Audiologist vs. Hearing Instrument Specialist: Who Should You See?
How audiologists and hearing aid specialists differ in training, licensing and scope, what AuD, CCC-A and BC-HIS mean, and how to check a provider.
Two kinds of hearing care professionals
When you search for help with hearing loss, most clinics you find will be staffed by one or both of two kinds of professionals: audiologists and hearing instrument specialists (a role that states may call a hearing aid dispenser, hearing aid fitter or hearing aid specialist). Both can test hearing and fit hearing aids, and many clinics employ both. But their training, their scope of practice and the situations they are best suited for are different. Knowing the difference helps you pick the right starting point and ask better questions.
Audiologists: training and scope
According to the American Academy of Audiology, most audiologists today earn a Doctor of Audiology (AuD) degree, a clinical doctorate that includes years of coursework and supervised clinical training. Some hold a PhD or ScD in hearing and balance sciences instead, and audiologists who trained before the doctoral degree became standard may hold a master's degree. Audiologists must be licensed or registered to practice in every state, the District of Columbia and Puerto Rico.
Audiologists evaluate, diagnose, treat and manage hearing loss and balance disorders in people of all ages, from newborns to older adults. Their work commonly includes:
- Comprehensive diagnostic hearing evaluations, including tests of the middle ear
- Selecting, fitting and adjusting hearing aids
- Assessing dizziness and balance (vestibular) problems, often together with physicians
- Tinnitus evaluation and management
- Evaluating candidacy for and programming cochlear implants
- Hearing care for infants and children
Hearing instrument specialists: training and scope
The International Hearing Society describes hearing aid specialists as professionals who conduct hearing evaluations and screenings, fit and adjust hearing aids, and provide ongoing support and education to people who use them. Training usually comes through a formal education program or a supervised apprenticeship, followed by written and practical exams. Specialists are licensed by the state, must keep up with continuing education, and are regulated under state rules that differ from one jurisdiction to another.
The focus of a hearing instrument specialist is testing hearing for the purpose of fitting hearing aids, then fitting, adjusting and maintaining those devices over time. They generally do not diagnose medical conditions of the ear, manage balance disorders or work with young children. Exactly what a specialist may do is set by each state's licensing law.
These licenses govern testing and prescription hearing aids. Over-the-counter (OTC) hearing aids are different: under the FDA rule at 21 CFR 800.30, a state cannot require a licensed person to be involved for an adult to buy one, or require a store to hold a special license to sell them. Licensed audiologists and specialists may still sell and adjust OTC devices.
Credentials you may see after a name
- AuD: Doctor of Audiology, the clinical doctoral degree held by most audiologists.
- CCC-A: the Certificate of Clinical Competence in Audiology from the American Speech-Language-Hearing Association (ASHA). It is a voluntary national certification, separate from a state license, that requires a qualifying doctoral degree, supervised clinical experience, a national exam and ongoing professional development.
- BC-HIS: Board Certified in Hearing Instrument Sciences, awarded by the independent National Board for Certification in Hearing Instrument Sciences (NBC-HIS). Candidates must already hold a state dispensing license and meet experience or education requirements, pass a national competency exam, and complete continuing education to renew.
Voluntary certifications show extra commitment, but the state license is what legally allows someone to practice. A missing certification is not a red flag by itself; a missing license is.
What the difference means for Medicare
Medicare treats the two professions differently. Its Benefit Policy Manual (chapter 15, section 80.3.1) says diagnostic hearing tests must be done by a qualified audiologist, meaning someone with a master's or doctoral degree in audiology who is licensed as an audiologist in that state, or, where state law allows, by a physician or certain other practitioners. Medicare cannot pay for these tests when they are done by aides, technicians or others who do not meet that definition, which leaves out a hearing instrument specialist who is not also an audiologist.
With Part B you can also see an audiologist once every 12 months without a doctor's order for non-acute hearing problems, as Medicare.gov explains. For either profession, Original Medicare does not pay for hearing aids or for exams to fit them.
Which one should you see?
For many adults with gradual, similar hearing loss in both ears who mainly want hearing aids, either type of licensed professional can be a reasonable choice. Consider starting with an audiologist, or with a physician such as an ear, nose and throat (ENT) doctor, when:
- Your hearing changed suddenly, or is much worse in one ear than the other
- You have ear pain, drainage, dizziness or ringing in only one ear
- The hearing aid is for a child
- You are interested in cochlear implants or have severe to profound loss
- You need balance testing or tinnitus care
Sudden hearing loss deserves special attention: the National Institute on Deafness and Other Communication Disorders advises treating it as a medical emergency and seeing a doctor right away, because delays can reduce the chance that treatment helps.
How to check a provider
Our directory lists providers from the NPPES registry, the federal database of National Provider Identifiers (NPIs). An NPI shows that a provider has registered with a particular specialty and practice address, but it is not proof of a license. The specialty is self-selected, and the "Audiologist-Hearing Aid Fitter" code is defined for states that license people under that combined title, so the label alone does not show which license someone holds. To check:
- Open the listing and follow the link to its NPPES record. Note the license number and state, if the provider entered one.
- Find that state's licensing board. Some states use one board for both professions, such as California's Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board. Others split them: Florida has a Board of Hearing Aid Specialists and a separate Board of Speech-Language Pathology and Audiology.
- Search by name or license number, and confirm the license type, an active status and the expiration date.
- Read any disciplinary actions listed. Complaints about a licensee go to the same board.
The FDA's guide to getting hearing aids also suggests checking with your state consumer protection agency or attorney general's office and with professional organizations.
When you call a clinic, it is reasonable to ask:
- Who will do my testing and fitting, and what is their license type?
- Do you perform real-ear measurement to check the fit of hearing aids?
- What is your trial or return period, and are any fees nonrefundable?
- Which hearing aid brands do you work with?
- What follow-up visits are included in the price?
Good providers of either type will answer these questions openly, and will refer you to a physician when something in your history or test results calls for a medical evaluation.
General information only, current as of the date above. The information on Hearing Clinic Finder is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Rules and programs change; check the official sources linked in this guide.