Credential Holders Dec 2025

 

The NBCRNA’s NSPM-C credential program is accredited by both the National Commission for Certifying Agencies (NCCA) and the Accreditation Board for Specialty Nursing Certification (ABSNC).