How to Become an Audiologist in 2026: Complete Licensing Guide

Audiologists are doctoral-level healthcare professionals who diagnose, treat, and manage hearing and balance disorders. Across the 51 states we track, 51 require the Praxis Audiology exam, 0 require CCC-A certification from ASHA, and 36 are members of the Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC). The average initial licensing fee is $354.

This guide covers everything you need to know about becoming a licensed audiologist in 2026 -- from earning your Doctor of Audiology (Au.D.) degree and passing the Praxis exam to obtaining CCC-A certification, hearing aid dispensing privileges, and state-specific licensure.

What Does an Audiologist Do?

Audiologists are healthcare specialists who evaluate, diagnose, and treat hearing, balance, and related disorders. They work with patients of all ages, from newborns to older adults. Their core responsibilities include:

• Hearing evaluations: Conducting comprehensive audiological assessments using pure-tone audiometry, speech audiometry, otoacoustic emissions (OAE), and auditory brainstem response (ABR) testing
• Hearing aid fitting and dispensing: Selecting, fitting, programming, and verifying hearing aids and assistive listening devices
• Cochlear implant programming: Mapping and adjusting cochlear implant processors for optimal hearing outcomes
• Balance and vestibular assessment: Diagnosing and treating dizziness, vertigo, and balance disorders using videonystagmography (VNG) and other tests
• Tinnitus management: Evaluating and treating tinnitus (ringing in the ears) through counseling, sound therapy, and hearing aids
• Newborn hearing screening: Performing early hearing detection screenings in hospitals and following up on failed screenings
• Cerumen management: Removing earwax that blocks the ear canal or interferes with hearing aid use
• Aural rehabilitation: Teaching communication strategies and providing counseling to patients and families adjusting to hearing loss

Audiologists practice in hospitals, private clinics, ENT offices, universities, schools, VA medical centers, hearing aid manufacturers, and corporate hearing conservation programs. The profession requires a doctoral degree (Au.D.) and state licensure, making it one of the more rigorous healthcare paths.

Doctor of Audiology (Au.D.) Programs

All states require audiologists to hold a Doctor of Audiology (Au.D.) degree from a program accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), which is part of the American Speech-Language-Hearing Association (ASHA). Key details about Au.D. programs:

What You Learn in an Au.D. Program

• Anatomy and physiology: Auditory and vestibular system anatomy, neural pathways, and physiology of hearing
• Diagnostics: Audiometric testing, immittance measures, electrophysiology (ABR, OAE), and vestibular evaluation
• Amplification: Hearing aid technology, selection, fitting, verification, and validation techniques
• Cochlear implants: Candidacy evaluation, surgical considerations, programming, and long-term management
• Pediatric audiology: Assessment and management of hearing loss in infants, children, and adolescents
• Counseling: Patient and family counseling for hearing loss, tinnitus, and communication difficulties
• Practice management: Clinic operations, billing, coding, ethics, and professional issues
• Research methods: Evidence-based practice, research design, and critical evaluation of audiology literature

There are approximately 80 CAA-accredited Au.D. programs in the United States. Programs are competitive, with applicants typically needing a GPA of 3.0 or higher in prerequisite courses. Prerequisites typically include anatomy, physiology, physics, statistics, and an introduction to communication sciences and disorders.

The Praxis Audiology Exam

The Praxis Examination in Audiology (Test Code 5343) is administered by the Educational Testing Service (ETS) and is the primary national exam for audiologists. Currently, 51 of 51 states require a passing Praxis score for licensure. Key details:

• Format: Computer-delivered, 120 selected-response (multiple-choice) questions covering foundations of practice, prevention and identification, assessment, and intervention
• Duration: 2 hours and 30 minutes
• Passing score: 162 out of 200 (set by ASHA for CCC-A certification; some states may set their own passing scores)
• Fee: Approximately $120-$160
• Availability: Offered year-round at Prometric testing centers nationwide
• Retake policy: Can be retaken after 21 days; no limit on the number of attempts

The Praxis covers four main content areas: foundations of audiology practice (including anatomy, pathology, and psychoacoustics), prevention and screening, assessment and diagnosis, and treatment and management. Most Au.D. programs prepare students thoroughly for this exam, and pass rates are generally high.

CCC-A Certification from ASHA

The Certificate of Clinical Competence in Audiology (CCC-A) is a voluntary national credential issued by the American Speech-Language-Hearing Association (ASHA). While it is technically voluntary at the national level, 0 of 51 states require it (or accept it in lieu of other requirements) for licensure. Requirements for the CCC-A include:

1. Earn an Au.D. or doctoral degree from a CAA-accredited program
2. Complete a minimum of 1,820 hours of supervised clinical experience as part of your Au.D. program
3. Pass the Praxis Audiology Examination with a score of 162+
4. Complete a clinical fellowship (CF) or equivalent supervised professional experience -- a minimum of 36 weeks of full-time mentored clinical practice after completing your Au.D.
5. Apply to ASHA and maintain certification through continuing education (30 hours per 3-year cycle)

Even in states that do not require CCC-A, holding this credential is highly advantageous. Many employers prefer or require it, and it demonstrates a national standard of clinical competence. The CCC-A also facilitates licensure reciprocity and is recognized by Medicare and most insurance plans.

Hearing Aid Dispensing

One of the key scope-of-practice questions for audiologists is whether hearing aid dispensing is included in the audiology license or requires a separate dispensing license. Currently, 43 of 51 states include hearing aid dispensing privileges within the standard audiology license.

In states where dispensing is not included, audiologists may need to obtain an additional hearing aid dispensing license or certificate. This typically involves additional fees and may require a separate exam. The trend has been toward including dispensing in the audiology license, as dispensing hearing aids is considered a core competency of the profession.

Hearing aid dispensing involves selecting appropriate devices, taking ear impressions, programming and fitting hearing aids, performing real-ear verification measurements, and providing ongoing adjustments and counseling. With the emergence of over-the-counter (OTC) hearing aids in 2022, audiologists continue to play a critical role in fitting prescription hearing aids for moderate-to-severe hearing loss and providing professional-level care.

ASLP Interstate Compact (ASLP-IC)

The Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC) allows audiologists and speech-language pathologists to practice across state lines without obtaining a separate license in each member state. Currently, 36 of 51 states are compact members or have enacted compact legislation.

To participate in the compact, audiologists must hold an active, unencumbered license in their home state, hold an active CCC-A from ASHA, have no disciplinary actions, pass an FBI background check, and pay the applicable compact privilege fees. The compact is especially valuable for audiologists who practice via telepractice or who work near state borders.

Steps to Become a Licensed Audiologist

While requirements vary by state, the general path to becoming a licensed audiologist follows these steps:

1. Earn a bachelor's degree: Complete an undergraduate degree with prerequisite courses in communication sciences and disorders, biology, physics, statistics, and related fields (4 years).
2. Complete a Doctor of Audiology (Au.D.) program: Graduate from a CAA-accredited Au.D. program with at least 1,820 hours of supervised clinical experience (4 years).
3. Pass the Praxis Audiology Exam: Take and pass the Praxis Examination in Audiology (Test Code 5343) with a score of 162 or higher. Required in 51 states.
4. Complete a clinical fellowship (if required): Some states and the CCC-A require a supervised professional experience period of at least 36 weeks full-time after completing the Au.D.
5. Obtain CCC-A certification (if required): Apply for the Certificate of Clinical Competence in Audiology through ASHA. Required or accepted in 0 states.
6. Apply for state licensure: Submit your application, transcripts, exam scores, and fees to your state's licensing board. Some states require a jurisprudence exam on state-specific laws and regulations.
7. Obtain hearing aid dispensing authorization: If your state does not include dispensing in the audiology license, apply for a separate hearing aid dispensing license or permit.
8. Maintain your license: Complete required continuing education (average of 20.2 hours per renewal period) and renew your license on schedule.

State-by-State Audiologist Requirements

The table below summarizes key audiologist licensing requirements across all 51 states we track. Click any state for the full breakdown of requirements, fees, and renewal details.

Compact Member States

The following 36 states are members of the Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC), which allows audiologists to practice across member state lines without obtaining a separate license in each state:

Compact membership is particularly valuable for audiologists who provide telehealth services, work for multi-state healthcare systems, or practice near state borders. The compact requires an active, unencumbered home-state license and CCC-A certification from ASHA. Additional states continue to introduce compact legislation.

States with Hearing Aid Dispensing Included

In these 43 states, the audiology license includes authorization to dispense hearing aids without a separate dispensing license:

In states where dispensing is not included, audiologists typically need to obtain a separate hearing aid dispensing license, which may involve additional fees and examination requirements. Check your specific state's page for details on dispensing requirements.

Frequently Asked Questions

How long does it take to become an audiologist?

The path to becoming a licensed audiologist takes approximately 8 years after high school: 4 years for a bachelor's degree and 4 years for a Doctor of Audiology (Au.D.) program. Some states and the CCC-A require an additional clinical fellowship (typically 9-12 months) after completing the Au.D., which can extend the total timeline to about 9 years. However, many Au.D. programs now incorporate the clinical fellowship experience into their fourth-year externship.

How much does it cost to become an audiologist?

Total education costs vary widely. Undergraduate education ranges from $40,000-$120,000 depending on the institution. Au.D. programs cost $60,000-$200,000+ for tuition and fees over four years. Additional costs include the Praxis exam ($120-$160), ASHA CCC-A application fees (~$400), and state licensing fees (average of $354 for initial licensing). Many students fund their Au.D. through graduate assistantships, externship stipends, scholarships, or federal student loans.

What is the difference between an audiologist and a hearing instrument specialist?

Audiologists hold a doctoral degree (Au.D.) and are trained to diagnose hearing and balance disorders, fit hearing aids, program cochlear implants, and provide comprehensive audiological care. Hearing instrument specialists (HIS) typically hold a high school diploma or associate's degree and are licensed to test hearing and fit hearing aids but cannot diagnose medical conditions or manage cochlear implants. Audiologists have a broader scope of practice, more extensive training, and are recognized as healthcare providers by Medicare and insurance companies.

Can I practice audiology via telehealth?

Yes, many states now permit audiologists to provide services via telehealth (also called telepractice). Telehealth audiology services may include hearing aid programming adjustments, counseling, tinnitus management, and follow-up appointments. However, you typically need to be licensed in the state where the patient is located. The ASLP-IC compact (36 member states) makes cross-state telepractice easier by allowing practice in any member state without a separate license.

What is the job outlook and salary for audiologists?

The Bureau of Labor Statistics projects 11% growth for audiologists through 2032, much faster than the average for all occupations. An aging population, increased awareness of hearing health, noise exposure in modern life, and advances in hearing technology drive demand. The median annual salary for audiologists is approximately $82,000-$87,000, with those in private practice or specialized settings often earning more. Geographic location, years of experience, and practice setting significantly influence earnings.

Can I practice in multiple states?

Yes, but you generally need a license in each state where you practice. The ASLP-IC compact simplifies this for its 36 member states by allowing compact-eligible audiologists to practice across member state lines without obtaining a separate license. For non-compact states, you must apply for licensure by endorsement or reciprocity, which typically requires submitting your credentials, passing any state-specific exams, and paying applicable fees. Having CCC-A certification often streamlines the endorsement process.

Next Steps

Click any state in the table above to see its complete audiologist licensing requirements. Each state page includes detailed information on education requirements, exam procedures, scope of practice, hearing aid dispensing rules, fees, and renewal processes.

If you are already licensed in one state and looking to practice in another, check whether both states are members of the ASLP-IC compact or review the individual state pages for endorsement and reciprocity policies.

Sources

Education, exam, scope of practice, and fee data are sourced from official state licensing boards and national audiology organizations.

• Individual state licensing board websites (cited on each state page).
• American Speech-Language-Hearing Association (ASHA) -- asha.org
• Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) -- accredited program listings.
• Educational Testing Service (ETS) -- Praxis Audiology Examination information.
• Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC) -- compact membership and eligibility information.
• Bureau of Labor Statistics -- Occupational Outlook Handbook, Audiologists.

Data was last verified in February 2026. Requirements can change as states update their regulations. Always confirm current requirements with your state's licensing board before beginning your audiology career path.