For his second edition, NACNS President Rick Bassett discusses the CNS certification process, advice for finding a CNS program, and more.
1. What are the national CNS certification options for an experienced CNS, nationally board-certified in a specialty (CWOCN), and practicing since 1989? This question is in regards to Medicare billing as a CNS. Medicare will only allow billing by a CNS if they are ANCC certified.
This is a great question that needs some additional context in order to provide a clear answer. In most states, the title CNS is title-protected, which means you are academically trained, certified, and licensed as a Clinical Nurse Specialist before you can use the title CNS. With regard to Medicare billing, while they do mention ANCC, the American Association of Critical-Care Nurses (AACN) Certification Corporation also offers Clinical Nurse Specialist certifications, and my understanding is that those would be acceptable as well. It would be best to check with your local Medicare Administrative Contractor (MAC) to confirm which ANCC and AACN CNS certifications are accepted. Unfortunately, your CWOCN is not an Advanced Practice Registered Nurse certification, and my understanding is that it is not listed among Medicare’s recognized certification bodies.
To become a Clinical Nurse Specialist (CNS), you must apply to and complete a Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP), or a post-graduate CNS program. After completing the educational requirements, you must pass a certification exam administered by either the ANCC or AACN, and then obtain CNS licensure in your state.
2. I’m trying to find a CNS program that would allow me to practice in the hospital setting, not gerontology. Do you have any suggestions?
NACNS offers a valuable resource called the CNS Program Directory, which helps prospective Clinical Nurse Specialists identify programs by population focus, delivery format, and location. If you are seeking certification in Adult-Gerontology, it is important to note that gerontology content is required to sit for the certification exam. This requirement applies to both the ANCC and AACN certification pathways.
Currently, there are three population-specific CNS certifications available through AACN Certification Corporation:
ACCNS-Adult-Gerontology
ACCNS-Pediatric
ACCNS-Neonatal
The ANCC offers the Adult-Gerontology CNS (AGCNS-BC) certification.
If your interest lies in Pediatric or Neonatal CNS practice, you may pursue programs that focus exclusively on those populations. These certifications do not require gerontology content, and graduates are eligible to practice in hospital settings without it.
3. I have been an RN for 20 years, but 99% of my work experience is in ambulatory care. In fact, I am a Certified Ambulatory Care nurse. I am interested in becoming a CNS, but I wonder if my lack of hospital experience would be an issue?
Congratulations on your 20 years of nursing experience and on earning your Ambulatory Care Nurse certification. It is exciting that you are considering becoming a Clinical Nurse Specialist. CNSs across the country specialize in ambulatory care, and your background positions you well for this path.
During your academic preparation, you will be required to complete clinical experiences in a variety of settings, which may include both clinics and hospitals. However, you can work with your program to focus the majority of your clinical hours in ambulatory care environments, aligning with your intended area of practice. This is a conversation you should have with the Program Director of the CNS program you are considering.
Importantly, a lack of hospital experience does not disqualify you from becoming a CNS. Your expertise in ambulatory care is valuable and can be leveraged throughout your education and future practice.
4. The University of Colorado has paused enrollment in its Adult-Gerontology CNS program with the Spring 2025 semester. I am wondering if the decision is related to a possible lack of interest in or knowledge about what a CNS can do, or a lack of CNS jobs in my state. Any thoughts?
Thank you for sharing this update. The University of Colorado’s decision to pause enrollment in its Adult-Gerontology Clinical Nurse Specialist (CNS) program beginning Spring 2025 appears to be part of a broader strategic adjustment rather than a reflection of the CNS role’s value or viability. While the university has not publicly cited a specific reason, such pauses often relate to internal factors such as faculty availability, curriculum restructuring, or shifting institutional priorities.
Nationally, the CNS role remains strong and continues to demonstrate its value across healthcare settings. According to the NACNS 2022 CNS Census, there is a growing demand for CNSs, particularly as nearly 30 percent of the current workforce plans to retire within five years. This underscores the need for succession planning and expanded educational pathways. While exact employment figures for CNSs in Colorado are not publicly available through NACNS or the Bureau of Labor Statistics, the census highlights a nationwide need for CNSs, suggesting that states like Colorado with robust healthcare systems are likely to reflect similar trends in demand.
However, awareness of the CNS role can vary by region and institution. Some healthcare leaders may lack a complete understanding of the CNS’s contributions, particularly in areas like quality improvement, clinical education, and systems leadership. This can influence hiring practices and program support.
5. I am currently pursuing an MSN degree in Nurse Executive Leadership. What is the next step to become a CNS?
Once you have completed your MSN degree in Nurse Executive Leadership, you will want to seek information on a Post-Graduate Certificate Clinical Nurse Specialist program. Please check out this resource, CNS Program Directory on the NACNS website, as there are several options across the nation.
6. I have a CNS title but not a license. What is the process to obtain one in my situation?
Thank you for your question. If you currently hold the title of Clinical Nurse Specialist (CNS) but are not licensed. It is important to clarify your status and ensure you are practicing within the legal and professional boundaries of your state. The title “Clinical Nurse Specialist” is protected in many states, meaning it may only be used by individuals who have completed the required education, obtained national certification, and are licensed by their state board of nursing.
Using the CNS title without meeting these requirements can be misleading and may violate state regulations. I encourage you to verify whether your state enforces title protection for CNSs. If you are unsure, contacting your state board of nursing is a good first step.
To move forward toward licensure, you will need to:
- Complete a CNS-specific graduate program: either a master’s, DNP, or post-master’s certificate focused on your chosen population.
- Earn national certification through an accredited body such as the ANCC or AACN.
- Apply for licensure as a CNS through your state’s board of nursing.
The NACNS CNS Program Directory is an excellent resource to help you identify programs that meet these requirements and align with your goals. This guide will help you complete the necessary academic preparation to become certified and licensed to practice as a CNS.