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Iowa Hearing Instrument Specialist — Requirements & Free Practice

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Hearing Aid Specialist License

The ordinary Iowa license for fitting, dispensing and selling hearing aids under Iowa Code chapter 154A.

Licensing authority: Iowa Department of Inspections, Appeals, and Licensing · Application information

Licensure by endorsement
International Licensing Examination for Hearing Healthcare Professionals
Alternative other profession exam
A passing Praxis Examination in audiology through Educational Testing Service is an alternative under 481—2060.4(2)(b). It is another profession’s examination and is an applicant condition under this contract.
Applicant
Applicant who is or has been licensed as a hearing aid specialist in another jurisdiction.
Application
Submit the completed online application and the nonrefundable licensure fee (481—2060.4(1)).
Application expiry
An incomplete application on file more than two years is invalid and destroyed unless the candidate requests otherwise in writing (481—2060.4(6)).
Application page education conflict
The controlling rule 481—2060.5(1)(d) specifies 24 hours or compliance with the currently licensing jurisdiction. DIAL — Apply for a Hearing Aid Specialist Permanent License (Applicants Licensed in Another State, evidence alternatives) states: Provide evidence of one of the following: Proof of board certification from IHS; Proof of 32 continuing education hours within the 24 months prior to application for an Iowa license; orContinuing education certificates that verify you met the minimum hours of continuing education required by the state where you are currently licensed.
Attempt limit
Taking the IHS examination more than six times requires department approval (481—2060.4(2)(a)).
Continuing education
Provide evidence of 24 continuing-education hours within the prior 24 months, or certificates establishing compliance with the currently licensing jurisdiction’s minimum hours.
Health
Be free of contagious or infectious disease (Iowa Code §154A.10(2)).
Initial requirements
481—2060.5(1)(a) requires verification of the requirements in 481—2060.4; retain its currently offered IHS examination even if the applicant passed it earlier or uses an accepted exception.
Licensure requirements
Show licensure requirements similar to Iowa’s and official verification from the most recent licensing jurisdiction, including initial licensure date, current status and discipline; disclose public or pending complaints.
Score or certification
Provide official verification of an IHS national-examination passing score, a score on an examination the department determines equivalent, or current National Board for Certification in Hearing Instrument Sciences certification. The unidentified equivalent slot and certification status are conditions; certification alone does not identify a separate NCE examination requirement.
Score transmission
DIAL instructs the applicant to have IHS transmit the final examination score directly to the department.
Initial licensure
International Licensing Examination for Hearing Healthcare Professionals
Alternative other profession exam
A passing Praxis Examination in audiology through Educational Testing Service is an alternative under 481—2060.4(2)(b). It is another profession’s examination and is an applicant condition under this contract.
Applicant
Applicant for ordinary licensure who has not held an Iowa training permit.
Application
Submit the completed online application and the nonrefundable licensure fee (481—2060.4(1)).
Application expiry
An incomplete application on file more than two years is invalid and destroyed unless the candidate requests otherwise in writing (481—2060.4(6)).
Attempt limit
Taking the IHS examination more than six times requires department approval (481—2060.4(2)(a)).
Health
Be free of contagious or infectious disease (Iowa Code §154A.10(2)).
Score transmission
DIAL instructs the applicant to have IHS transmit the final examination score directly to the department.
Initial licensure after temporary permit training
International Licensing Examination for Hearing Healthcare Professionals
Alternative other profession exam
A passing Praxis Examination in audiology through Educational Testing Service is an alternative under 481—2060.4(2)(b). It is another profession’s examination and is an applicant condition under this contract.
Applicant
Applicant who holds or has held an Iowa hearing aid specialist temporary permit.
Application
Submit the completed online application and the nonrefundable licensure fee (481—2060.4(1)).
Application expiry
An incomplete application on file more than two years is invalid and destroyed unless the candidate requests otherwise in writing (481—2060.4(6)).
Attempt limit
Taking the IHS examination more than six times requires department approval (481—2060.4(2)(a)).
Health
Be free of contagious or infectious disease (Iowa Code §154A.10(2)).
Score transmission
DIAL instructs the applicant to have IHS transmit the final examination score directly to the department.
Supervision report
Submit the supervisor’s department-approved report each time examination approval is requested; attach the completed temporary-permit supervision schedule when applying for permanent licensure.
Training
Training and supervision must satisfy 481—2060.3, including supervisor eligibility, initial direct supervision, cosigned evaluations and contracts, and replacement-supervisor notification.
Late renewal during the grace period
No examination is required for this applicant pathway.
Application fee
Submit the completed renewal application and renewal fee before expiration; Iowa Code §147.10(1) states application with fee at least 30 days before expiration.
Continuing education
Applicable 24-hour biennial continuing-education requirements and permitted first-renewal exemptions apply.
Late period
Complete renewal requirements and submit the late fee within the 30-day grace period; after the grace period an unrenewed license is inactive.
Mandatory reporting
If examining, attending, counseling or treating children or dependent adults, complete applicable HHS mandatory-reporter training and retain documentation for three years; active military service or an approved hardship waiver excuses this training.
Practice status
An inactive license retains the privilege of licensure but authorizes no practice until reactivation.
Renewal period
Biennial period is January 1 of an odd-numbered year through December 31 of the next even-numbered year.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure with military education, training or service credit
International Licensing Examination for Hearing Healthcare Professionals
Alternative other profession exam
A passing Praxis Examination in audiology through Educational Testing Service is an alternative under 481—2060.4(2)(b). It is another profession’s examination and is an applicant condition under this contract.
Application
Submit the completed online application and the nonrefundable licensure fee (481—2060.4(1)).
Application expiry
An incomplete application on file more than two years is invalid and destroyed unless the candidate requests otherwise in writing (481—2060.4(6)).
Attempt limit
Taking the IHS examination more than six times requires department approval (481—2060.4(2)(a)).
Credit application
Submit the military-service credit application and verifying military records, transcripts, affidavit or forms; no fee is charged for the credit application.
Credit discretion
The authority determines the credit, provides reasons for a denial and allows reconsideration with additional documentation.
Exam credit
Military education or experience credit does not apply to examination requirements under 481—7.2(2).
Health
Be free of contagious or infectious disease (Iowa Code §154A.10(2)).
Military service
Honorably obtained qualifying military education, training or service may satisfy identified education or experience requirements.
Score transmission
DIAL instructs the applicant to have IHS transmit the final examination score directly to the department.
Expedited licensure for a veteran or active duty military spouse with substantially similar licensed practice
No examination is required for this applicant pathway.
Application
Submit application, fees, attestation of Iowa Code §272C.12 compliance, a written scope-of-practice statement and relevant laws; fingerprint cards and waiver are required if the authority requires an initial-license background check.
Compact
An Iowa compact practice privilege makes the applicant ineligible under 481—501.1(5); verification licensure grants no interstate compact privilege.
Criminal history
No criminal history that prevents licensure; provide criminal and disciplinary records where relevant.
Current license
Hold a current good-standing license in another state with a substantially similar scope of practice (Iowa Code §272C.12(1)(a)).
Discipline
Discipline must be resolved and its cause corrected; unresolved matters hold the application without issuance or denial.
Hearing profession referral
481—2060.5(2) makes verification available if the applicant cannot satisfy endorsement requirements. This distinct statutory route is issued without examination under Iowa Code §272C.12; the current hearing-aid initial-licensure rules identify only the IHS examination and Praxis Audiology, and impose no Iowa-law examination.
Implementation exam statement
Apply the controlling no-examination provision of Iowa Code §272C.12 to eligible verification applicants. The lower-ranked reciprocity rule states: 481 IAC chapter 7 — Military Service, Veteran Reciprocity, and Spouses of Active-Duty Service Members (481—7.3(1)–(4)) states: 7.3(1) A veteran or spouse with an unrestricted professional license in another jurisdiction may apply for licensure in Iowa through reciprocity in accordance with Iowa Code chapter 272C. A veteran or spouse must pass any examinations required for licensure to be eligible for licensure through reciprocity and will be given credit for examinations previously passed when consistent with the licensing authority’s laws and rules on examination requirements. A fully completed application for licensure submitted by a veteran or spouse under this subrule will be given priority and will be expedited. 7.3(2) Such an application shall contain all of the information required of all applicants for licensure who hold unrestricted licenses in other jurisdictions and who are applying for licensure by reciprocity, including but not limited to completion of all required forms, payment of applicable fees, disclosure of criminal or disciplinary history, and, if applicable, a criminal history background check. The applicant will use the same forms as any other applicant for licensure by reciprocity and shall additionally provide such documentation as is reasonably needed to verify the applicant’s status as a veteran under Iowa Code section 35.1(2) or as a spouse. 7.3(3) Upon receipt of a fully completed licensure application, the licensing authority will promptly determine if the scope of practice of the jurisdiction where the veteran or spouse is licensed is substantially equivalent to the scope of practice in Iowa. The licensing authority shall make this determination based on information supplied by the applicant and such additional information as the licensing authority may acquire from the applicable jurisdiction. 7.3(4) The licensing authority will promptly grant a license to the applicant if the applicant is licensed in the same or similar profession in another jurisdiction whose scope of practice is substantially equivalent to the scope required in Iowa unless the applicant is ineligible for licensure based on other grounds, including, for example, the applicant’s disciplinary history or criminal background.
Initial qualifications
The issuing jurisdiction must verify satisfaction of its minimum education and, where applicable, experience and clinical supervision requirements.
Military status
Veteran within Iowa Code §35.1(2), or spouse of an active-duty United States military member, holding an unrestricted license in another jurisdiction.
Pending complaints
No pending complaint, allegation or investigation concerning unprofessional conduct; unresolved matters hold the application without issuance or denial.
Previous examination
Show any examination previously required by the issuing jurisdiction was passed, if applicable. The statute does not name an examination; this is an applicant condition.
Priority
Application is expedited; provide documentation verifying veteran or spouse status.
Revocation or surrender
No revocation or voluntary surrender while under investigation in another jurisdiction or country; 481—501.1(3) states that a revoked or voluntarily surrendered license is ineligible.

Official no-examination sources

Effective from 2026-09-22.

Full licensure after military temporary license education or training
International Licensing Examination for Hearing Healthcare Professionals
Alternative other profession exam
A passing Praxis Examination in audiology through Educational Testing Service is an alternative under 481—2060.4(2)(b). It is another profession’s examination and is an applicant condition under this contract.
Education training
Submit records completing the education or training prescribed by the authority; Iowa Code §272C.12A(3) then requires issuance of the ordinary license.
Military status
Qualifying veteran or active-duty military spouse previously issued the remedial temporary license under Iowa Code §272C.12A(2).
Prior examination
481—7.3(5)(a) requires the ordinary licensure examinations to have been passed before the temporary license is issued. This currently offered IHS examination remains a leaf even when passed before the full-license application; no additional sitting is asserted.
Temporary period
The full-license application remains pending until training is completed or the temporary license expires; the authority may extend the temporary license for good cause (481—7.3(5)(d)).
Reactivation after more than five years of inactivity
No examination is required for this applicant pathway.
Application
Submit the completed online reactivation application and nonrefundable fee.
Continuing education
Verify 48 continuing-education hours completed within two years before the reactivation application.
Inactive period
Inactive for more than five years.
License verification
Verify the license from the jurisdiction most recently licensed, showing licensee name, initial licensure date, current status and disciplinary action.

Official no-examination sources

Effective from 2026-09-22.

Reactivation after five years or less of inactivity
No examination is required for this applicant pathway.
Application
Submit the completed online reactivation application and nonrefundable fee.
Continuing education
Verify 24 continuing-education hours completed within two years before the reactivation application.
Inactive period
Inactive for five years or less.
License verification
Verify the license from the jurisdiction most recently licensed, showing licensee name, initial licensure date, current status and disciplinary action.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after revocation, suspension or voluntary surrender
No examination is required for this applicant pathway.
Cross reference
The hearing-aid definition still refers to 481—506.31; the obtained current chapter numbers the reinstatement procedure 481—506.32 and uses 506.31 for public records. This numbering discrepancy does not identify any currently offered licensing examination.
Department approval
Apply for and obtain department-approved reinstatement, and obtain reactivation before resuming practice (481—2060.9).
Individual assessments
Any physical, mental, substance-abuse or clinical-competency evaluation ordered in an individual case is a condition, not an identified registered licensing examination. 481 IAC chapter 500 — Model Rules for Board Administrative Processes (481—500.10 introductory provision) states: 481—500.10(147,272C) Order for physical, mental, substance abuse or clinical competency examination. If the board has probable cause, a licensee may be required to submit to a physical, mental, substance abuse or clinical competency examination at the licensee’s expense.
Order conditions
Meet the terms and conditions of the disciplinary order. If the order sets no reinstatement conditions or the license was surrendered, the model procedure generally requires one year before the initial reinstatement application.
Proof
Applicant bears the burden to show that the basis for discipline or surrender no longer exists and reinstatement serves the public interest; the authority issues a decision with findings and legal conclusions.
Reactivation
Complete the applicable reactivation application, fee, license verification and 24-hour or 48-hour continuing-education requirements.
Status
License revoked, suspended or voluntarily surrendered; a permanently revoked license is not eligible under the model reinstatement procedure.

Official no-examination sources

Effective from 2026-09-22.

Subsequent biennial renewal
No examination is required for this applicant pathway.
Application fee
Submit the completed renewal application and renewal fee before expiration; Iowa Code §147.10(1) states application with fee at least 30 days before expiration.
Continuing education
Complete 24 continuing-education hours per biennium, including at least two hours in Iowa hearing aid law and rules or ethics; up to 12 excess hours may carry forward from the preceding period.
Exemptions
481—500.8 provides qualifying active military duty, out-of-state continuing-education residency and overseas government-duty exemptions; 481—500.9 permits disability, illness or qualifying caregiver extensions or exemptions by application.
Mandatory reporting
If examining, attending, counseling or treating children or dependent adults, complete applicable HHS mandatory-reporter training and retain documentation for three years; active military service or an approved hardship waiver excuses this training.
Practice status
An inactive license retains the privilege of licensure but authorizes no practice until reactivation.
Reactivation credit
Continuing-education credit earned in the current compliance period for reactivation may be used for the first renewal after reactivation.
Renewal period
Biennial period is January 1 of an odd-numbered year through December 31 of the next even-numbered year.

Official no-examination sources

Effective from 2026-09-22.

First renewal
No examination is required for this applicant pathway.
Application fee
Submit the completed renewal application and renewal fee before expiration; Iowa Code §147.10(1) states application with fee at least 30 days before expiration.
First renewal
A person licensed for the first time need not complete continuing education for the first renewal. If issued within six months of the renewal date, renewal is deferred until the next renewal two years later.
Mandatory reporting
If examining, attending, counseling or treating children or dependent adults, complete applicable HHS mandatory-reporter training and retain documentation for three years; active military service or an approved hardship waiver excuses this training.
Practice status
An inactive license retains the privilege of licensure but authorizes no practice until reactivation.
Renewal period
Biennial period is January 1 of an odd-numbered year through December 31 of the next even-numbered year.

Official no-examination sources

Effective from 2026-09-22.

Licensure by verification
No examination is required for this applicant pathway.
Application
Submit application, fees, attestation of Iowa Code §272C.12 compliance, a written scope-of-practice statement and relevant laws; fingerprint cards and waiver are required if the authority requires an initial-license background check.
Compact
An Iowa compact practice privilege makes the applicant ineligible under 481—501.1(5); verification licensure grants no interstate compact privilege.
Criminal history
No criminal history that prevents licensure; provide criminal and disciplinary records where relevant.
Current license
Hold a current good-standing license in another state with a substantially similar scope of practice (Iowa Code §272C.12(1)(a)).
Discipline
Discipline must be resolved and its cause corrected; unresolved matters hold the application without issuance or denial.
Hearing profession referral
481—2060.5(2) makes verification available if the applicant cannot satisfy endorsement requirements. This distinct statutory route is issued without examination under Iowa Code §272C.12; the current hearing-aid initial-licensure rules identify only the IHS examination and Praxis Audiology, and impose no Iowa-law examination.
Initial qualifications
The issuing jurisdiction must verify satisfaction of its minimum education and, where applicable, experience and clinical supervision requirements.
Pending complaints
No pending complaint, allegation or investigation concerning unprofessional conduct; unresolved matters hold the application without issuance or denial.
Previous examination
Show any examination previously required by the issuing jurisdiction was passed, if applicable. The statute does not name an examination; this is an applicant condition.
Revocation or surrender
No revocation or voluntary surrender while under investigation in another jurisdiction or country; 481—501.1(3) states that a revoked or voluntarily surrendered license is ineligible.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure with work experience from a jurisdiction without licensure
International Licensing Examination for Hearing Healthcare Professionals
Alternative other profession exam
A passing Praxis Examination in audiology through Educational Testing Service is an alternative under 481—2060.4(2)(b). It is another profession’s examination and is an applicant condition under this contract.
Application
Submit the completed online application and the nonrefundable licensure fee (481—2060.4(1)).
Application expiry
An incomplete application on file more than two years is invalid and destroyed unless the candidate requests otherwise in writing (481—2060.4(6)).
Attempt limit
Taking the IHS examination more than six times requires department approval (481—2060.4(2)(a)).
Documentation
Provide proof of Iowa residency, qualifying duration of work experience and substantially similar scope of practice.
Health
Be free of contagious or infectious disease (Iowa Code §154A.10(2)).
Other requirements
All other initial-license requirements, including the required examination, still apply.
Relocation
Relocate to Iowa from a jurisdiction that did not require licensure for this profession.
Score transmission
DIAL instructs the applicant to have IHS transmit the final examination score directly to the department.
Work experience
At least three years of substantially similar practice within the four years before applying may substitute for education and training.

Hearing Aid Specialist Temporary License — Military Spouse or Veteran

Temporary authorization for a qualifying veteran or active-duty military spouse to complete prescribed education or training.

Licensing authority: Iowa Department of Inspections, Appeals, and Licensing · Application information

Temporary licensure for military spouse or veteran to remedy education or training differences
International Licensing Examination for Hearing Healthcare Professionals
Alternative other profession exam
A passing Praxis Examination in audiology through Educational Testing Service is an alternative under 481—2060.4(2)(b). It is another profession’s examination and is an applicant condition under this contract.
Education training
Complete the education or training identified by the authority during its specified temporary-license period.
Extension
The authority may extend the temporary license case by case for good cause.
Full license
The ordinary-license application remains pending; records of completing the prescribed education or training lead to full licensure under Iowa Code §272C.12A(3).
Military status
Veteran or active-duty military spouse licensed in another jurisdiction, whose scope of practice is not substantially equivalent to Iowa’s.
Prior examination
Under 481—7.3(5)(a), the required licensure examinations must already have been passed; no temporary license is issued while this is outstanding.
Public protection
The authority sets conditions to protect public health, welfare and safety; the rule permits denial when deficiencies adversely affect public protection.

International Licensing Examination for Hearing Healthcare Professionals

Provider
International Hearing Society (IHS); scheduled and paid through the TestWise system at testing centers
Format
Practice-based computer-delivered multiple-choice examination; most questions present a scenario; a few questions require selecting two (or three) correct answers to earn one point; dichotomous right/wrong scoring
Exam questions
105 multiple-choice questions: 80 scored and 25 unscored pilot questions
Time limit
120 minutes (two hours)
Passing score
Pass/Fail on the overall raw score against the IHS-recommended passing score; the licensing agency makes the final decision
Exam fee
$260.00 (USD) per examination appointment, including re-takes, plus applicable taxes
Examination outline
  • Domain 1. Conduct Patient/Client Assessment (21%) (21%)
    • Objective 1.1 Apply infection control protocols (5%). Includes but is not limited to choosing appropriate infection control processes for tools and equipment; observing universal precautions for infection control; distinguishing between single- and multiple-use items; differentiating among sanitization, disinfection and sterilization processes; and identifying personal protective equipment.
    • Objective 1.2 Apply otoscopic inspection protocols (5%). Includes but is not limited to observing safety protocols during otoscopy; identifying anatomical structures; identifying abnormalities through otoscopic inspection; and recognizing the presence of referral criteria. This objective helps provide evidence of the candidate’s ability to perform otoscopy.
    • Objective 1.3 Utilize audiometric testing protocols (11%). Includes but is not limited to performing air and bone conduction threshold and suprathreshold testing; performing speech audiometry; performing effective masking; and applying principles to include interpreting results of tympanometry/immittance audiometry. This objective helps provide evidence of the candidate’s ability to perform audiometric testing and application of tympanometry.
  • Domain 2. Interpret and Apply Assessment Results (22%) (22%)
    • Objective 2.1 Interpret and explain audiometric results (11%). Includes but is not limited to demonstrating an understanding of referral criteria; interpreting pure tone and speech testing results; identifying the need for additional testing; identifying the degree and configuration of hearing loss; and identifying the type of hearing loss.
    • Objective 2.2 Determine candidacy for amplification (11%). Includes but is not limited to interpreting the case history and outlining contraindications to hearing instrument use.
  • Domain 3. Select Hearing Devices (18%) (18%)
    • Objective 3.1 Select style and type of hearing instruments (9%). Includes but is not limited to establishing fitting goals and selecting specific hearing instruments based on test results, case history, and individual patient/client preferences and lifestyle; selecting electroacoustic and physical properties; and evaluating the need for accessory devices.
    • Objective 3.2 Select earmold or other acoustic coupler (9%). Includes but is not limited to assessing physical properties of the outer ear, taking ear impressions, critiquing ear impressions, and selecting coupler based on patient/client needs.
  • Domain 4. Fit and Dispense Hearing Devices (20%) (20%)
    • Objective 4.1 Utilize protocols to fit hearing instruments and other devices (10%). Includes but is not limited to confirming physical and acoustic integrity of hearing devices; programming and adjusting hearing devices; verifying physical fit and acoustic comfort; orienting patient/client to hearing instruments; and orienting patient/client to assistive devices. This objective helps provide evidence of the candidate’s ability to program and dispense hearing instruments and other devices.
    • Objective 4.2 Verify fitting (5%). Includes but is not limited to selecting verification method based on patient/client; assessing physical and acoustic integrity of hearing devices; interpreting and explaining verification results; and modifying physical and acoustic parameters of device. This objective helps provide evidence of the candidate’s ability to perform fitting verification (e.g., speech mapping, REM).
    • Objective 4.3 Validate fitting (5%). Includes but is not limited to selecting validation method based on patient/client; interpreting and explaining validation results; and modifying physical and acoustic parameters of device. This objective helps provide evidence of the candidate’s ability to perform fitting validation (e.g., questionnaire, self-assessment).
  • Domain 5. Provide Continuing Care (19%) (19%)
    • Objective 5.1 Implement aural rehabilitation and counseling (8%). Includes but is not limited to demonstrating an understanding of the psychology of the hearing impaired; defining and managing patient/client expectations for improved communication; defining and managing family/caregiver expectations for improved communication; and identifying communication strategies.
    • Objective 5.2 Apply instrument maintenance and troubleshooting protocols (9%). Includes but is not limited to employing hearing instrument cleaning procedures; performing listening checks on hearing instruments; troubleshooting acoustic properties of hearing instruments; and adjusting based upon changes in patient/client hearing loss and/or listening needs. This objective helps provide evidence of the candidate’s ability to maintain and troubleshoot instrument performance.
    • Objective 5.3 Interpret electroacoustic analysis results (2%). Includes but is not limited to identifying need for electroacoustic analysis and comparing electroacoustic analysis of patient’s/client’s hearing instruments to fitting specifications.
Examination sources