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Missouri Hearing Instrument Specialist — Requirements & Free Practice

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Hearing Instrument Specialist License

Authorizes selection, fitting and sale of hearing instruments.

Licensing authority: Missouri Board of Examiners for Hearing Instrument Specialists · Application information

Licensure by examination — Graduate audiology degree

All of the following:

Age
At least eighteen years of age (RSMo 346.055.1(1)).
Application
Submit original legible, signed and notarized application, appropriate fees, official transcript directly from school, passport photograph, and verification from every jurisdiction where previously licensed (20 CSR 2165-2.025(2)). Application is valid for three years from receipt; reapplication must meet current requirements (subsection (4)).
Application Character Statement
The June 2025 Application for License states: (2) Is of good moral character; and Current RSMo 346.055.1 omits that item. The Board form also requires explanations and certified records for affirmative disciplinary and criminal-history answers.
Education Before Issuance
Examinations may be completed before finishing education; issuance awaits completion and an official conferred-degree transcript (20 CSR 2165-2.025(3)).
Exam Sequence
Pass the ILE before eligibility for the practical assessment; the Board must receive written scores at least thirty days before the scheduled practical assessment (20 CSR 2165-2.030(5)). Out-of-state ILE scores are accepted if transferred directly from IHS.
Practical Application Deadline
The Board must receive the practical application at least thirty days before the next scheduled practical assessment (20 CSR 2165-2.030(1)).
Practical Requirements
Supply permitted calibrated equipment. Failure of any practical portion requires retaking the whole practical assessment. After the initial failure and two further failures, obtain Board approval after presenting a written plan and meeting with the Board; the registered supervisor must attend for a trainee (20 CSR 2165-2.030(6), (8), (9)).
Qualifying Education Or License
Master’s or doctoral degree in audiology from a state- or regionally-accredited institution.
Training If Permit Held
A Missouri trainee permit holder must accrue at least 100 hours under a registered supervisor and submit supervisor attestation before licensure by examination. Holding a temporary permit is not mandatory before applying for a full license (20 CSR 2165-2.010(3), (6), Board FAQ).
Licensure by examination — Degree plus IHS course

All of the following:

Age
At least eighteen years of age (RSMo 346.055.1(1)).
Application
Submit original legible, signed and notarized application, appropriate fees, official transcript directly from school, passport photograph, and verification from every jurisdiction where previously licensed (20 CSR 2165-2.025(2)). Application is valid for three years from receipt; reapplication must meet current requirements (subsection (4)).
Application Character Statement
The June 2025 Application for License states: (2) Is of good moral character; and Current RSMo 346.055.1 omits that item. The Board form also requires explanations and certified records for affirmative disciplinary and criminal-history answers.
Education Before Issuance
Examinations may be completed before finishing education; issuance awaits completion and an official conferred-degree transcript (20 CSR 2165-2.025(3)).
Exam Sequence
Pass the ILE before eligibility for the practical assessment; the Board must receive written scores at least thirty days before the scheduled practical assessment (20 CSR 2165-2.030(5)). Out-of-state ILE scores are accepted if transferred directly from IHS.
Practical Application Deadline
The Board must receive the practical application at least thirty days before the next scheduled practical assessment (20 CSR 2165-2.030(1)).
Practical Requirements
Supply permitted calibrated equipment. Failure of any practical portion requires retaking the whole practical assessment. After the initial failure and two further failures, obtain Board approval after presenting a written plan and meeting with the Board; the registered supervisor must attend for a trainee (20 CSR 2165-2.030(6), (8), (9)).
Qualifying Education Or License
Associate-level degree or higher from a state- or regionally-accredited institution and completed IHS Distance Learning for Professionals in Hearing Health Sciences Course.
Training If Permit Held
A Missouri trainee permit holder must accrue at least 100 hours under a registered supervisor and submit supervisor attestation before licensure by examination. Holding a temporary permit is not mandatory before applying for a full license (20 CSR 2165-2.010(3), (6), Board FAQ).
Licensure by examination — Equivalent foreign license

All of the following:

Age
At least eighteen years of age (RSMo 346.055.1(1)).
Application
Submit original legible, signed and notarized application, appropriate fees, official transcript directly from school, passport photograph, and verification from every jurisdiction where previously licensed (20 CSR 2165-2.025(2)). Application is valid for three years from receipt; reapplication must meet current requirements (subsection (4)).
Application Character Statement
The June 2025 Application for License states: (2) Is of good moral character; and Current RSMo 346.055.1 omits that item. The Board form also requires explanations and certified records for affirmative disciplinary and criminal-history answers.
Education Before Issuance
Examinations may be completed before finishing education; issuance awaits completion and an official conferred-degree transcript (20 CSR 2165-2.025(3)).
Exam Sequence
Pass the ILE before eligibility for the practical assessment; the Board must receive written scores at least thirty days before the scheduled practical assessment (20 CSR 2165-2.030(5)). Out-of-state ILE scores are accepted if transferred directly from IHS.
Practical Application Deadline
The Board must receive the practical application at least thirty days before the next scheduled practical assessment (20 CSR 2165-2.030(1)).
Practical Requirements
Supply permitted calibrated equipment. Failure of any practical portion requires retaking the whole practical assessment. After the initial failure and two further failures, obtain Board approval after presenting a written plan and meeting with the Board; the registered supervisor must attend for a trainee (20 CSR 2165-2.030(6), (8), (9)).
Qualifying Education Or License
Current unsuspended, unrevoked license from another country with standards the Board determines equivalent to or greater than RSMo 346.055.1(3)(a) or (b).
Training If Permit Held
A Missouri trainee permit holder must accrue at least 100 hours under a registered supervisor and submit supervisor attestation before licensure by examination. Holding a temporary permit is not mandatory before applying for a full license (20 CSR 2165-2.010(3), (6), Board FAQ).
Licensure by examination — Foreign practice with advanced certification

All of the following:

Age
At least eighteen years of age (RSMo 346.055.1(1)).
Application
Submit original legible, signed and notarized application, appropriate fees, official transcript directly from school, passport photograph, and verification from every jurisdiction where previously licensed (20 CSR 2165-2.025(2)). Application is valid for three years from receipt; reapplication must meet current requirements (subsection (4)).
Application Character Statement
The June 2025 Application for License states: (2) Is of good moral character; and Current RSMo 346.055.1 omits that item. The Board form also requires explanations and certified records for affirmative disciplinary and criminal-history answers.
Education Before Issuance
Examinations may be completed before finishing education; issuance awaits completion and an official conferred-degree transcript (20 CSR 2165-2.025(3)).
Exam Sequence
Pass the ILE before eligibility for the practical assessment; the Board must receive written scores at least thirty days before the scheduled practical assessment (20 CSR 2165-2.030(5)). Out-of-state ILE scores are accepted if transferred directly from IHS.
Practical Application Deadline
The Board must receive the practical application at least thirty days before the next scheduled practical assessment (20 CSR 2165-2.030(1)).
Practical Requirements
Supply permitted calibrated equipment. Failure of any practical portion requires retaking the whole practical assessment. After the initial failure and two further failures, obtain Board approval after presenting a written plan and meeting with the Board; the registered supervisor must attend for a trainee (20 CSR 2165-2.030(6), (8), (9)).
Qualifying Education Or License
Current unsuspended, unrevoked license from another country, active licensed hearing-aid practice there for forty-eight of the preceding seventy-two months, and advanced certification from IHS or NBC-HIS. The certification is a qualification; this provision names no NCE examination requirement.
Training If Permit Held
A Missouri trainee permit holder must accrue at least 100 hours under a registered supervisor and submit supervisor attestation before licensure by examination. Holding a temporary permit is not mandatory before applying for a full license (20 CSR 2165-2.010(3), (6), Board FAQ).
Licensure by examination — Hearing instrument sciences degree

All of the following:

Age
At least eighteen years of age (RSMo 346.055.1(1)).
Application
Submit original legible, signed and notarized application, appropriate fees, official transcript directly from school, passport photograph, and verification from every jurisdiction where previously licensed (20 CSR 2165-2.025(2)). Application is valid for three years from receipt; reapplication must meet current requirements (subsection (4)).
Application Character Statement
The June 2025 Application for License states: (2) Is of good moral character; and Current RSMo 346.055.1 omits that item. The Board form also requires explanations and certified records for affirmative disciplinary and criminal-history answers.
Education Before Issuance
Examinations may be completed before finishing education; issuance awaits completion and an official conferred-degree transcript (20 CSR 2165-2.025(3)).
Exam Sequence
Pass the ILE before eligibility for the practical assessment; the Board must receive written scores at least thirty days before the scheduled practical assessment (20 CSR 2165-2.030(5)). Out-of-state ILE scores are accepted if transferred directly from IHS.
Practical Application Deadline
The Board must receive the practical application at least thirty days before the next scheduled practical assessment (20 CSR 2165-2.030(1)).
Practical Requirements
Supply permitted calibrated equipment. Failure of any practical portion requires retaking the whole practical assessment. After the initial failure and two further failures, obtain Board approval after presenting a written plan and meeting with the Board; the registered supervisor must attend for a trainee (20 CSR 2165-2.030(6), (8), (9)).
Qualifying Education Or License
Associate degree or higher in hearing instrument sciences from a state- or regionally-accredited institution.
Training If Permit Held
A Missouri trainee permit holder must accrue at least 100 hours under a registered supervisor and submit supervisor attestation before licensure by examination. Holding a temporary permit is not mandatory before applying for a full license (20 CSR 2165-2.010(3), (6), Board FAQ).
Activation of inactive license
No examination is required for this applicant pathway.
Application And Fee
Submit renewal application and balance of the active renewal fee, without prorating.
Calibration
Annual calibration receipt.
Continuing Education
Proof of CE for each inactive renewal cycle.
License
Return the stamped inactive license.
Supervisor Credential
Registered supervisors must provide current board-certification proof; this is a qualification rather than a named examination.

Official no-examination sources

Effective from 2022-11-30.

Renewal or reinstatement after active military service
No examination is required for this applicant pathway.
Eligibility
A previously current license lapsed during active military service.
Notice
Submit signed, dated Notice of Active Military Duty or accepted written communication, naming license and activation date, with military orders or sufficient service-date evidence, within sixty days after completion of duty. Upon Board approval reinstatement requires nothing further and has no penalty.

Official no-examination sources

Effective from 2020-03-30.

Reactivation of non current license within two years
No examination is required for this applicant pathway.
Documents And Fees
Renewal application, renewal fee, reactivation fee, annual calibration receipt and proof of CE obtained during the preceding twenty-four months.
Elapsed Time
Within two years after expiration; no practice while non-current.

Official no-examination sources

Effective from 2022-11-30.

Reapplication by examination after more than two years non current

All of the following:

Age
At least eighteen years of age (RSMo 346.055.1(1)).
Application
Submit original legible, signed and notarized application, appropriate fees, official transcript directly from school, passport photograph, and verification from every jurisdiction where previously licensed (20 CSR 2165-2.025(2)). Application is valid for three years from receipt; reapplication must meet current requirements (subsection (4)).
Application Character Statement
The June 2025 Application for License states: (2) Is of good moral character; and Current RSMo 346.055.1 omits that item. The Board form also requires explanations and certified records for affirmative disciplinary and criminal-history answers.
Education Before Issuance
Examinations may be completed before finishing education; issuance awaits completion and an official conferred-degree transcript (20 CSR 2165-2.025(3)).
Exam Sequence
Pass the ILE before eligibility for the practical assessment; the Board must receive written scores at least thirty days before the scheduled practical assessment (20 CSR 2165-2.030(5)). Out-of-state ILE scores are accepted if transferred directly from IHS.
Lapsed License
After more than two years non-current, submit a new application, all required documentation and all fees; qualify again for issuance by examination. The examinations remain the currently offered ILE and state practical assessment on the examination pathway; prior ILE evidence may be transferred directly from IHS.
Practical Application Deadline
The Board must receive the practical application at least thirty days before the next scheduled practical assessment (20 CSR 2165-2.030(1)).
Practical Requirements
Supply permitted calibrated equipment. Failure of any practical portion requires retaking the whole practical assessment. After the initial failure and two further failures, obtain Board approval after presenting a written plan and meeting with the Board; the registered supervisor must attend for a trainee (20 CSR 2165-2.030(6), (8), (9)).
Qualification
Satisfy one of the degree, degree-plus-course, graduate audiology, equivalent foreign-license, or foreign-practice-plus-certification qualifications in RSMo 346.055.1(3).
Training If Permit Held
A Missouri trainee permit holder must accrue at least 100 hours under a registered supervisor and submit supervisor attestation before licensure by examination. Holding a temporary permit is not mandatory before applying for a full license (20 CSR 2165-2.010(3), (6), Board FAQ).
Reapplication by reciprocity after more than two years non current
No examination is required for this applicant pathway.
Compact
Licensure elsewhere through an interstate compact excludes this route. The resulting Missouri license is valid only in Missouri and creates no compact eligibility (RSMo 324.009.11).
Fees And Discretion
Fees, bonds and insurance are not waived; the Board retains statutory grounds for denial (RSMo 324.009.5, .7).
Good Standing
Waiver is prohibited for revocation, pending investigation or complaint, unresolved discipline, lack of good standing, Missouri-disqualifying criminal record or no current other-jurisdiction license upon receipt. Resolved discipline is reviewed under RSMo 324.009.4(2).
Lapsed License
A formerly Missouri licensed specialist whose license has been non-current for more than two years must submit a new application, all required documentation and fees; a qualifying current other-jurisdiction license supports the statutory reciprocity waiver.
Lower Ranked Application Examination Demands
MO 375-0281 (6-2025), Instructions item 5, states: 5. Applicants must submit the application for licensure, the application fee and Practical Examination fee to the Board of Examiners for Hearing Instrument Specialists and the written examination (International Licensing Examination) fee directly to the International Hearing Society. Required documents item 4 states: 4. Written Examination (ILE) scores must be submitted by the International Hearing Society (IHS). Applicants must request that the score be transferred directly to the Board from IHS. The mandatory examination waiver in RSMo 324.009.3 controls for a qualifying applicant; these lower-ranked form demands remain applicant conditions.
Minimum Requirements
The other jurisdiction verifies satisfaction of its minimum education and applicable experience and clinical-supervision requirements when licensed.
Prior License
Current license at the same practice level from another state, US territory, District of Columbia, or branch or unit of the military; at least one year of licensure; submit verification directly from the authority.

Official no-examination sources

Effective from 2026-08-28.

Reapplication by spouse reciprocity after more than two years non current — Nonresident military or law enforcement spouse
No examination is required for this applicant pathway.
Compact
Licensure elsewhere through an interstate compact excludes this route. The resulting Missouri license is valid only in Missouri and creates no compact eligibility (RSMo 324.009.11).
Fees And Discretion
Fees, bonds and insurance are not waived; the Board retains statutory grounds for denial (RSMo 324.009.5, .7).
Good Standing
Waiver is prohibited for revocation, pending investigation or complaint, unresolved discipline, lack of good standing, Missouri-disqualifying criminal record or no current other-jurisdiction license upon receipt. Resolved discipline is reviewed under RSMo 324.009.4(2).
Lapsed License
Submit a new application with all documentation and fees after more than two years non-current.
Lower Ranked Application Examination Demands
MO 375-0281 (6-2025), Instructions item 5, states: 5. Applicants must submit the application for licensure, the application fee and Practical Examination fee to the Board of Examiners for Hearing Instrument Specialists and the written examination (International Licensing Examination) fee directly to the International Hearing Society. Required documents item 4 states: 4. Written Examination (ILE) scores must be submitted by the International Hearing Society (IHS). Applicants must request that the score be transferred directly to the Board from IHS. The mandatory examination waiver in RSMo 324.009.3 controls for a qualifying applicant; these lower-ranked form demands remain applicant conditions.
Minimum Requirements
The other jurisdiction verifies satisfaction of its minimum education and applicable experience and clinical-supervision requirements when licensed.
Prior License
Current license at the same practice level from another state, US territory, District of Columbia, or branch or unit of the military; at least one year of licensure; submit verification directly from the authority.
Processing
The statutory spouse route requires waiver of examinations, education and experience and issuance within thirty days for a qualifying applicant.
Spouse Eligibility
"Nonresident military or law enforcement spouse" :   (a)  A nonresident spouse of an active duty member of the Armed Forces of the United States who has been transferred or is scheduled to be transferred to the state of Missouri, or who has been transferred or is scheduled to be transferred to an adjacent state and is or will be domiciled in the state of Missouri, or has moved to the state of Missouri on a permanent change-of-station basis; or   (b)  A nonresident spouse of a person residing outside the state of Missouri who has accepted an offer of employment from and with the state or a local governmental entity in the state of Missouri and who will become a Missouri law enforcement officer upon the commencement of such employment;

Official no-examination sources

Effective from 2026-08-28.

Reapplication by spouse reciprocity after more than two years non current — Resident military or law enforcement spouse
No examination is required for this applicant pathway.
Compact
Licensure elsewhere through an interstate compact excludes this route. The resulting Missouri license is valid only in Missouri and creates no compact eligibility (RSMo 324.009.11).
Fees And Discretion
Fees, bonds and insurance are not waived; the Board retains statutory grounds for denial (RSMo 324.009.5, .7).
Good Standing
Waiver is prohibited for revocation, pending investigation or complaint, unresolved discipline, lack of good standing, Missouri-disqualifying criminal record or no current other-jurisdiction license upon receipt. Resolved discipline is reviewed under RSMo 324.009.4(2).
Lapsed License
Submit a new application with all documentation and fees after more than two years non-current.
Lower Ranked Application Examination Demands
MO 375-0281 (6-2025), Instructions item 5, states: 5. Applicants must submit the application for licensure, the application fee and Practical Examination fee to the Board of Examiners for Hearing Instrument Specialists and the written examination (International Licensing Examination) fee directly to the International Hearing Society. Required documents item 4 states: 4. Written Examination (ILE) scores must be submitted by the International Hearing Society (IHS). Applicants must request that the score be transferred directly to the Board from IHS. The mandatory examination waiver in RSMo 324.009.3 controls for a qualifying applicant; these lower-ranked form demands remain applicant conditions.
Minimum Requirements
The other jurisdiction verifies satisfaction of its minimum education and applicable experience and clinical-supervision requirements when licensed.
Prior License
Current license at the same practice level from another state, US territory, District of Columbia, or branch or unit of the military; at least one year of licensure; submit verification directly from the authority.
Processing
The statutory spouse route requires waiver of examinations, education and experience and issuance within thirty days for a qualifying applicant.
Spouse Eligibility
"Resident military or law enforcement spouse" , a spouse of an active duty member of the Armed Forces of the United States who has been transferred or is scheduled to be transferred to the state of Missouri or an adjacent state and who is a permanent resident of the state of Missouri, who is domiciled in the state of Missouri, or who has Missouri as his or her home of record, or a spouse of a Missouri law enforcement officer.

Official no-examination sources

Effective from 2026-08-28.

Licensure by reciprocity under RSMo 324.009
No examination is required for this applicant pathway.
Compact
Licensure elsewhere through an interstate compact excludes this route. The resulting Missouri license is valid only in Missouri and creates no compact eligibility (RSMo 324.009.11).
Fees And Discretion
Fees, bonds and insurance are not waived; the Board retains statutory grounds for denial (RSMo 324.009.5, .7).
Good Standing
Waiver is prohibited for revocation, pending investigation or complaint, unresolved discipline, lack of good standing, Missouri-disqualifying criminal record or no current other-jurisdiction license upon receipt. Resolved discipline is reviewed under RSMo 324.009.4(2).
Lower Ranked Application Examination Demands
MO 375-0281 (6-2025), Instructions item 5, states: 5. Applicants must submit the application for licensure, the application fee and Practical Examination fee to the Board of Examiners for Hearing Instrument Specialists and the written examination (International Licensing Examination) fee directly to the International Hearing Society. Required documents item 4 states: 4. Written Examination (ILE) scores must be submitted by the International Hearing Society (IHS). Applicants must request that the score be transferred directly to the Board from IHS. The mandatory examination waiver in RSMo 324.009.3 controls for a qualifying applicant; these lower-ranked form demands remain applicant conditions.
Minimum Requirements
The other jurisdiction verifies satisfaction of its minimum education and applicable experience and clinical-supervision requirements when licensed.
Prior License
Current license at the same practice level from another state, US territory, District of Columbia, or branch or unit of the military; at least one year of licensure; submit verification directly from the authority.

Official no-examination sources

Effective from 2026-08-28.

Licensure by reciprocity — Nonresident military or law enforcement spouse
No examination is required for this applicant pathway.
Compact
Licensure elsewhere through an interstate compact excludes this route. The resulting Missouri license is valid only in Missouri and creates no compact eligibility (RSMo 324.009.11).
Fees And Discretion
Fees, bonds and insurance are not waived; the Board retains statutory grounds for denial (RSMo 324.009.5, .7).
Good Standing
Waiver is prohibited for revocation, pending investigation or complaint, unresolved discipline, lack of good standing, Missouri-disqualifying criminal record or no current other-jurisdiction license upon receipt. Resolved discipline is reviewed under RSMo 324.009.4(2).
Lower Ranked Application Examination Demands
MO 375-0281 (6-2025), Instructions item 5, states: 5. Applicants must submit the application for licensure, the application fee and Practical Examination fee to the Board of Examiners for Hearing Instrument Specialists and the written examination (International Licensing Examination) fee directly to the International Hearing Society. Required documents item 4 states: 4. Written Examination (ILE) scores must be submitted by the International Hearing Society (IHS). Applicants must request that the score be transferred directly to the Board from IHS. The mandatory examination waiver in RSMo 324.009.3 controls for a qualifying applicant; these lower-ranked form demands remain applicant conditions.
Minimum Requirements
The other jurisdiction verifies satisfaction of its minimum education and applicable experience and clinical-supervision requirements when licensed.
Prior License
Current license at the same practice level from another state, US territory, District of Columbia, or branch or unit of the military; at least one year of licensure; submit verification directly from the authority.
Processing
For an otherwise qualified spouse the oversight body shall waive examination, education and experience requirements and issue the license within thirty days after application receipt.
Spouse Eligibility
"Nonresident military or law enforcement spouse" :   (a)  A nonresident spouse of an active duty member of the Armed Forces of the United States who has been transferred or is scheduled to be transferred to the state of Missouri, or who has been transferred or is scheduled to be transferred to an adjacent state and is or will be domiciled in the state of Missouri, or has moved to the state of Missouri on a permanent change-of-station basis; or   (b)  A nonresident spouse of a person residing outside the state of Missouri who has accepted an offer of employment from and with the state or a local governmental entity in the state of Missouri and who will become a Missouri law enforcement officer upon the commencement of such employment;

Official no-examination sources

Effective from 2026-08-28.

Licensure by reciprocity — Resident military or law enforcement spouse
No examination is required for this applicant pathway.
Compact
Licensure elsewhere through an interstate compact excludes this route. The resulting Missouri license is valid only in Missouri and creates no compact eligibility (RSMo 324.009.11).
Fees And Discretion
Fees, bonds and insurance are not waived; the Board retains statutory grounds for denial (RSMo 324.009.5, .7).
Good Standing
Waiver is prohibited for revocation, pending investigation or complaint, unresolved discipline, lack of good standing, Missouri-disqualifying criminal record or no current other-jurisdiction license upon receipt. Resolved discipline is reviewed under RSMo 324.009.4(2).
Lower Ranked Application Examination Demands
MO 375-0281 (6-2025), Instructions item 5, states: 5. Applicants must submit the application for licensure, the application fee and Practical Examination fee to the Board of Examiners for Hearing Instrument Specialists and the written examination (International Licensing Examination) fee directly to the International Hearing Society. Required documents item 4 states: 4. Written Examination (ILE) scores must be submitted by the International Hearing Society (IHS). Applicants must request that the score be transferred directly to the Board from IHS. The mandatory examination waiver in RSMo 324.009.3 controls for a qualifying applicant; these lower-ranked form demands remain applicant conditions.
Minimum Requirements
The other jurisdiction verifies satisfaction of its minimum education and applicable experience and clinical-supervision requirements when licensed.
Prior License
Current license at the same practice level from another state, US territory, District of Columbia, or branch or unit of the military; at least one year of licensure; submit verification directly from the authority.
Processing
For an otherwise qualified spouse the oversight body shall waive examination, education and experience requirements and issue the license within thirty days after application receipt.
Spouse Eligibility
"Resident military or law enforcement spouse" , a spouse of an active duty member of the Armed Forces of the United States who has been transferred or is scheduled to be transferred to the state of Missouri or an adjacent state and who is a permanent resident of the state of Missouri, who is domiciled in the state of Missouri, or who has Missouri as his or her home of record, or a spouse of a Missouri law enforcement officer.

Official no-examination sources

Effective from 2026-08-28.

Biennial active license renewal
No examination is required for this applicant pathway.
Calibration
Provide annual audiometer calibration receipts; an employed specialist may reference the employer’s submitted receipts under 20 CSR 2165-2.060(4).
Continuing Education
Twenty-four approved hours during the two-year period beginning January 1 of even-numbered years through December 31 of the following year. Initial-year exemptions and Board-approved conditional waivers apply under 20 CSR 2165-2.050(2), (6). Retain certificates for the current and preceding two reporting periods; produce them within fifteen days of an audit request.
Fee
Pay the active renewal fee.
License
Renew the current license by its renewal date; initial qualifications under RSMo 346.055.1 do not apply. Board FAQ states licenses expire December 31 in odd-numbered years.

Official no-examination sources

Effective from 2024-06-30.

Hearing Instrument Specialist in-training Temporary Permit

One-year permit for supervised training with a single six-month extension.

Licensing authority: Missouri Board of Examiners for Hearing Instrument Specialists · Application information

Temporary training permit — Graduate audiology degree
No examination is required for this applicant pathway.
Age
At least eighteen.
Application
Submit original application, photograph, fee, direct educational or credential documentation and license verifications.
Character
Meet the character requirement in RSMo 346.070 and the Board permit application.
Duration
One year of supervised practice.
Generic Form Examination Statement
MO 375-0949 (6-2025) repeats full-license qualifications: Successfully passes a qualifying examination as described under sections 346.010 to 346.250; RSMo 346.070 defines permit eligibility by age, character and education, and RSMo 346.075.1 prescribes issuance on application and fee. The generic form’s examination language is retained as an applicant condition.
Qualifying Education Or License
Master’s or doctoral degree in audiology from a state- or regionally-accredited institution.
Supervision
Register supervision, name a qualified supervisor and obtain the supervisor’s signature.

Official no-examination sources

Effective from 2020-08-28.

Reissuance on change of registered supervision
No examination is required for this applicant pathway.
Change
File change-of-supervision form and fee and name the new qualified registered supervisor.
Return
The former supervisor must submit the attestation and original permit before a new permit is issued. The original maximum duration still applies.

Official no-examination sources

Effective from 2022-11-30.

Temporary training permit — Degree plus IHS course
No examination is required for this applicant pathway.
Age
At least eighteen.
Application
Submit original application, photograph, fee, direct educational or credential documentation and license verifications.
Character
Meet the character requirement in RSMo 346.070 and the Board permit application.
Duration
One year of supervised practice.
Generic Form Examination Statement
MO 375-0949 (6-2025) repeats full-license qualifications: Successfully passes a qualifying examination as described under sections 346.010 to 346.250; RSMo 346.070 defines permit eligibility by age, character and education, and RSMo 346.075.1 prescribes issuance on application and fee. The generic form’s examination language is retained as an applicant condition.
Qualifying Education Or License
Associate-level degree or higher from a state- or regionally-accredited institution and completed IHS Distance Learning for Professionals in Hearing Health Sciences Course.
Supervision
Register supervision, name a qualified supervisor and obtain the supervisor’s signature.

Official no-examination sources

Effective from 2020-08-28.

Single six month temporary permit extension

All of the following:

Duration
One six-month extension immediately after initial expiration regardless of receipt date; total duration cannot exceed eighteen months.
Education And Supervision
Remain qualified under RSMo 346.055 and practice only under registered supervision.
Permit
Hold the original one-year permit and pay the extension fee.
Statutory Examination Conflict
RSMo 346.055.2 applies the subsection 1 qualifications, including its examination requirement, to trainee-permit renewal. RSMo 346.080 nevertheless states: If a hearing instrument specialist in-training under this section or section 346.075 has not successfully passed the licensing examination within one year from the date of issuance of the temporary permit, the temporary permit may be renewed by the board once for a period of six months upon payment by the applicant of a fee, as defined by board rule. The current examination leaves are retained under the contract’s same-rank disagreement rule; section 346.080 allows the extension before successful passage.
Temporary training permit — Equivalent foreign license
No examination is required for this applicant pathway.
Age
At least eighteen.
Application
Submit original application, photograph, fee, direct educational or credential documentation and license verifications.
Character
Meet the character requirement in RSMo 346.070 and the Board permit application.
Duration
One year of supervised practice.
Generic Form Examination Statement
MO 375-0949 (6-2025) repeats full-license qualifications: Successfully passes a qualifying examination as described under sections 346.010 to 346.250; RSMo 346.070 defines permit eligibility by age, character and education, and RSMo 346.075.1 prescribes issuance on application and fee. The generic form’s examination language is retained as an applicant condition.
Qualifying Education Or License
Current unsuspended, unrevoked license from another country with standards the Board determines equivalent to or greater than RSMo 346.055.1(3)(a) or (b).
Supervision
Register supervision, name a qualified supervisor and obtain the supervisor’s signature.

Official no-examination sources

Effective from 2020-08-28.

Temporary training permit — Foreign practice with advanced certification
No examination is required for this applicant pathway.
Age
At least eighteen.
Application
Submit original application, photograph, fee, direct educational or credential documentation and license verifications.
Character
Meet the character requirement in RSMo 346.070 and the Board permit application.
Duration
One year of supervised practice.
Generic Form Examination Statement
MO 375-0949 (6-2025) repeats full-license qualifications: Successfully passes a qualifying examination as described under sections 346.010 to 346.250; RSMo 346.070 defines permit eligibility by age, character and education, and RSMo 346.075.1 prescribes issuance on application and fee. The generic form’s examination language is retained as an applicant condition.
Qualifying Education Or License
Current unsuspended, unrevoked license from another country, active licensed hearing-aid practice there for forty-eight of the preceding seventy-two months, and advanced certification from IHS or NBC-HIS. The certification is a qualification; this provision names no NCE examination requirement.
Supervision
Register supervision, name a qualified supervisor and obtain the supervisor’s signature.

Official no-examination sources

Effective from 2020-08-28.

Temporary training permit — Hearing instrument sciences degree
No examination is required for this applicant pathway.
Age
At least eighteen.
Application
Submit original application, photograph, fee, direct educational or credential documentation and license verifications.
Character
Meet the character requirement in RSMo 346.070 and the Board permit application.
Duration
One year of supervised practice.
Generic Form Examination Statement
MO 375-0949 (6-2025) repeats full-license qualifications: Successfully passes a qualifying examination as described under sections 346.010 to 346.250; RSMo 346.070 defines permit eligibility by age, character and education, and RSMo 346.075.1 prescribes issuance on application and fee. The generic form’s examination language is retained as an applicant condition.
Qualifying Education Or License
Associate degree or higher in hearing instrument sciences from a state- or regionally-accredited institution.
Supervision
Register supervision, name a qualified supervisor and obtain the supervisor’s signature.

Official no-examination sources

Effective from 2020-08-28.

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

Missouri Hearing Instrument Specialist Practical Examination

This assessment does not have a question bank.

Examination sources