How Do You Get an Audiology License? Steps From AuD to Your First Licensed Job

Audiology is a licensed profession: BLS's Occupational Outlook Handbook states that all states require audiologists to be licensed, with requirements that vary by state.

Practice is gated on the license, and the defined ways to work before it is in hand are narrow — they belong to specific employers and states, a question the last section below takes up.

You get the license from the state where you will work, issued by the state's audiology licensing board or agency.

Each board writes its own rules, so what follows is the national shape of the path, not one state's checklist.

What the license allows is defined by state law, not by the profession's national associations.

ASHA's current Scope of Practice in Audiology is the 2018 edition, and it describes activities across the profession — cerumen (earwax) management is listed as part of audiologic intervention.

ASHA itself states that the scope document does not supersede state licensure laws; it can serve as a model for them.

The license is also what payers and federal employers gate on.

Medicare's Benefit Policy Manual defines a qualified audiologist as an individual with a master's or doctoral degree in audiology who is licensed by the state where the services are furnished; the manual also spells out an alternative route for a state without licensure.

And Medicare will not pay for audiological tests performed by aides, assistants, technicians or others who do not meet that definition.

The VA's audiologist qualification standard requires a full, current, unrestricted doctoral-level audiology license in any U.S. state, territory, commonwealth or DC.

What the license does not automatically include is selling hearing aids — that is decided state by state, under the credentials question below.

And what the license sits inside — settings, specialties, employers — is the subject of the audiologist career guide.

Step 1 is education, and the degree at the center of it is the Doctor of Audiology.

What the AuD covers and how it differs from a PhD or MD are the subject of the Doctor of Audiology degree guide — here, only the licensure-relevant parts.

Two accreditors' names matter.

ASHA's certification standards — the 2020 standards that CCC-A applicants apply under today — require a doctoral degree in audiology from a program accredited by the CAA, a program holding CAA candidacy status, or an equivalent.

The VA's qualification standard takes a parallel shape: an AuD from an ACAE- or CAA-recognized program, or another doctoral degree in hearing science or a directly related field from a U.S.-recognized accredited institution.

BLS's licensure summary says state requirements typically include an AuD from an accredited program.

The routes a state accepts are written in that state's own rules, though, and boards differ — the education that satisfies your board is the education your board's current rules name, not what a national summary assumes.

Which program you choose is an education decision; for licensure, what matters is that the degree and its accreditation satisfy the board where you will apply.

Coursework is only part of the degree.

Supervised clinical practicum runs through the program and culminates in the full-time externship year — the working year covered in the AuD externship as a job guide.

The standards that shape those hours are ASHA's certification standards, and they are precise about composition.

Under the 2020 standards, up to 10% of the supervised clinical experience may come from clinical simulation, counted only if obtained within the doctoral program.

Under the same standards, the practicum supervisor must be an ASHA-certified audiologist with at least 9 months of full-time clinical experience and at least 2 hours of professional development in clinical instruction or supervision.

ASHA has published 2027 standards with an effective date of August 1, 2027.

They tie the practicum to the CAA's standards, which include a minimum of 12 months' full-time-equivalent supervised clinical experience — at least 50% on site or in person, telepractice up to 40%, and simulation up to 10%.

There is also a defined path for incomplete hours.

Applicants who did not finish the supervised practicum under a qualifying supervisor during the AuD have 24 months from application to start the remainder and 48 months from that start to complete it, and post-graduation practicum may be telesupervised.

State licensure applications document clinical experience the way the state's rules require — your board's application packet lists what it accepts as proof.

Step 3 is the exam: ETS's Praxis Audiology (5343).

ASHA's certification requires a passing score on it, and where a state's licensure rules require the exam, that state sets its own cut score.

The format is set by ETS.

It is a computer-delivered test of 120 selected-response questions with a 2-hour time limit, and the registration fee is US$146 — the ETS store price as of October 12, 2026.

The content breaks into five weighted categories: Foundations of Audiology (20%, 24 questions), Prevention and Screening (10%, 12), Assessment (35%, 42), Intervention (25%, 30), and Professional and Ethical Responsibilities (10%, 12).

The score is where careful applicants get burned.

ASHA's passing score for the 5343 is 162 on the 100–200 scale, as of October 2026.

The 170 figure that still circulates belongs to the older 5342 and 0342 test versions — not to the current exam.

ASHA does still accept a 170 on those older versions where a state licensing agency requires that version.

States set their own scores for licensure.

ASHA says most states adopt the ASHA score, but in some states the licensure score sits higher or lower — your board's rules name yours, so check before you schedule.

Timing rules apply on the certification side.

ASHA recommends taking the exam no earlier than completion of graduate coursework and practicum, or during the first year of clinical practice after graduation.

Scores for ASHA certification go to ASHA directly from ETS using recipient code R5031, and must be no more than 5 years old at application.

Under the 2020 standards, a passing score counts if it was earned no earlier than 5 years before — and no later than 2 years after — ASHA receives the application.

A candidate who has not passed within the 2-year certification application period has the file closed and must reapply under the standards then in effect.

Step 4 is where one national path becomes state-by-state ones: the application goes to the board or licensing agency your state's practice act creates, under that state's rules.

What the packet contains is the board's to define: which transcripts it wants, which exam scores, which fees, and whether the state adds steps such as fingerprinting or a jurisprudence exam on state law.

No national summary substitutes for the board's current application packet, this page included.

Fees are the clearest example of why.

They are set in state rule, and they move: even the American Academy of Audiology's national state-licensing table warns that state statutes and regulations may change frequently and directs applicants to their state board for current requirements.

Where you send exam scores follows the board's instructions too — the ASHA route described above takes them straight from ETS, and your board names its own process.

One federal rule cuts across state processes for military families.

Under section 4025a of title 50 of the U.S. Code, a servicemember's or spouse's professional license must be treated as valid in the new state after a move on military orders; the applicant supplies their orders, a marriage certificate for spouses, and a notarized affidavit.

Licensees who practice through an interstate compact follow the compact's process instead.

Short answer: the state license is the credential you must have; the others depend on the job and on what you choose to add.

The CCC-A is ASHA's national certification, and it is built from the same pieces as the steps above: the doctorate from a CAA-accredited or candidacy program or an equivalent, a Praxis score inside the required window, and a complete application.

That application means passing scores sent directly from ETS, an official doctoral transcript, and payment of the dues and fees.

As of October 12, 2026, the initial fee is US$490 with ASHA membership, US$446 for certification without membership, and US$240 at the NSSLHA conversion rate for graduates with 2 consecutive years of NSSLHA membership who apply by August 31 of the year after graduation.

ASHA asks applicants to allow 6 weeks for review; its pathway page says up to 6–8 weeks after the last document arrives.

What the CCC-A is not is a license — and two federal gatekeepers do not require it.

Medicare's qualified-audiologist definition asks for the audiology degree plus licensure by the state where services are furnished, with ASHA certification absent from it; the VA's qualification standard likewise does not list the CCC-A among its basic requirements.

The American Board of Audiology (ABA) runs its own voluntary certification.

Per the ABA, it requires no membership in a professional organization and can be held independently of any other certification — ASHA's CCC-A included — so it sits alongside the state license rather than replacing it.

Dispensing is the conditional piece.

Whether an audiologist needs a second credential to sell hearing aids is decided state by state: a state's rules may treat dispensing prescription hearing aids as inside audiology practice, or may require a separate hearing aid license or registration on top of it.

Which side your state falls on is in that state's rules — the audiology board's and the dispensing regulator's alike.

Renewal is where the two-track structure — state license and national certification — shows most clearly.

The state license renews on the cycle your board sets, with the continuing-education total your state's rules name.

Each board sets its own hours, deadlines and fees, and the board's renewal instructions are the authority for yours.

ASHA's CCC-A runs on its own clock.

Certificate holders earn 30 professional development hours (PDHs — the current name for what ASHA used to call CMHs) every 3-year certification maintenance interval.

Since January 1, 2026, those hours must include 1 PDH in ethics and 2 PDHs in the renamed area covering individuals' unique histories, values and circumstances, and self-reflection, adaptability and collaboration — replacing the earlier "cultural competence/DEI" wording.

Renewal dues are US$250 a year for certified members and US$221 a year for certified nonmembers, due by December 31.

The consequences of falling behind are concrete: holders who miss the payment or CE deadline become "not current" on April 1 — they cannot use the CCC, they are listed publicly as CCC Not Current, and they cannot supervise students or mentor clinical fellows.

Reinstatement after expiry is tiered: 10, 20 or 30 PDHs depending on whether 1 year or less, 1–2 years, or more than 2 years have lapsed.

If the credential has been expired for more than 1 year, ASHA also requires a passing Praxis score no more than 5 years old.

The license is the legal gate to practice, so the practical question is what can start before it is in hand — and two federal answers define the edges.

At the VA, a not-yet-licensed graduate audiologist may be hired on a temporary GS-11 appointment under supervision for up to 2 years.

The appointment cannot be promoted to GS-12 until licensure is obtained, and failure to obtain the license leads to termination.

The VA standard accepts a full, unrestricted license from any U.S. state, territory, commonwealth or DC — so the license that unlocks federal practice does not have to be the state where the facility sits.

Under Medicare, a provisional license alone does not open the door: a fourth-year AuD student holding only a provisional state license is not a qualified audiologist unless they already hold a master's or doctoral degree in audiology.

Medicare also will not pay for audiological tests performed by audiology aides, assistants or technicians who do not meet the qualified-audiologist definition.

States may run their own bridge routes.

Where a state offers an extern or provisional license, who qualifies for it, what it covers and how long it lasts are written in the state's rules — the board confirms what yours allows and what it does not.

If you are on the other side of the table, the sequence runs in reverse: hiring a licensed audiologist means verifying the license a candidate holds, and the hiring guide covers the check from the practice's side.

Career information, not licensing, legal, medical, clinical or billing advice. Requirements change — confirm yours with your state's audiology licensing board, and with ASHA, ETS, CMS or the VA where they apply.