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State Neurophysiological Intraoperative Monitoring (NIOM) Requirements

Alabama, Colorado, Florida, Idaho, Louisiana, Maine, Missouri, Montana, New Hampshire, New Jersey, Pennsylvania, South Dakota, Utah, Washington, West Virginia and Wyoming have laws, regulations, or policies related to the use of neurophysiological intraoperative monitoring (NIOM) for audiologists, which are summarized below. This information is reviewed on an annual basis. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information.


870-X-7-.03 Audiology Scope of Practice

Providing and interpreting behavioral and (electro) physiological measurements of auditory, vestibular, and neural functions.

Alabama Rules and Regulations [PDF]


12-5.5-101. Definitions

(3.5) "Practice of audiology" means:
    (a) The application of principles, methods, and procedures related to the development, disorders, and conditions of the human auditory-vestibular system, whether such disorders or conditions are of organic or functional origin, including, but not limited to, disorders of hearing, balance, tinnitus, auditory processing, and other neural functions, as those principles, methods, and procedures are taught in accredited programs in audiology.

Colorado Practice Act [PDF] 


64B20-9.001 Scope of Practice

The scope of practice of Speech-Language Pathology and Audiology is affected by the development of new treatment modalities and equipment, as well as by improvements in existing treatment modalities and equipment. Any licensee providing any service or treatment shall have acquired the competence to perform said service or treatment through appropriate education and/or training. Any licensee who provides any treatment or service for which he or she has not been specifically educated or trained shall be deemed to have committed negligence or misconduct in the practice.

Florida Rules and Regulations


54-2903. Definitions

As used in this chapter:

11) "Practice of audiology" means to apply the principles, methods and procedures of measurement, evaluation, testing, counseling, consultation and instruction that relate to the development and disorders of hearing, vestibular functions and related language and speech disorders to prevent, modify or rehabilitate the disorders or to assist individuals in auditory and related skills for communication, and may include intraoperative monitoring and the fitting, adjustment, programming, selling and dispensing of hearing aids and assistive devices.

Idaho Practice Act 


§ 2651. Definitions

(7) (a) "Practice of audiology" means providing, or offering to provide, to individuals or groups of individuals who have, or are suspected of having, disorders of the auditory system, any service in audiology, including prevention, identification, evaluation, interpretation, counseling, consultation, habilitation, rehabilitation, instruction, supervision, and research. The practice of audiology shall also include audiology services for disorders of the vestibular system upon referral of a physician. An audiologist may engage in any task, procedure, act, or practice that is necessary:

    (i) For the evaluation of hearing and the monitoring of neural functioning. 
    (ii) For training in the use of amplification, including hearing aids and assistive listening devices. 
    (iii) For the making of earmolds. 
    (iv) For the fitting, dispensing, and selling of hearing aids.

Louisiana Practice Act [PDF]


§17304. Scope of practice; audiologists

Audiologists identify, assess, manage and interpret test results related to disorders of human hearing, balance and other neural systems, including the dispensing of hearing aids.

Maine Practice Act


345.015 Definitions

(8) "Practice of audiology": 
    (g) Provides and interprets behavioral and neurophysiologic measurements of auditory balance, cognitive processing and related functions, including intraoperative monitoring.

Missouri Practice Act



(1) The scope of practice of audiology includes but is not limited to:

    (f) measurement and interpretation of sensory and motor evoked potentials, electromyography, and other electrodiagnostic tests for purposes of neurophysiologic intraoperative monitoring.

Montana Rules and Regulations

New Hampshire 

137-F:2 Definitions

VII. "Practice of audiology'' means, but shall not be limited to:

    (b) Rendering to individuals or groups of individuals, who are suspected of having hearing disorders, basic and comprehensive audiological and vestibular site-of-lesion tests, including otoscopic examinations, electrophysiologic test procedures, and auditory evoked assessment.

New Hampshire Practice Act

New Jersey


a) The practice of audiology includes the following functions related to hearing, its disorders and related communication impairments:

    3) Measurement and interpretation of sensory and motor evoked potentials, electronystagmography, and other electrodiagnostic tests for purposes of neurophysiologic intraoperative monitoring and cranial nerve assessment.

New Jersey Rules and Regulations [PDF]


"Practice of audiology." The application of principles, methods and procedures related to disorders of the auditory and vestibular systems. Areas of audiology practice include the following:

(13) administration of electrophysiologic measures of neural function, including, but not limited to, sensory and motor-evoked potentials, preoperative and postoperative evaluation of neural function, neurophysiologic intraoperative monitoring of the central nervous system, spinal cord and cranial nerve function, provided that an audiologist shall not perform neurophysiologic intraoperative monitoring except upon delegation from and under the overall direction of a physician, and the audiologist shall be certified by the board; and

(14) referral of persons with auditory and vestibular dysfunction abnormalities to an appropriate physician for medical evaluation when indicated based upon the interpretation of the audiologic and vestibular test results.

Senate Bill 137

South Dakota

36-24-1.6. Scope of audiology

(6) Measurement and interpretation of sensory and motor evoked potentials, electromyography, and other electrodiagnostic tests for purposes of neurophysiologic intraoperative monitoring and cranial nerve assessment.

South Dakota Practice Act


R156-41-102. Definitions

(4) "Evoked potentials evaluation", as used in Subsection 58-41-2(4), includes neurophysiological intraoperative monitoring.

Utah Practice Act [PDF]


WAC 246-828-095 Audiology minimum standards of practice

Audiologists must engage in and supervise only those aspects of the profession that are within the scope of their education, training and experience. Standard procedures for providing audiology services may include one or more of the following: 
    (8) Intraoperative neurophysiologic monitoring.

Washington Rules and Regulations

West Virginia

§30-32-14. Scope of practice for audiology

(3) Providing and interpreting behavioral and electro- physiological measurements of Auditory and vestibular functions.

West Virginia Practice Act


Section 3. Definitions

(m) "Measurement" includes but is not limited to, facilitating where applicable the conservation of auditory system function; developing and implementing environmental and occupational hearing conservation programs; cerumen management; screening, identifying, assessing and interpreting, diagnosing, preventing, and rehabilitating peripheral and central auditory system dysfunction; providing and interpreting behavioral and electro-physiological measurements of auditory and vestibular functions, such as auditory evoked potential assessment, neurophysiologic intraoperative monitoring or balance system assessment; providing aural rehabilitation and related counseling services to hearing impaired individuals and their families; and screening of speech-language and other factors affecting communication function for the purposes of an audiologic evaluation and/or the initial identification of individuals with other communication disorders.

Wyoming Rules and Regulations [PDF]

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