CRNA Job Contracts Explained: W-2 vs 1099 vs Locums

CRNA job offers often look similar on the surface, but the underlying contract structure can dramatically change compensation, taxes, benefits, risk, and long-term sustainability.

Understanding the difference between W-2 employment, 1099 independent contracting, and locums work is essential for nurse anesthetists evaluating job offers. Each model serves a purpose, but each comes with tradeoffs that are often misunderstood—especially early in a career.

This article breaks down how each contract type actually works in practice and what nurse anesthetists should consider before choosing a model.

What a CRNA Job Contract Really Defines

A job contract is more than a pay agreement. It defines:

• How you are paid
• How you are taxed
• Who carries liability and risk
• What benefits you receive
• How flexible your schedule is
• How easily you can change jobs

The contract model shapes your professional and financial life far more than base salary alone.

W-2 CRNA Jobs Explained

What W-2 Employment Means

In a W-2 role, the employer classifies the nurse anesthetist as an employee.

The employer typically:

• Withholds income and payroll taxes
• Provides benefits
• Sets work schedules and policies
• Carries malpractice insurance

This is the most common employment model for nurse anesthetists.

Typical Features of W-2 CRNA Jobs

W-2 positions often include:

• Predictable schedules
• Health, dental, and vision insurance
• Retirement plans with employer contributions
• Paid time off and CME allowances
• Employer-paid malpractice coverage

These roles are common in hospitals, large anesthesia groups, and health systems.

Advantages of W-2 Employment

• Financial predictability
• Lower administrative burden
• Built-in benefits
• Easier loan qualification
• Lower personal liability exposure

For many nurse anesthetists, especially new graduates, W-2 roles provide stability and structure.

Limitations of W-2 Employment

• Less tax flexibility
• Lower ceiling for net income compared to contracting
• Less control over scheduling
• Limited deduction opportunities

Higher gross pay is often offset by taxes and reduced autonomy.

1099 CRNA Jobs Explained

What 1099 Contracting Means

In a 1099 role, the nurse anesthetist is classified as an independent contractor rather than an employee.

The contractor:

• Is paid gross compensation
• Handles their own taxes
• Provides their own benefits
• Carries their own malpractice insurance

This model is often associated with higher hourly or daily rates.

Typical Features of 1099 CRNA Jobs

1099 roles often include:

• Higher advertised compensation
• Flexible schedules
• Fewer employer-imposed policies
• Greater autonomy over work structure

These roles are common in independent practice settings, rural hospitals, and smaller anesthesia groups.

Advantages of 1099 Contracting

• Greater tax planning flexibility
• Potential for higher net income
• Ability to deduct business expenses
• Increased control over work arrangements

For experienced nurse anesthetists, 1099 contracting can significantly improve take-home pay when managed properly.

Risks and Limitations of 1099 Work

• No employer-provided benefits
• Self-employment tax responsibility
• Income variability
• Greater administrative complexity
• Increased personal responsibility for compliance

1099 work requires strong financial organization and planning.

Locums CRNA Work Explained

What Locums Work Means

Locums work refers to temporary or short-term assignments, often to fill staffing gaps.

Locums positions may be structured as:

• W-2 temporary employment, or
• 1099 independent contracting

The defining feature is temporary placement, not tax classification.

Typical Features of Locums CRNA Jobs

Locums roles often include:

• High daily or weekly pay rates
• Travel and housing coverage
• Short-term commitments
• Rapid onboarding

These roles are frequently used in rural hospitals, facilities with staffing shortages, or during transitions.

Advantages of Locums Work

• Very high short-term earning potential
• Schedule flexibility
• Opportunity to explore different practice settings
• Minimal long-term commitment

Locums work can be attractive for nurse anesthetists seeking variety or supplemental income.

Limitations of Locums Work

• Inconsistent income
• Limited continuity
• Frequent travel
• Variable support structures
• Less predictable scheduling

Locums work is often best suited for experienced clinicians comfortable with rapid adaptation.

Comparing W-2, 1099, and Locums Roles

Each model serves different priorities:

• W-2: Stability, benefits, predictability
• 1099: Autonomy, tax flexibility, higher income potential
• Locums: Flexibility, short-term income maximization

No model is inherently superior. The right choice depends on experience level, financial goals, and lifestyle preferences.

How Contract Choice Affects Taxes

Taxes are one of the largest differentiators between contract types.

• W-2 employees pay payroll taxes automatically
• 1099 contractors pay self-employment taxes but may deduct expenses
• Locums tax treatment depends on whether the role is W-2 or 1099

Gross pay alone is not an accurate measure of compensation.

Common Contract Mistakes CRNAs Make

Common pitfalls include:

• Choosing roles based only on headline pay
• Underestimating tax obligations
• Overlooking benefit replacement costs
• Ignoring non-compete clauses
• Failing to clarify malpractice coverage

Understanding contract structure prevents costly mistakes.

Which Contract Model Fits Different Career Stages

General patterns include:

• New graduates often benefit from W-2 roles
• Mid-career CRNAs may explore 1099 contracting
• Experienced CRNAs may use locums strategically

Career needs evolve, and contract choices can evolve with them.

What to Review Before Signing Any Contract

Before signing, nurse anesthetists should review:

• Tax classification
• Call and coverage expectations
• Malpractice coverage details
• Termination clauses
• Non-compete language

Contracts should be evaluated holistically, not emotionally.

Where This Information Comes From

The guidance in this article is based on:

• Common CRNA employment contracts
• Tax and employment classification standards
• Observed compensation structures across anesthesia groups
• Patterns reported by practicing nurse anesthetists

Wise CRNA emphasizes real-world contract implications, not simplified comparisons.

Final Thoughts

W-2, 1099, and locums CRNA jobs each serve a role in the anesthesia workforce. Understanding how these models affect compensation, taxes, benefits, and risk allows nurse anesthetists to choose roles that align with their current goals.

The best contract is not the one that pays the most on paper—it is the one that fits your career stage, financial plan, and lifestyle priorities.

Wise CRNA exists to help nurse anesthetists navigate these decisions with clarity and realism.