Nebraska Hearing Instrument Specialist — Requirements & Free Practice
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Hearing Instrument Specialist License
Licensure to order, fit, and sell hearing instruments. Cerumen-removal practice has additional training, competence, insurance, and continuing-education conditions under section 38-1523.
Licensing authority: Nebraska Department of Health and Human Services, Board of Hearing Instrument Specialists · Application information
Licensure by examination — licensure program outside the United States
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Competency qualification
- Department and Board case-by-case eligibility determination for a person who completed a licensure program outside the United States, under section 38-1512(2); document the other applicable statutory age, education, and competency qualifications.
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Prior score and nonpractice
- Section 38-1515 requires continuing competency when the examination was passed more than three years before application and the applicant is not practicing. The implementing 172 NAC 75-003.01(E)(i) specifies 20 hours of acceptable continuing education within the three years preceding application.
Licensure by examination — hearing instrument sciences degree
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Competency qualification
- Hold a two-year degree in hearing instrument sciences or an equivalent determined by the Board, under section 38-1512(1)(c)(ii).
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Prior score and nonpractice
- Section 38-1515 requires continuing competency when the examination was passed more than three years before application and the applicant is not practicing. The implementing 172 NAC 75-003.01(E)(i) specifies 20 hours of acceptable continuing education within the three years preceding application.
Licensure by examination — advanced IHS credential qualification
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Competency qualification
- Hold an advanced credential offered by the International Hearing Society when taking the examination, under section 38-1512(1)(c)(v).
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Prior score and nonpractice
- Section 38-1515 requires continuing competency when the examination was passed more than three years before application and the applicant is not practicing. The implementing 172 NAC 75-003.01(E)(i) specifies 20 hours of acceptable continuing education within the three years preceding application.
Licensure by examination — NBC HIS certification qualification
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Competency qualification
- Be certified by the National Board for Certification in Hearing Instrument Sciences when taking the examination, under section 38-1512(1)(c)(iv). The statute requires certification as a qualification, not a separately named NCE examination requirement.
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Prior score and nonpractice
- Section 38-1515 requires continuing competency when the examination was passed more than three years before application and the applicant is not practicing. The implementing 172 NAC 75-003.01(E)(i) specifies 20 hours of acceptable continuing education within the three years preceding application.
Licensure by examination — practicum qualification
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Competency qualification
- Complete the minimum practicum hours prescribed by the Board under section 38-1512(1)(c)(i). Current 172 NAC 75 requires 80 hours of face-to-face supervision in the first 90 days and later monthly evaluation. The September 2025 minutes recommend 480 hours, but describe recommendations to be voted upon when regulation review is complete; this is not presented as an effective rule.
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Prior score and nonpractice
- Section 38-1515 requires continuing competency when the examination was passed more than three years before application and the applicant is not practicing. The implementing 172 NAC 75-003.01(E)(i) specifies 20 hours of acceptable continuing education within the three years preceding application.
Licensure by examination — prior jurisdiction licence qualification
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Competency qualification
- Hold a current, unsuspended, unrevoked licence to dispense hearing instruments from another jurisdiction for at least twelve of the eighteen months before examination, under section 38-1512(1)(c)(iii).
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Prior score and nonpractice
- Section 38-1515 requires continuing competency when the examination was passed more than three years before application and the applicant is not practicing. The implementing 172 NAC 75-003.01(E)(i) specifies 20 hours of acceptable continuing education within the three years preceding application.
Restoration after physical or mental disability
- Eligibility
- The cause of disability-related denial, refusal of renewal, limitation, or suspension no longer exists.
- Evaluation
- Board-selected or approved physician/professional examination or evaluation establishes fitness to practice, at the applicant’s expense. This is an applicant-health evaluation, not an identified examination of the hearing instrument specialist profession.
- Other qualifications
- Applicant is otherwise qualified as determined by the Board; the Director issues, returns, reinstates, or removes limitations as section 38-1,111 requires. Original temporary-credential duration and renewal/reissuance restrictions remain applicable where relevant.
Official no-examination sources
Effective from 2026-09-22.
- Uniform Credentialing Act
Neb. Rev. Stat. § 38-1,111(1)–(2)
Reinstatement — expired
- Application
- Submit complete reinstatement application, applicable reinstatement/renewal fees, good-character and lawful-presence documentation, prior credential and conviction information, and any unauthorized-practice explanation.
- Continuing competency
- Meet current continuing-competency requirements; the published reinstatement application requires 24 acceptable hours in the preceding 24 months or an approved waiver.
- Eligibility
- The ordinary licence expired without renewal.
Official no-examination sources
Effective from 2026-09-22.
- Uniform Credentialing Act
Neb. Rev. Stat. § 38-147(1)
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.03
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.01–007.02
- Application for Reinstatement to Practice as a Hearing Instrument Specialist
Section E, continuing competency requirements
Reinstatement — historically lapsed
- Application
- Submit complete reinstatement application, applicable reinstatement/renewal fees, good-character and lawful-presence documentation, prior credential and conviction information, and any unauthorized-practice explanation.
- Continuing competency
- Meet current continuing-competency requirements; the published reinstatement application requires 24 acceptable hours in the preceding 24 months or an approved waiver.
- Eligibility
- The licence was placed on lapsed status before December 1, 2008, as recognized in section 38-147(3).
Official no-examination sources
Effective from 2026-09-22.
- Uniform Credentialing Act
Neb. Rev. Stat. § 38-147(1)
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.03
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.01–007.02
- Application for Reinstatement to Practice as a Hearing Instrument Specialist
Section E, continuing competency requirements
Reinstatement — inactive
- Application
- Submit complete reinstatement application, applicable reinstatement/renewal fees, good-character and lawful-presence documentation, prior credential and conviction information, and any unauthorized-practice explanation.
- Continuing competency
- Meet current continuing-competency requirements; the published reinstatement application requires 24 acceptable hours in the preceding 24 months or an approved waiver.
- Eligibility
- The ordinary licence was placed on inactive status; seek return to active practice.
Official no-examination sources
Effective from 2026-09-22.
- Uniform Credentialing Act
Neb. Rev. Stat. § 38-147(1)
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.03
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.01–007.02
- Application for Reinstatement to Practice as a Hearing Instrument Specialist
Section E, continuing competency requirements
Biennial licence renewal
- Application
- Submit complete renewal application, applicable fee, lawful-presence documentation, and required conviction/disciplinary disclosures before expiration.
- Continuing education
- 24 acceptable continuing-education hours in the preceding 24 months, with authorized military, first-licensure, illness or disability waivers. Cerumen-removal practice additionally requires one hour specific to cerumen removal annually.
- Expiration
- December 31 of each even-numbered year.
Official no-examination sources
Effective from 2026-09-22.
- 172 NAC 75 — Practice of Hearing Instrument Specialists
172 NAC 75-005
- 172 NAC 75 — Practice of Hearing Instrument Specialists
172 NAC 75-006
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-004
- Hearing Instrument Specialists Practice Act
Neb. Rev. Stat. § 38-1523(12)
Reinstatement after non disciplinary voluntary surrender for a definite period
- Eligibility
- Non-disciplinary voluntary surrender for a definite period; that period must have elapsed.
- Order
- Comply with the Department acceptance order and its reinstatement terms under section 38-1,109(4). Permanent surrender is ineligible for reinstatement.
- Requirements
- Complete application, current continuing competency and lawful-presence documentation, disclosures, and fees under 172 NAC 10-007.
Official no-examination sources
Effective from 2026-09-22.
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.01–007.02
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.03
- Uniform Credentialing Act
Neb. Rev. Stat. § 38-1,109(4)
Reinstatement after non disciplinary voluntary surrender for a indefinite period
- Eligibility
- Non-disciplinary voluntary surrender for an indefinite period; eligible to apply at any time.
- Order
- Comply with the Department acceptance order and its reinstatement terms under section 38-1,109(4). Permanent surrender is ineligible for reinstatement.
- Requirements
- Complete application, current continuing competency and lawful-presence documentation, disclosures, and fees under 172 NAC 10-007.
Official no-examination sources
Effective from 2026-09-22.
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.01–007.02
- 172 NAC 10 — Credentials Issued Under the Uniform Credentialing Act
172 NAC 10-007.03
- Uniform Credentialing Act
Neb. Rev. Stat. § 38-1,109(4)
Licensure based on licensure in another jurisdiction — not currently practicing
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Other jurisdiction licensure
- Provide a valid other-jurisdiction licence, equivalence of regulatory standards and written/practical examinations, examination grades, and licence issuance date under 172 NAC 75-003.01(D). Examination results from a different jurisdiction are equivalence evidence and applicant conditions; they are not separate state examination leaves.
- Practice status
- Not practicing at application: provide at least 20 hours of acceptable continuing education within the preceding three years under 172 NAC 75-003.01(E)(ii).
Licensure based on licensure in another jurisdiction — currently practicing
All of the following:
- International Licensing Examination for Hearing Healthcare Professionals
- Nebraska Practical Examination (assessment without a question bank)
- Age
- At least 21 years old under section 38-1512(1)(a).
- Application
- Submit the complete DHHS application, age and citizenship/lawful-presence documentation, requested conviction and prior-licensure records, and applicable fee or waiver documentation; meet good-character requirements.
- Board application sequence
- The currently linked DHHS application states: "You need to apply for the temporary HIS license, pass the ILE, then apply for the Hearing Instrument Specialist license." The ILE passing score remains an examination leaf regardless of when it is obtained.
- Cerumen removal
- Before providing cerumen removal, section 38-1523 requires two consecutive years of a valid undisciplined licence, Board-approved cerumen training and competence attestation, professional liability insurance with annual evidence, and an additional hour of cerumen continuing education annually. The course completion certificate is signed by the physician or audiologist overseeing training; it is an applicant/practice qualification rather than a separately identified licensure examination.
- Education
- Education equivalent to a four-year course in an accredited high school; provide official documentation. Substantially similar military education, training, or service may be submitted for Department review.
- Examination waiver
- Under section 38-1512(3), the Department on Board recommendation may waive examination components when the applicant passed the same or a substantially equivalent examination. This discretion does not remove currently offered examination references.
- Jurisprudence slot
- Section 38-1514(1)(c) requires a jurisprudence examination approved by the Board. Its Board-approved, currently offered identity and version remain undetermined: September 5, 2025 Board minutes item 7(b) state, "The Board requested that the Department develop an open book test and present it to the Board for their consideration." The June and August 2026 minutes still describe regulation revision or preliminary draft approval. This is retained as an unresolved examination slot condition, not treated as an exemption or as a registered examination.
- Other jurisdiction licensure
- Provide a valid other-jurisdiction licence, equivalence of regulatory standards and written/practical examinations, examination grades, and licence issuance date under 172 NAC 75-003.01(D). Examination results from a different jurisdiction are equivalence evidence and applicant conditions; they are not separate state examination leaves.
- Practice status
- Practicing at the time of application; the nonpractice continuing-competency condition in section 38-1516(1) does not apply.
Nebraska Practical Examination
This assessment does not have a question bank.
- Provider
- Nebraska Board of Hearing Instrument Specialists / Nebraska Department of Health and Human Services
- Format
- Practical proficiency demonstrations
- Passing score
- At least 70 out of 100 in each subject examined
Examination sources
- Hearing Instrument Specialists Practice Act
Neb. Rev. Stat. § 38-1514(3)(b)
- Hearing Instrument Specialists Practice Act
Neb. Rev. Stat. § 38-1514(1)(b)
- 172 NAC 75 — Practice of Hearing Instrument Specialists
172 NAC 75-004.03
- 172 NAC 75 — Practice of Hearing Instrument Specialists
172 NAC 75-004.01–004.02
- Nebraska Application for Hearing Instrument Specialist Licensure
Examination instructions, item 5(B)
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
- IHS — Competency Model for the International Licensing Examination for Hearing Healthcare Professionals
Title block (p. 1)
- IHS — Competency Model for the International Licensing Examination for Hearing Healthcare Professionals
Structure key, item D (p. 1)
- IHS — Competency Model for the International Licensing Examination for Hearing Healthcare Professionals
Domain 1 heading (p. 2)
- IHS — Competency Model for the International Licensing Examination for Hearing Healthcare Professionals
Domain 5, Objective 5.3 (p. 4)
- IHS — International Licensing Examination for Hearing Healthcare Professionals (ILE) web page
About the Exam
- IHS — International Licensing Examination for Hearing Healthcare Professionals (ILE) web page
About the Exam
- IHS — ILE Study Guide (January 2026)
After the Examination, Examination Scoring (p. 31)
- IHS — ILE Study Guide (January 2026)
Taking the Examination (p. 28)
- IHS — ILE Exam Results & Score Transfer web page
Topic/Domain Feedback
- IHS — ILE Exam Results & Score Transfer web page
Results
- IHS — International Licensing Examination for Hearing Healthcare Professionals (ILE) web page
Eligibility and Exam Scheduling
- IHS — ILE Study Guide (January 2026)
Before the Examination, Scheduling an Examination Appointment (p. 20)