Audiology Licensure and Certification Requirements by State

Important Note on This Guide

Licensure requirements are set and updated by individual state legislatures and licensing boards. This article describes the general national framework and common requirements — but specific requirements in any given state may differ and can change over time. Always verify current requirements directly with your state’s audiology licensing board before making career or practice decisions. ASHA and AAA state licensing pages are a useful starting point.

Why audiologist licensing exists and who regulates it

Healthcare licensure exists to protect patients. By requiring audiologists to meet specific standards for education, exams, and supervised training before practicing independently, states create a baseline level of safety and trust for patients seeking care.

In the United States, audiologist licensing is regulated at the state level, not federally. Each of the 50 states, plus the District of Columbia and U.S. territories, has its own licensing board with authority over audiology practice. This decentralized structure means that an audiologist licensed in one state is not automatically licensed in another — an important consideration for anyone who moves, practices across state lines, or provides teleaudiology services.

The federal government does not issue audiology licenses, but federal agencies still influence the field. For example, the FDA regulates hearing aids and over-the-counter (OTC) devices, while the Department of Veterans Affairs (VA) sets its own credentialing standards for audiologists it employs (which typically align with or require state licensure).

What credentials actually mean, according to an audiologist

The following perspective is shared by Dr. Jessica Hinson, Au.D., and reflects her clinical experience.

Licensure alone does not determine value when searching for a hearing healthcare provider. A provider should be:

• state licensed (to verify training has been met)
• in good standing (to verify no malpractice suits)
• have experience in the area of audiology needed

For example, if you have Starkey hearing aids and move cross country, working with an audiologist who hasn’t fit that brand in years may not serve you well, even if they’re licensed. Hearing technology changes quickly, and your provider needs to be comfortable with the current fitting software to help you get the most out of your devices.

The same idea applies to other areas of care. If you’re dealing with dizziness or vertigo, it’s important to see an audiologist who has experience with balance disorders, not just general hearing care.

In my view, patients should prioritize experience, communication, and follow-up care. From a real-world perspective, I also tend to place more value on specialty certifications through the ABA than general credentials like the CCC-A or BC-A. Specialty certifications require additional training and hands-on experience, and they can signal a deeper level of expertise in a focused area of care.

Core audiologist licensing requirements across most states

While the specifics vary, the large majority of states have converged on a common set of licensure requirements that reflect the national professional standards set by ASHA and the AAA. For audiologists entering practice today, the typical path to licensure involves the following components.

1. A Doctor of Audiology (Au.D.) from an accredited program

The foundational requirement in all U.S. states is a doctoral degree in audiology from a program accredited by the Council on Academic Accreditation (CAA).

Accreditation is critical. Graduation from a non-accredited program, even a doctoral program, may disqualify an applicant from licensure in many states.

2. Passing the Praxis exam in audiology

Most states require passing the national Praxis exam, which assesses knowledge across hearing science, diagnostics, treatment, and professional practice. Each state sets its own minimum passing score, though many states adopt the national recommended score established by ETS.

3. Supervised clinical experience 

States require proof of hands-on clinical training, typically through:

• A supervised clinical fellowship (CF), or
• Documented clinical hours completed during the Au.D. externship

Requirements vary significantly here. Some states require post-graduate experience, while others consider the embedded 4th-year externship sufficient.

4. Application, documentation, and background check

Licensure applicants must submit documentation of their degree, exam scores, and clinical training, along with a formal application and fee to their state licensing board. Most states also require a background check.

5. Continuing education (CE) for renewal

Licensure is not a one-time achievement. State audiology licenses must be renewed periodically (typically every 1-2 years) and renewal requires documentation of completed continuing education (CE). The number of CE hours required per year varies by state, but most fall in the range of 10-12 hours per year. Some states specify that a portion of CE hours must be in particular subject areas, such as ethics, hearing aid dispensing, or infection control.

What the CCC-A certification means beyond state licensing

State licensure is the legal requirement to practice. The Certificate of Clinical Competence in Audiology (CCC-A) is an optional national credential that goes further. While it is not a license, it signals adherence to nationally recognized professional standards and often functions as a de facto benchmark in the field.

The CCC-A is often:

• Required or preferred by employers
• Helpful when transferring licensure between states
• Considered a professional standard across many clinical settings

To earn the CCC-A, audiologists must complete an Au.D. from a CAA-accredited program, pass the Praxis examination, and complete a supervised 9-month full-time Clinical Fellowship.

To maintain the CCC-A, audiologists must complete 30 Professional Development Hours every three years.

Board certification (BC-A): an addition to the CCC-A

The American Board of Audiology (ABA), part of the American Academy of Audiology, offers the Board Certified in Audiology (BC-A) credential as an addition to the CCC-A. Like the CCC-A, the BC-A requires an Au.D. from an accredited program, passing the Praxis exam, completion of supervised clinical training, and ongoing continuing education to maintain the credential.

The BC-A is accepted by many of the same employers and payers that accept the CCC-A, and some states accept it as part of licensure requirements. The ABA also administers specialty board certifications in pediatric audiology and cochlear implants, which require additional supervised experience, examination, and continuing education beyond the baseline credential.

Practicing across state lines: reciprocity, telehealth, and licensing challenges

One of the biggest challenges in audiology today is that providers must be licensed in every state where they deliver care. This has become increasingly complex as teleaudiology expands access across state lines.

Some states offer reciprocity or streamlined licensure pathways, allowing audiologists licensed in one state to obtain licensure in another without completing the full application process again—though requirements and eligibility vary.

The profession has made meaningful progress toward a broader solution through the Audiology & Speech-Language Pathology Interstate Compact (ASLP-IC). This compact is now active and allows licensed audiologists to practice across participating states through a privilege-to-practice model, rather than obtaining full additional licenses.

As of now, Ohio, West Virginia, and Louisiana have begun issuing privileges to qualified practitioners. An additional 30+ states have passed legislation to join the compact but have not yet started issuing privileges.

While this is a significant step forward, licensure requirements still vary by state, and not all states participate. Audiologists providing telehealth services must continue to verify and comply with regulations in each state where their patients are located.

For the most current updates, the ASLP Compact Map and ASHA both maintain resources tracking telepractice and multi-state licensure requirements.

Specialty certifications: pediatric audiology, cochlear implants, and more

For audiologists who want to develop advanced expertise in a specific area, the ABA offers board certification in two specialty domains:

• Pediatric Audiology (BC-APN) — requires documented supervised experience working with children, passage of a specialty exam, and ongoing CE
• Cochlear Implants (BC-CI) — requires supervised experience in implant programming and candidacy evaluation, passage of a specialty exam, and ongoing CE

These specialty certifications are not required to practice. They are optional credentials that signal advanced training.

For patients, they can be a meaningful indicator of expertise. An audiologist with a BC-APN or BC-CI has invested additional training in that area, which can be especially important when choosing care for a child with hearing loss or considering cochlear implants.

What audiologist credentials mean for you as a patient

From a patient’s perspective, an audiologist’s license is a baseline safeguard. It confirms that the provider has met the minimum education and exam requirements to practice legally in your state.

But licensure alone does not guarantee specialization or ongoing training — it’s the starting point, not the full picture.

Credentials like the CCC-A or BC-A add another layer. They reflect nationally recognized standards and require ongoing continuing education, helping ensure audiologists stay current in their field. Specialty certifications go further, signaling focused expertise beyond general practice.

Finding a trusted audiologist

When choosing an audiologist, you can verify their license through your state licensing board and check certifications through ASHA’s public directory. These simple checks can help you make a more informed decision about your care.

You can also use our directory to find audiologists near you and read patient reviews, then cross-reference their credentials through your state board or ASHA to confirm qualifications.