Who Are Qualified Providers?

An audiologist is a specialist in normal and impaired hearing and balance who provides assessment, fitting, and orientation of hearing aids and other assistive devices.

A speech-language pathologist is a professional who identifies, assesses, and provides treatment for individuals with speech, language, and swallowing problems.

Certification and Licensure

Both state licensure and certification play a vital role in the provision of audiology and speech-language pathology services. Licensure ensures basic consumer protection and provides a mechanism by which incompetent and/or unethical practitioners may be removed from practice. Certification provides a different level of consumer protection by assuring that an individual has met rigorous and valid standards endorsed by a national professional body. State licensure and certification dovetail with one another and should be regarded as equal partners in the delivery of speech-language pathology and audiology services.

By designating only certified and, where applicable, licensed professionals as providers of speech and hearing services, you will assure a level of quality to this very important employee health benefit.


The Certificate of Clinical Competence (CCC) is granted by the American Speech-Language-Hearing Association (ASHA) in both speech-language pathology and audiology. It is the only universally recognized credential for the professions.

Only individuals who meet specific requirements may obtain the CCC. Holders of the CCC must abide by the ASHA Code of Ethics, which incorporates the highest standards of integrity and ethical principles.

Every individual who holds the CCC has:

  • Earned a graduate degree
  • Completed a minimum of 30 semester hours of professional course work,
  • Taken at least 27 semester hours in the basic sciences,
  • Earned at least 21 graduate credits,
  • Completed a minimum of 350 clock-hours of clinical practicum under a certified supervisor,
  • Completed 36 weeks of supervised clinical fellowship, and
  • Passed a national examination.

Maintaining the CCC is contingent upon participation in 30 contact hours of professional development activities every three years.

Speech-language pathologists and audiologists are qualified to practice under the Medicare and Medicaid programs, which are administered by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services, if they have the equivalent education and experience required for certification by ASHA.

Certain employment settings require certification; in the U.S. Military, the CCC is required for promotion as an audiologist.

The Role and Advantages of Certification

Certification is a fundamental standard among major health professions in this country. Whereas licensure is important to legally perform the work of a profession, certification is important for internal professional recognition and external accountability.

The CCC is the nations most widely recognized symbol of competency for speech-language pathology and audiology professionals. The CCC is recognized in 34 states for the purposes of reciprocity or interim practice and, for that reason, may aid the practitioner who moves or wishes to work in another state. In recognizing the CCC for the purposes of reciprocity or interim practice, states appreciate the scientific validity and high standards of the credential.

The requirements for the CCC are equivalent to or higher than any state requirements for initial licensure. Thus, an individual who attains the CCC can be assured that they will meet the requirements for licensure in every state.


The professions of audiology and speech-language pathology are regulated at the state level and each state maintains its own standards for licensure, registration or certification. State regulation is different from certification from a national or professional association, such as the Certificate of Clinical Competence (CCC), which is awarded by ASHA. That being said, many states do model their regulatory requirements after the CCC requirements.

The Role and Advantages of State Licensure

Licensure is mandatory and its requirements must be met by all practitioners in a state. Licensure also provides the state with the necessary authority to intervene in cases of practitioner misconduct and ultimately gives the state the power to revoke an individual's license and prohibit the individual from practicing. For these reasons, state licensure is essential in ensuring that consumers are protected from incompetent and or unethical practitioners.

In contrast, certification is voluntary, and only those individuals who choose to be certified are bound by the ASHA Code of Ethics. In addition, the maximum penalty that ASHA can administer to a certificated member is to revoke his or her CCC. The revocation of a certification by itself has no bearing on the status of the individual's state license or the ability to practice.

Clinical Specialty Certification

Audiologists or speech-language pathologists with advanced knowledge, skills, and experience beyond the Certificate of Clinical Competence (CCC-A or CCC-SLP) can be recognized as specialists in selected areas of clinical practice. Effective January 1, 2014, the Clinical Specialty Certification (CSC) program replaced the previous Clinical Specialty Recognition (CSR) program. Individuals who hold specialty certification identify themselves as a "Board Certified Specialist" in a specific area of practice. To identify specialists in an area of clinical practice or to verify that an individual currently holds specialty certification, contact the Specialty Certification Board in that area of practice.

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