W2 vs 1099 CRNA: The Basics of How to Build Wealth and Freedom as a CRNA
When I walked out of my last W2 CRNA shift, I had no idea just how much my life was about to change. After almost 10 years in nursing and one year as a CRNA, I made the leap into my first locum CRNA contract as a 1099 independent contractor.
Now, two months into my first assignment, I can say without hesitation: switching from W2 to 1099 was one of the best career moves I have ever made. It changed how I work, how I earn, how I plan for the future, and most importantly, how much time I get with my family.
This post will walk you through the key differences between W2 and 1099 as a CRNA, what I learned during my transition, and why being your own boss is one of the fastest paths to financial freedom and generational wealth.
Why I Left My W2 CRNA Job
On paper, my W2 position was “stable.” The salary was steady, my benefits were streamlined, and my schedule was predictable. But there were trade-offs I could no longer ignore:
My earning potential was capped by a salary scale (no matter how much overtime I worked).
My time off requests had to fit into an existing staffing puzzle.
My taxes and limits on accounts had strict limits.
I wanted more flexibility and more control. I wanted to choose when I worked, how much I worked, and how I used my income. That is when I started looking into locum CRNA opportunities and learning what it meant to work as a 1099 contractor.
W2 vs 1099 CRNA: The Basics
If you are a CRNA considering this shift, here is the simplest breakdown (think: 7th grade edition).
W2 CRNA (Employee):
Paid a set salary or hourly wage
Taxes automatically withheld
Employer provides benefits (health insurance, retirement match, paid time off)
Schedule set by employer
Limited deductions and less control over income
1099 CRNA (Independent Contractor):
Negotiate your own rate (often higher than W2 pay)
Responsible for your own taxes and benefits
Flexible scheduling based on contracts you choose
Ability to deduct business expenses
More control over income, schedule, and career growth
The Mindset Shift: From Employee to Business Owner
This was the biggest adjustment for me. As a W2 employee, everything is handled for you. Taxes are withheld automatically. Benefits are already chosen. Your role is to show up and do the work.
As a 1099 CRNA, you are running a business. You decide on your contracts, negotiate your pay, and set up your own systems for taxes, benefits, retirement, and budgeting.
In the months leading up to going full time as a 1099 CRNA, I remember sitting at my kitchen table, laptop open, rocking my 5-month-old while I compared health insurance options. It was overwhelming at first, but also incredibly empowering.
How to Set Up an LLC as a CRNA
If you are ready to move from W2 to 1099, one of the first steps is forming a Limited Liability Company (LLC). This creates a legal separation between you and your business, which is important for liability protection and tax purposes.
Some states require healthcare professionals, including CRNAs, to form a Professional Limited Liability Company (PLLC) instead of a standard LLC. This is usually just an extra licensing requirement to verify your professional credentials when you file, but the process is very similar. Check your state’s Secretary of State website or talk to a CPA before filing to make sure you are setting up the correct type of entity.
Here is the basic process:
Choose a Business Name
Check your state’s business registry to make sure it is available.
Keep it professional (for example, Your Name Anesthesia Services, PLLC if your state requires it).
File Articles of Organization
Submit your paperwork through your state’s Secretary of State website.
Pay the required filing fee (usually $50–$300 depending on the state).
If forming a PLLC, you may need to submit proof of your professional license.
Get an EIN (Employer Identification Number)
Apply online through the IRS website. It is free and instant.
You will need this to open a business bank account and file taxes.
Open a Business Bank Account
Keep your business income and expenses separate from your personal accounts.
This is crucial for both taxes and liability protection.
Consider an S-Corp Election
Once your LLC or PLLC is formed, talk to a CPA about electing S-Corp status for tax savings.
Not sure what S-corp is? Keep reading!
Stay Compliant
Renew your LLC/PLLC each year as required by your state.
Keep good records of your contracts, income, and expenses.
Setting up your LLC or PLLC is usually quick and straightforward, and it is the first step in running your CRNA career like a business.
Filing S-Corp as a CRNA
One of the first steps after I set up my LLC was considering filing S-Corporation status.
Here’s why this matters:
With an S-Corp, my business earns the income.
I pay myself a “reasonable salary” through payroll (just like a W2 job).
The rest of my earnings come as owner distributions, which are not subject to self-employment tax.
This setup can save thousands of dollars in taxes each year.
It also opens the door to higher retirement contributions through accounts like a Solo 401(k). Definitely work with a CPA who specializes in healthcare professionals!
Taking Control of Your CRNA Finances
Working as a 1099 CRNA means becoming your own HR department, payroll manager, and CFO. You are responsible for:
Taxes: Instead of automatic withholdings, you make quarterly estimated tax payments.
Benefits: You choose your own health, dental, vision, and life insurance.
Retirement: You decide how much to contribute and where to invest.
Budget: You create a plan so you set aside money for taxes, savings, and lifestyle without overspending.
Why 1099 CRNA Work Builds Generational Wealth
W2 CRNAs have a ceiling. Your pay is tied to your employer’s pay scale. Raises are incremental. Your retirement plan is whatever the employer offers.
As a 1099 CRNA:
You set your rates and can increase them as demand rises.
You decide when and how often you work.
You can invest in assets like real estate, index funds, or even other businesses.
You can keep more of what you earn through tax strategy and business deductions.
This is how you go from simply earning a living to building long-term wealth. For me, the biggest motivator is knowing I am creating flexibility and security for my family, not just for today but for decades ahead.
The Freedom of Time and Money
One of the most immediate changes I felt was in my schedule. I now have the ability to plan time off without asking permission. I can choose contracts that allow me to work fewer weeks in a row and still meet my income goals.
Financially, I am earning more per hour than I did as a W2 CRNA, and because of my S-Corp structure, I am keeping more of it. That combination of time and financial freedom is exactly why I made the switch.
Is 1099 CRNA Work for Everyone?
No, and that is okay! If you value stability and want someone else to handle the administrative side of your career, a W2 position may be a better fit and there is absolutely nothing wrong with that!
But if you are ready to learn new systems, take ownership of your finances, and think like a business owner, 1099 can completely transform your life and career. Don’t the idea of being a business owner intimidate you into a life that you want MORE from.
1099 Takeaway
The hardest part of becoming a 1099 CRNA is the beginning. The learning curve is steep. But once you have your systems in place, you gain something priceless: control.
Control over your money.
Control over your time.
Control over your future.
For me, that control has been worth every bit of the transition. If you are a CRNA considering the leap from W2 to 1099, my advice is simple: start learning, find the right guidance, and do it. The freedom and financial potential on the other side are worth it.
