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Massachusetts Hearing Instrument Specialist — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Apprentice Hearing Instrument Specialist

Supervised apprentice registration during the approved training program.

Licensing authority: Massachusetts Board of Registration of Hearing Instrument Specialists · Application information

Initial apprentice registration and training
International Licensing Examination for Hearing Healthcare Professionals
Application fee
Submit the prescribed application and filing fee.
Duration
Initial apprentice registration expires 18 months after issuance; the apprenticeship requires at least one year full-time or equivalent part-time.
Education
Accredited high school diploma or equivalent proof of high school education.
Exam timing
The ILE is involved after completion of the training program under §198(b); it need not be passed before the apprentice certificate is first issued. After three failed examinations, reexamination is at Board discretion.
Minimum age
At least 18 years old.
Supervision
Direct on-site supervision for at least the first 30 days full-time or equivalent part-time; subsequent written supervisor review and approval until full licensure or termination.
Supervisor
Identify a Massachusetts hearing instrument specialist or audiologist licensed in good standing who certifies the application and accepts supervisory responsibility.
Training completion
Complete the approved home-study course or approved academic substitute and the 150-hour practicum required by 265 CMR 4.03.
Training enrollment
Enroll in a Board-approved training program and agree in writing to the training duties and standards of ethics and professional conduct.
Reissuance or extension of apprentice registration
International Licensing Examination for Hearing Healthcare Professionals
Approval
265 CMR 4.02(1) permits one reissuance for 18 months, at Board discretion for good cause shown.
Delegated first extension
The January 17, 2025 Board vote delegates a six-month first extension to staff for an apprentice with no Board discipline; requests for additional time require Board appearance. The January 16, 2026 minutes record approval of a subsequent 12-month extension.
Exam timing
The ILE remains the examination the apprenticeship involves; passing is not a prerequisite to extension. Retakes after three failures are at Board discretion.
Existing registration
Hold an apprentice registration needing extension because the minimum one-year full-time or equivalent part-time training remains incomplete, or training is complete but the examination has not been passed.
Supervision
Continue supervised practice and the remaining apprenticeship duties.

Hearing Instrument Specialist

License to fit and dispense hearing aids in Massachusetts.

Licensing authority: Massachusetts Board of Registration of Hearing Instrument Specialists · Application information

Initial licensure under the pre July 1999 practice exception
No examination is required for this applicant pathway.
Accepted practice
Satisfy the Board that the applicant dispensed hearing aids with accepted professional practice standards.
Application
Submit the Board application completely filled out, signed under penalties of perjury, with required information.
Character
Good moral character.
Education
High school diploma or its equivalent.
Exemption
Section 197(g) excludes qualifying applicants from §197(f)(4), including apprenticeship and certification/examination.
Fee
Pay the applicable application and license fees.
Historic practice
Have practiced dispensing hearing aids in Massachusetts full-time for more than three years before July 1, 1999.
Minimum age
At least 18 years old.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by approved apprenticeship and examination or current approved certification
International Licensing Examination for Hearing Healthcare Professionals
Application
Submit the Board application completely filled out, signed under penalties of perjury, with required information.
Apprenticeship
Complete a Board-approved minimum 12-month apprenticeship, including training and supervised work experience; passing the exam does not shorten the 12-month minimum.
Certification alternative
M.G.L. c.112 §197(f)(4)(i) and 265 CMR 3.01(2)(d) permit current certification from a Board-approved nationally recognized body instead of passing the approved examination. The text does not name a particular certification examination. M.G.L. c.112 §198(b) also says: "Upon completion of the training program, the apprentice shall take the board approved examination." The ILE remains a leaf; applicants must determine the applicability of the certification alternative with the Board.
Character
Good moral character.
Education
High school diploma or its equivalent.
Fee
Pay the applicable application and license fees.
Minimum age
At least 18 years old.
Practicum
Complete 150 directly supervised practicum hours: 25 audiometry; 25 post-fitting evaluations; 20 fittings with clients; 10 earmold orientation; 15 earmold impressions and otoscopy; 15 troubleshooting; 20 case history; 10 state and federal laws; 10 supplemental work. Submit supervisor certification.
Proposed practical exam
The January 17, 2025 Board minutes describe adoption of a practical examination as requiring a statutory change. The controlling §197(f)(4) still specifies certification or a written/electronic examination.
Retakes
After three failed examinations, further reexamination is at Board discretion under M.G.L. c.112 §198(b).
Training
Pass the IHS Distance Learning for Professionals in Hearing Health Sciences course or another Board-approved home study course before the licensure examination. An accredited certificate, associate degree or higher degree in audiology or hearing instrument technology with passing grades in every relevant class may substitute; the Board may approve another significantly related degree. Submit the required transcript or proof.
Renewal of an expired license within four years
No examination is required for this applicant pathway.
Continuing education
Document all Board-required continuing education contact hours since the license was last issued or renewed.
Elapsed time
Request reinstatement within four years after expiration.
Fees
Pay the renewal fee for the current period and one late fee.
Practice restriction
An expired license does not authorize dispensing or use of the hearing instrument specialist title.

Official no-examination sources

Effective from 2026-09-22.

Licensure by reciprocity
No examination is required for this applicant pathway.
Application
Submit the Board application completely filled out, signed under penalties of perjury, with required information.
Character
Good moral character.
Education
High school diploma or its equivalent.
Existing license
Hold a hearing instrument specialist license or Board-determined equivalent from a jurisdiction the Board deems to have substantially equivalent or higher requirements. The statutory definition includes United States jurisdictions and foreign countries, states or provinces.
Fee
Pay the applicable application and license fees.
Minimum age
At least 18 years old.
Waiver
The Board may license the applicant without the apprenticeship and certification/examination requirements in §197(f)(4) and 265 CMR 3.01(2)(d); qualification and approval are determined by the Board.

Official no-examination sources

Effective from 2026-09-22.

Regular biennial renewal
No examination is required for this applicant pathway.
Application fee
Submit the completed renewal application and required fee.
Ce waiver
The Board may waive continuing education for health, disability, out-of-state military service or undue hardship, for one renewal period at a time with up to two further consecutive waivers.
Continuing education
Complete and document 20 contact hours during the 24 months before renewal, at least ten through Board-recognized programs; attest under penalties of perjury and retain documentation.
Existing license
Renew an existing license before expiration.
Practice standards
Comply with the required standards of practice and conduct.

Official no-examination sources

Effective from 2026-09-22.

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