Tax Planning for CRNAs Who Work in Multiple States

As a CRNA, you have the unique ability to work where you want, when you want. That flexibility can lead to higher income, exciting new opportunities, and the chance to experience different practice settings. But if you’re working in multiple states, there’s one thing you can’t ignore: tax complexity.

Whether you’re a 1099 independent contractor, a travel CRNA, or even a PRN provider picking up shifts across state lines, multi-state work can trigger additional tax filings, potential double taxation, and confusion about where you truly “owe” taxes.

At CBFC, we work with CRNAs who live in one state, work in others, and sometimes change work locations multiple times a year. Here’s what you need to know about multi-state tax planning—and how to keep your earnings working for you instead of the IRS.

1. Understanding State Tax Residency

The first thing to know is that you have a home state—the place you officially reside, own or rent a home, register your vehicle, and have your driver’s license. This is your domicile.

Even if you work in other states, your home state typically:

• Taxes you on all income earned, regardless of where it was earned.

• May offer a credit for taxes paid to other states (to avoid double taxation).

If your home state has no income tax (like Texas, Florida, or Washington), you’ll only owe income tax to the states where you actually worked.

2. Nonresident State Taxes

When you work in a state where you’re not a resident, that state may require you to:

• File a nonresident tax return.

• Pay state income tax only on the earnings you made within that state.

Example: You live in Oklahoma but take a 13-week travel CRNA contract in Colorado. Colorado will want its share of the income you earned there—regardless of your Oklahoma residency.

3. Avoiding Double Taxation

If you live in a state with income tax and work in another state that also has income tax, you could owe taxes to both—unless your home state offers a reciprocal agreement or tax credit.

Reciprocal agreements: Some states have agreements that allow you to pay taxes only in your home state (common in certain regions).

Tax credits: If there’s no reciprocal agreement, your home state may give you a credit for taxes paid to another state, reducing your overall liability.

4. Multi-State Work for 1099 CRNAs

If you’re a 1099 CRNA working in multiple states, the complexity increases:

• You may need business registrations in certain states.

• You’ll owe self-employment tax to the IRS, plus state income tax where applicable.

• Tracking deductions by state is critical for accurate reporting.

For example, travel expenses, licensing fees, and CME courses may need to be allocated based on where the work occurred.

5. Why Tax Planning Matters for Multi-State CRNAs

Without planning ahead, you could:

• Miss filing requirements in certain states (triggering penalties).

• Overpay due to double taxation.

• Underpay and face an unexpected tax bill in April.

The goal is to map your contracts, residency, and tax requirements before the year starts—so you can set aside the right amount for each state and avoid surprises.

6. CBFC’s Multi-State Tax Planning Checklist for CRNAs

Here’s how we help clients stay ahead:

✔ Identify Residency & Domicile
We clarify where you are officially a resident and which states you’ll need to file in.

✔ Track Income by State
We recommend keeping a simple spreadsheet or using accounting software to log:

• Contract dates

• Location

• Gross earnings per location

✔ Adjust Quarterly Tax Payments
We calculate your estimated taxes for each state and adjust quarterly payments to match your actual earnings distribution.

✔ Maximize Deductions
We track deductions like travel, licensing, and housing stipends, ensuring they’re allocated properly for state tax purposes.

✔ File Strategically
We prepare or coordinate multi-state returns to ensure credits are applied correctly and no income is taxed twice.

7. Special Considerations for Travel CRNAs

Travel CRNAs often:

• Work in multiple states in the same year.

• Receive tax-free stipends for housing and meals.

• Need multiple state licenses (which are deductible business expenses).

If you’re on a travel assignment, proper tax home designation is critical. If the IRS doesn’t recognize your tax home, your stipends could become taxable—significantly increasing your tax bill.

8. The CBFC Advantage

While many accountants handle multi-state filings, not all understand the unique nature of CRNA work:

• Variable, high income

• Short-term contracts

• Frequent location changes

• Complex deductions

We specialize in building custom tax plans for CRNAs that keep your tax liability as low as legally possible, no matter how many states you work in.

Final Thoughts

Working in multiple states can be exciting, lucrative, and professionally rewarding—but it requires careful tax planning. By tracking your earnings, understanding residency rules, and filing correctly, you can avoid penalties, prevent double taxation, and keep more of what you earn.

If you’re a CRNA working in multiple states, now is the time to get ahead of your taxes—not in April, when it’s too late to make changes.

Schedule a consultation with CBFC and let’s build a multi-state tax strategy that works as hard as you do.