The Missouri Hearing Instrument Specialist license, issued by the Board of Examiners for Hearing Instrument Specialists under Chapter 346 of the Revised Statutes of Missouri, authorizes the holder to engage in the practice of fitting hearing instruments in Missouri. Section 346.060 requires examination “by means of written and practical tests”: the written examination is the International Licensing Examination (ILE), taken through the International Hearing Society, and the practical examination is administered by the Board at least every six months — reachable only after the written examination is passed. The PassProfessor Missouri Hearing Instrument Specialist program, described on the companion program page at /missouri-hearing-instrument-specialist-exam-prep/, prepares candidates for that examination set.
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The credential at a glance
| Item | Verified position |
|---|---|
| Program | Missouri Hearing Instrument Specialist, the Board of Examiners for Hearing Instrument Specialists license to engage in the practice of fitting hearing instruments |
| Licensing authority | Board of Examiners for Hearing Instrument Specialists, Division of Professional Registration, Department of Commerce and Insurance; RSMo ch. 346 (§§346.010–346.250) and 20 CSR 2165 |
| Examination | Written and practical, per §346.060. The written examination is the International Licensing Examination (ILE): once the application is complete, the Board submits the eligible applicant’s name to the International Hearing Society (IHS), the applicant schedules and pays IHS directly, and IHS transfers the score to the Board. The practical examination is administered by the Board at least every six months (20 CSR 2165-2.030) and may be scheduled only after the written examination is passed. No separate Missouri law or jurisprudence examination is part of the licensure-by-examination route |
| Examination fees | Application fee $250 and practical examination fee $150, paid to the Board (Board application form, rev. 6-2025); the written examination (ILE) fee is paid directly to IHS |
| Passing standard | No passing score or percentage is printed in this guide, because none is published numerically in the Board sources verified for it — the Board’s FAQ states that the actual percentage score cannot be provided to the applicant, and 20 CSR 2165-2.030 provides that the passing score is determined according to the standards of the examination |
| Eligibility | At least eighteen years of age, of good moral character, successful passage of the qualifying examination, and one of the education routes in §346.055 — an associate degree or higher in hearing instrument sciences; or an associate degree or higher together with the IHS Distance Learning for Professionals in Hearing Health Sciences Course; or a master’s or doctoral degree in audiology; or a qualifying out-of-state license route |
| Route | Qualify (education first) → apply to the Board → written examination (ILE through IHS) → Board practical examination → license. A temporary permit for supervised training is available but is not required before applying for the full license |
| Administrator note | PassProfessor is independent and is not affiliated with the Board of Examiners for Hearing Instrument Specialists or the International Hearing Society |
Missouri rewards candidates who read the credential as the Board built it: an education-gated profession with a two-part examination in its middle. A degree route opens the application; the application opens the written examination, which is administered by a national society on the Board’s referral; the written result — received by the Board on a thirty-day clock — opens the practical; and the practical, sat with the candidate’s own calibrated equipment before the Board, opens the license. Supervised training on a temporary permit is available alongside that spine, strongly structured and entirely optional as a prerequisite. The guide below takes each verified element in turn.
Reading the verified facts
Every fact in the table above was pinned to Board primary material — the Practice Act and Rules booklet (Chapter 346 and 20 CSR 2165, revised August 2024), the Board’s own FAQ, and its current application form (rev. 6-2025) — during this program’s research pass. Three reading rules apply throughout the guide. First, no passing score is printed, because the Board does not publish one numerically: the licensure-by-examination rule provides that the board or its approved vendor shall determine the passing score according to the standards of the examination, and the FAQ adds that the actual percentage score cannot be provided to the applicant — a candidate is told pass or fail, and any percentage quoted by third-party material for either Missouri component is unverified. Second, the three documents of the route are never merged: the temporary permit (specialist in training), the application file (valid for three years from receipt under 20 CSR 2165-2.025), and the license itself each do different work, and figures belonging to one are stated only for that one. Third, vendor roles are kept exact: IHS administers the written examination and reports its scores to the Board; the Board administers the practical, sets its calendar, and alone licenses — a candidate with a scheduling question about the practical is dealing with the Board, and a candidate with one about the written sitting is dealing with IHS, through the referral the Board initiates.
The route, step by step
Step one — complete an education route under §346.055, and be able to prove it the Board’s way. Hold an associate degree or higher in hearing instrument sciences, or an associate degree or higher plus the IHS Distance Learning for Professionals in Hearing Health Sciences Course, or a master’s or doctoral degree in audiology — in each case from a state or regionally accredited institution — or qualify through an out-of-state license route, including licensure by reciprocity for a person who holds a valid current license issued by another state, territory, or the District of Columbia and has been licensed for at least one year in that jurisdiction. Proof is an official transcript sent directly to the Board by the school; a transcript in the applicant’s own hands does not complete the file. Step two — apply to the Board: completed, signed application with original photograph, the $250 application fee, transcripts, verifications from every state where the applicant has ever been licensed, and any court documentation the application calls for — all received at least thirty days prior to the administration of the examinations, with all fees non-refundable. Step three — the written examination (ILE). If the examination has not yet been taken, the Board submits the applicant’s name to IHS once the application is complete; IHS emails the introduction with appointment and payment instructions; the applicant pays the ILE fee directly to IHS and sits the examination; IHS provides the Board with the score report; the Board notifies the applicant of pass or fail. An applicant who applies with examinations already completed before finishing an education program should note the rule’s sequencing provision: the Board will not issue the license until the education is complete and the conferring transcript is on file. Step four — the practical examination. File the Abbreviated Application — which is not available online and is mailed with examination results or on request — with the $150 practical examination fee at least thirty days before the sitting; ensure the written score has been received by the Board at least thirty days before that same sitting; arrange an ADA accommodation request, if needed, on the same thirty-day clock; and furnish all equipment, audiometer calibration receipt included. Step five — the license, issued when both examinations are passed and the file is complete; the application itself remains valid for three years, after which an unfinished process is void and a fresh application must meet the then-current requirements.
The outline in full
Missouri publishes no single blueprint document for its examination set; it publishes a statute, a licensure-by-examination rule, a supervised-training rule that names the craft’s procedures, and a Board FAQ that names the preparation source. Read together, they state the outline completely. The two components are taken here in the order a candidate meets them, and the training syllabus is stated alongside the practical, because in Missouri the same seven procedures define both what the trainee is taught and what the practical examiner is watching for.
The written examination: the International Licensing Examination
The written examination is the International Licensing Examination for hearing instrument dispensers, administered by the International Hearing Society, and it is the occupation’s general professional paper: the physics of sound and the anatomy and physiology of hearing; audiometric evaluation — pure tone air and bone conduction, speech audiometry, and the masking decisions that keep a test honest; hearing instrument technology, styles, and circuitry; selection and fitting grounded in measured thresholds; verification and follow-up; and the counseling through which a technically correct fitting becomes a worn one. Missouri’s own preparation direction is unusually direct: the Board’s FAQ tells applicants they can prepare for both the written and the practical examination by reviewing the International Hearing Society manuals — the closest thing to an official syllabus endorsement this examination set has, and the reason this program’s written preparation is built in the IHS manuals’ register. The examination’s standard-setting is the Board’s and its vendor’s: under the rule, the board or its approved vendor determines the passing score according to the standards of the examination, the written and practical portions may be administered by the Board or its approved vendor using a national testing service at the Board’s discretion, and a failed written examination is retaken entire. What the candidate experiences is deliberately spare — a referral from the Board, an appointment with IHS, a fee paid to IHS, and then a pass-or-fail notification from the Board, with the percentage withheld by stated policy.
The practical examination: the Board’s performed test
The practical examination is where Missouri examines the hands. It is administered by the Board or its approved vendor at least every six months, on different days from the written, and its governing rule (20 CSR 2165-2.030(6)) reads like a sitting protocol because it is one. The applicant furnishes all equipment needed. To protect the examination’s integrity, the Board or its vendor may determine what equipment an applicant is permitted to use and may prohibit equipment containing memory storage or automated testing procedures, unless the memory can be demonstrated and verified erased or the feature deactivated. Equipment must be in good working order, as evidenced by a receipt of annual calibration of the audiometer; failure to have the necessary equipment disallows the sitting and forfeits the fee, and re-entry is by reapplication and a fresh practical fee at the next sitting. The examination itself may be conducted using simulators or live subjects for all or part of it, at the Board’s or vendor’s discretion — except that every person taking the examination on a specific date is tested in the same manner — and a time limit may be imposed on any part, provided it is established beforehand and applied uniformly. The abilities under examination are the fitting craft’s core, best read off the training rule’s procedure list, which names what a Missouri specialist is trained to do: air conduction thresholds with masking where appropriate; bone conduction thresholds with masking where appropriate; speech reception thresholds with masking where appropriate, on a calibrated circuit; word recognition scores with masking where appropriate, on a calibrated circuit; verification of hearing instrument benefit; ear impressions; and visual otoscopy. A candidate who can perform those seven, on their own calibrated equipment, against a uniform clock, has rehearsed the practical in its actual form.
The training syllabus: the temporary permit’s seven procedures
Because Missouri’s supervised training is optional as a prerequisite but specified in detail, it deserves its own pass. A registered supervisor — a Missouri hearing instrument specialist of at least two years’ standing, credentialed as a Board Certified Hearing Instrument Specialist (BC-HIS) or through the American Conference of Audioprosthology, or a licensed audiologist also licensed as a hearing instrument specialist — exercises full order, control, guidance, and professional responsibility over the trainee’s practice, trains the trainee in the seven procedures above, meets the trainee face-to-face at least once per workweek to review all purchase agreements, audiometric evaluations, instrument orders, ear impressions, and fittings whether a purchase is made or not, signs purchase agreements and audiometric results, and files the attestation within thirty days of supervision’s completion or termination. The trainee accrues no less than one hundred hours of that supervision before eligibility for licensure, is identified to consumers by temporary permit number and the full words “hearing instrument specialist in training” on sales contracts and marketing — initials and acronyms are prohibited — and holds the permit for one year, extendable once by six months, eighteen months at the outside. Read as a syllabus, the training rules are the practical examination taught slowly; read as a route, they are the optional apprenticeship a candidate may run before, during, or instead of waiting for the examination cycle — but never as a substitute for passing it.
How Missouri reports results — and what is not published
A slower pass over the results mechanics is worthwhile, because Missouri publishes an unusually complete procedural scheme and withholds the one number candidates most ask for. What is published is the flow: IHS provides the Board with a score report containing the applicant’s results; the Board notifies the applicant whether the examination was passed or failed; a passing applicant receives information on scheduling the practical; a failing applicant — or one who does not show without prior notification — reschedules by Abbreviated Application through the Board’s office. What is withheld, by the FAQ’s own statement, is the score itself: “The actual percentage score cannot be provided to the applicant.” And what is nowhere published numerically is the passing standard for either component: the rule assigns its determination to the board or its approved vendor according to the standards of the examination. The preparation consequence is the one this guide follows throughout — the honest target is the syllabus and the performed procedures at working standard, judged against the IHS manuals the Board points to, rather than any rumoured percentage. A candidate told nothing but “passed” has, in Missouri’s design, been told everything the system intends to tell.
The sittings themselves
Each Missouri component is sat differently, and the candidate should rehearse each format as a format. The written examination begins offstage: no complete application, no referral to IHS; no referral, no introduction email; no appointment and fee to IHS, no sitting. Its administrative risks are correspondence risks — a stale email address, an incomplete file, a transcript the school never sent. The practical examination is a twice-yearly-or-better event with physical logistics: the Abbreviated Application and $150 fee thirty days out, the written score received thirty days out, ADA notice thirty days out if applicable, and on the day itself the candidate’s complete equipment set with its calibration receipt, tested on simulators or live subjects under a uniform manner and possibly a uniform clock. Applications for licensure remain valid for three years from receipt, which forgives a slow cycle or two; the temporary permit’s eighteen-month ceiling, where a candidate holds one, forgives nothing.
A study plan built on how this examination is actually put together
Build the plan in the order the route imposes its deadlines. First, the education audit — confirm the §346.055 route, order the official transcript’s direct transmission, and close any gap (the IHS Distance Learning course for route (b) candidates) before examination study peaks, because no result issues in a license on an incomplete education file. Second, the written syllabus — the ILE’s professional knowledge studied through the IHS manuals the Board directs applicants to, filed early enough that the score can be received by the Board a full thirty days before the target practical sitting, not merely earned by then. Third, the practical as performance with your own kit — the seven procedures rehearsed on the actual audiometer and equipment that will travel to the sitting, calibration receipt obtained and filed, memory and automation features checked against the rule’s restrictions, under timed, uniform conditions. Fourth, Missouri’s procedural law as working knowledge — not because Missouri examines law separately (it does not), but because Chapter 346’s purchase-agreement contents, medical clearance and waiver rule, and supervision and record duties are the daily law of the license the candidate is about to hold, and the practical’s examiners examine a practitioner, not a technician in isolation. Fifth, the administrative rehearsal — application complete, photograph attached, verifications requested, Abbreviated Application obtained by mail before it is needed, fees calendared, permit ceiling (if any) diarised: the details that void sittings without testing knowledge at all.
The working method: turning the outline into a performance
Missouri preparation fails most often as a modality problem compounded by a calendar problem: candidates study a performance examination as if it were a reading examination, on a cycle that punishes the delay by six months at a time. The working method that answers both has four parts. Perform weekly, on your own equipment. Full audiometric runs — air, bone, speech reception, word recognition, masking decisions defended aloud — plus impressions, otoscopy, and a verification, done on the kit that will be carried into the sitting, so the equipment’s quirks are old news before the examiners see it. An error log keyed to the seven procedures and the written domains. Every botched masking decision, skipped otoscopy, miscalibrated assumption, and missed written item filed under its procedure or domain, so after a month the log, not the candidate’s confidence, assigns the remaining study. Manual-anchored written review. The IHS manuals worked as the Board directs — as the preparation source for both components — with every principle tied to a performed memory from training or rehearsal. Deadline dry runs. Before each sitting, walk its checklist cold: referral received, appointment confirmed, score-receipt deadline calendared thirty days before the practical, Abbreviated Application and fee filed, calibration receipt in the kit, equipment restrictions checked. Missouri voids more candidacies through paperwork and timing than through audiometry, and both are rehearsable.
The errors this examination is built to catch
The Missouri set catches a recognisable set. Discovering the degree requirement at application time — Missouri’s education floor is real, route-specific, and proved by direct-from-school transcripts; a candidate without a route has no file, however strong their audiometry. Studying the practical as theory meets an examination that watches the candidate’s hands, on the candidate’s own equipment, possibly against a uniform clock. Arriving under-equipped — an audiometer without its annual calibration receipt, or equipment whose memory or automated features cannot be cleared under the rule — disallows the sitting and forfeits the fee before a single threshold is taken. Sitting the written examination late in the cycle and watching its score reach the Board inside the thirty-day window defers the practical by a full cycle, in success as surely as in failure. Expecting subsection banking at the practical collides with the rule: one failed portion means the entire practical again, fee included. Spending attempts casually collides with the escalation behind it: the practical and two re-examinations exhausted, the fourth attempt waits on a Board meeting, a written plan, and the Board’s approval — with the registered supervisor required to attend where the candidate is in training. And treating the temporary permit as either compulsory or as practice rights without end misreads it both ways the FAQ warns against: it is not required before applying, and it ends at eighteen months whatever the candidate’s examination position.
The credential in one view
The Missouri Hearing Instrument Specialist license in one view is a chain of demonstrated competence under a degree-gated door. Accredited education establishes that the candidate can learn the field; the written examination, administered by the profession’s national society on the Board’s referral, certifies the shared knowledge base; the practical, administered by the Board itself with the candidate’s own calibrated tools, certifies the hands; and supervised training — where the candidate elects it — certifies the judgement that only supervised practice builds, procedure by named procedure, attested by a supervisor answerable for it. The examination set sits at the hinge of that chain and is built in the chain’s own image: the written paper asks what the candidate knows, the practical asks what the candidate can do, and Missouri’s refusal to add a third, law-only test is itself a statement — the law of this credential is examined by being lived under, in training attestations, purchase agreements, waivers, calibration receipts, and audits, from the first permit to every renewal. The candidate who studies the two components as one event at two registers — principle and performance, both on the Board’s clocks — finds them reinforcing each other: threshold theory explains masking practice, impression practice explains fitting outcomes, and verification explains why the whole profession measures twice.
After the sittings: the license and its clocks
Passing both components, on a complete file, converts the applicant into a Hearing Instrument Specialist, and the two-year rhythm of the working credential begins: renewal applications mailed on or around October 1 of odd-numbered years, the renewed license running two years to December 31 of odd-numbered years, twenty-four hours of Board-approved continuing education in each reporting period that begins January 1 of even years, records retained across the current and two previous periods against the Board’s random post-renewal audit, and annual audiometer calibration receipts presented at renewal — the equipment discipline of the practical, made permanent. A non-current license can be reactivated within two years of expiration without examination; beyond that, a new application and the full route apply again.
Frequently asked questions
Which Board sources govern the Missouri route?
The Practice Act and Rules booklet — Chapter 346 of the Revised Statutes and 20 CSR 2165, above all §346.055 (requirements), §346.060 (written and practical examination required), and 20 CSR 2165-2.030 (licensure by examination) — together with the Board’s FAQ and its current application form. Candidates should read the FAQ early: it answers, in the Board’s own words, most of the mechanical questions this route generates.
Why does Missouri require a degree for a dispensing license?
Because §346.055 makes education a licensure requirement in its own right, alongside age, character, and the qualifying examination. The routes are alternatives — hearing instrument sciences degree, general degree plus the IHS Distance Learning course, or an audiology degree — but one of them, proved by a transcript sent directly from the school, must be on file before the license can issue.
Is there a published Missouri passing score I should aim at?
No numeric passing standard for either component was published in the Board sources verified for this guide, and none is printed here. The rule assigns the written passing score’s determination to the board or its approved vendor according to the standards of the examination, and the Board will tell you only whether you passed or failed — the actual percentage score cannot be provided. Any percentage quoted by third-party material should be treated as unverified.
How does the practical’s fourth-attempt rule work?
An applicant who fails the practical examination and two subsequent re-examinations is disqualified from retaking it a fourth time until they have met with the Board, presented a written plan for passing the examination, and obtained the Board’s approval. Where the applicant is a hearing instrument specialist in training, the current registered supervisor must be present at that meeting.
What does a registered supervisor have to be, and do?
A Missouri hearing instrument specialist licensed for a minimum of two years, holding a certificate of authority as a registered supervisor, and credentialed as a BC-HIS or through the American Conference of Audioprosthology — or a licensed audiologist also licensed as a hearing instrument specialist. The supervisor exercises full professional responsibility for the trainee’s practice, trains the seven named procedures, reviews the trainee’s work face-to-face at least once per workweek, signs purchase agreements and audiometric results, and files the attestation within thirty days of supervision ending.
Can I sit the examinations before finishing my degree?
The application procedures contemplate an applicant completing the written and/or practical examinations before completing the education program — but the Board will not issue the license until the education is complete, an official transcript verifying the conferred degree has been sent directly by the school, and all other requirements are met.
Does Missouri examine its own law separately?
No. No separate Missouri law or jurisprudence examination is identified in the Board’s FAQ, its licensure-by-examination rule, or its application form, and none is part of this route. Chapter 346 and the Board’s rules bind the licensee in practice — purchase agreements, medical clearance and waivers, supervision, calibration, and renewal — rather than through a third test.
What should I do after an unsuccessful practical attempt?
Reapply and repay the practical fee for the next sitting, and rebuild as performance, not reading: the entire practical is retaken, so rehearsal runs across all seven procedures on your own equipment. Count the attempts as you go — the meeting-and-plan requirement after the third failure is avoidable in exactly one way, which is passing before it is reached.
How long is my application valid if life intervenes?
Three years from the date the application is received in the Board’s office. An applicant who has not completed the process within that period has a void application and must reapply under the then-current requirements.
How is the license renewed, and what does the audit mean?
Every two years, expiring December 31 of odd-numbered years, with twenty-four hours of Board-approved continuing education per reporting period and annual audiometer calibration receipts. Proof of continuing education is not filed with renewal routinely; the Board audits randomly afterward, which is why records for the current and two previous periods must be kept and produced within the period the rule sets when requested.
Is PassProfessor affiliated with the Board or with IHS?
No. PassProfessor is an independent preparation provider. The Board alone licenses; IHS administers the written examination.
When does enrollment open for the PassProfessor program?
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