Audiologist vs Hearing Instrument Specialist: Licenses, Registries, Medicare

Three registry codes: audiologist, fitter and specialist

The federal provider registry, NPPES, records a primary provider type for each person, and three of its codes concern hearing aids: 231H00000X for audiologists, 237600000X for audiologist-hearing aid fitters and 237700000X for hearing instrument specialists. The fitter code is not the specialist code, so this page keeps all three apart.

In the file of August 2026, active individual records number 21,613 audiologists, 2,776 audiologist-hearing aid fitters and 10,715 hearing instrument specialists, counted by practice address across the states, the District of Columbia and Puerto Rico.

State by state: where each profession is registered

The first table gives each state's three counts. Audiologists are the larger group everywhere but Iowa, which records 198 hearing instrument specialists and 192 audiologists. The specialist column can still sit close to the audiologist one elsewhere, as in Florida, with 1,130 specialists and 1,400 audiologists. The fitter code is largest in California (420 records), Texas (242) and New York (179), while the District of Columbia and Puerto Rico count 1 and 2 hearing instrument specialists.

These are registry records: self-reported, counted by practice address, and not a license check. A count also says nothing about who takes new patients or how many hearing aids each person fits.

What 6 state laws ask of each license

Each state writes its own hearing aid license. The second table paraphrases 6 provisions read on the legislatures' sites:

• Washington (Revised Code of Washington § 18.35.040): a hearing aid specialist applicant passes the state examination and completes "a minimum of a two-year degree program in hearing aid specialist instruction", or takes another route, such as a 2- or 4-year degree plus "a nine-month board-approved certificate program" and a practical examination.
• Florida (Florida Statutes § 484.0445): the board sets a training program "for a minimum 6 months in length", and a trainee works "only under the direct supervision of a licensed hearing aid specialist."
• Oregon (Oregon Revised Statutes § 694.055): an applicant is 18 or older, has finished high school or an approved equivalency test, and meets the training and experience rules.
• Minnesota (Minnesota Statutes § 153A.14): the state issues a certificate to dispense prescription hearing aids, and an applicant must "be 21 years of age or older" and report education, training and experience in testing hearing and fitting aids.
• Texas (Occupations Code § 402.203): an exam applicant is 18 or older and a high school graduate or equivalent; the next section sets out the full route.
• New York (Education Law § 8206): the audiologist license, for contrast, asks for "at least a Masters degree in speech-language pathology and/or audiology or its equivalent", plus experience and an examination.

None of the hearing aid provisions quoted here mentions a doctorate. On the audiologist side, the Bureau of Labor Statistics says audiologists need "a doctor of audiology (Au.D.) degree" and that "All states require audiologists to be licensed." New York's own wording shows that a state's audiology law can set its floor differently, so the state board remains the reference for any one license.

How to become a hearing aid specialist: exam, training and pay

Texas shows one route in detail. Its Occupations Code asks an exam applicant for "documentation that the applicant is at least 18 years of age and has graduated from an accredited high school or equivalent" (§ 402.203). A new fitter must pass the department's examination (§ 402.202), but an audiologist licensed under the state's audiology chapter "is exempt from the examination required under this chapter but must comply with all other requirements under this chapter." After the exam, a trainee holds an apprentice permit and "shall work under the supervision of a license holder for at least one year" (§ 402.207).

The written test in many states comes from the International Hearing Society, a trade group. Its study guide of January 2026 says the exam is "administered by the International Hearing Society (IHS) on behalf of your state/provincial licensing board", has 105 multiple-choice questions with 120 minutes to finish, and lists 43 states that use it, Texas and Washington among them. Washington also asks for a practical examination.

For pay, the Bureau of Labor Statistics counted 11,270 hearing aid specialist jobs nationally in its May 2025 wage survey, with a median annual wage of $65,160. The survey covers wage and salary jobs, so a specialist who owns a practice is not in it.

What Original Medicare pays to each

Medicare treats the two titles differently. In the CMS crosswalk that maps provider taxonomy codes to Medicare provider and supplier types (version of October 2021), the audiologist code 231H00000X maps to Medicare specialty 64; neither the hearing instrument specialist code nor the audiologist-hearing aid fitter code appears in it. Part B "covers diagnostic hearing and balance (fall risk) exams if your doctor or other health care provider orders them", and Medicare.gov names audiologists in one route: "You can visit an audiologist once every 12 months without an order from your health care provider." The billing conditions of that route are on audiologist vs ENT.

The work a specialist license covers, in Texas the right to "fit and dispense hearing instruments", sits outside Original Medicare's coverage: "You pay all costs for non-covered services, including hearing aids and exams." Medicare Advantage plans can add a hearing aid benefit of their own, and what those plans file differs from plan to plan.

What this comparison leaves out

The tables compare registry records and statutory text. They don't measure skill, prices or results, and the page doesn't say whom to see. A count is self-reported and doesn't prove a license. A paraphrased provision leaves out conditions that the full statute and the board's rules add, including routes for people licensed in another state, so read your state's law or ask its board before relying on one row.