- CCC-A stands for Certificate of Clinical Competence in Audiology, awarded by ASHA's Council for Clinical Certification.
- The required exam is Praxis Audiology (5343): 120 selected-response questions, 2 hours, $146.
- ASHA's passing score is 162 on a 100-200 scale; some administered items may be unscored.
- Assessment is the heaviest domain at 35%, followed by Intervention at 25%.
What CCC-A Actually Means
CCC-A stands for Certificate of Clinical Competence in Audiology. It is the national clinical certification for audiologists in the United States, and it signals that the holder has completed the doctoral education, supervised clinical practicum, and examination requirements set by the American Speech-Language-Hearing Association (ASHA). If you have landed here searching for what those four letters mean after a hearing healthcare provider's name, this is the credential - not a similarly-abbreviated certification from an unrelated field. For a broader overview of the credential itself, see What Is CCC-A? and the companion piece CCC-A Certification.
People arrive at this question from different angles. Some want a plain-language definition; others are already enrolled in an audiology doctoral program and need to know exactly what stands between them and the credential. This article covers both: the meaning of the acronym and the concrete mechanics - exam format, fees, domains, and maintenance - that turn the meaning into something you can act on.
Who Awards the CCC-A and Who Administers the Exam
The certificate itself is awarded by ASHA's Council for Clinical Certification in Audiology and Speech-Language Pathology. The council sets the standards - doctoral degree, knowledge-and-skills outcomes, supervised clinical practicum hours, and a passing exam score - but it does not build or deliver the exam itself.
That job belongs to the required national exam, Praxis Audiology (5343), which is owned and administered by ETS. ETS will continue running this administration through 2026. Starting January 11, 2027, administration transitions to PSI, though ASHA has been clear that the exam content and the passing point stay the same - only the testing vendor changes. If your target test date sits near that transition, it's worth double-checking current scheduling details on CCC-A Exam Dates 2026: Testing Windows, Deadlines & Scheduling before you register.
Praxis Audiology (5343): Format, Cost, and Scoring
Once you understand what the letters stand for, the next practical question is almost always: what does earning them actually require on test day? Here's the exam in concrete terms.
- Format: 120 computer-delivered selected-response questions
- Time limit: 2 hours
- Cost: $146 per attempt
- Passing score: 162 on the 100-200 scale, as set by ASHA
- Note: the test may include unscored items mixed in with scored questions, so every item should be treated as if it counts
Because unscored items are indistinguishable from scored ones during the exam, pacing matters more than trying to guess which questions "don't count." With 120 questions in 120 minutes, you have roughly one minute per item on average, though some questions - particularly audiogram interpretation and case-based assessment scenarios - will take longer than others. For a deeper breakdown of what 162 actually represents and how ASHA's scale works, see CCC-A Passing Score 2026: Exactly What You Need to Pass.
Key Takeaway
Treat every question on the Praxis Audiology exam as scored, since unscored items are not identified during the test. Budget your two hours assuming all 120 questions matter equally to your pace.
What the Exam Actually Tests
The Praxis Audiology exam is organized into five content domains, and they are not weighted evenly. Knowing the weighting tells you where your study hours should go.
Domain 1: Foundations of Audiology (20%)
Covers the anatomical, physiological, and acoustic foundations underlying clinical audiology practice.
- Auditory and vestibular system anatomy and physiology
- Acoustics and psychoacoustic principles
Domain 2: Prevention and Screening (10%)
Focuses on identifying risk and catching hearing or balance issues before they progress.
- Hearing conservation and public health screening protocols
- Newborn and school-age screening programs
Domain 3: Assessment (35%)
The largest domain by far, covering the full diagnostic toolkit audiologists use daily.
- Pure-tone, speech, and immittance audiometry interpretation
- Electrophysiologic and vestibular test battery selection and interpretation
Domain 4: Intervention (25%)
Covers management once a diagnosis is made, from amplification to counseling.
- Hearing aid and cochlear implant candidacy and fitting principles
- Aural rehabilitation and counseling approaches
Domain 5: Professional and Ethical Responsibilities (10%)
Tests judgment around scope of practice, ethics, and interprofessional collaboration.
- ASHA Code of Ethics application in clinical scenarios
- Documentation, supervision, and referral responsibilities
Because Assessment alone accounts for over a third of the exam, and Intervention adds another quarter, roughly 60% of your score depends on just two domains. A full walkthrough of every domain, with subtopics and sample question styles, is available in CCC-A Exam Domains 2026: Complete Guide to All 5 Content Areas.
| Domain | Weight | Relative Priority |
|---|---|---|
| Assessment | 35% | Highest |
| Intervention | 25% | High |
| Foundations of Audiology | 20% | Moderate |
| Prevention and Screening | 10% | Lower |
| Professional and Ethical Responsibilities | 10% | Lower |
The Path Behind the Letters
Earning the right to put CCC-A after your name involves more than passing one exam. ASHA requires applicants to satisfy four categories of standards:
- A relevant doctoral degree
- Documented knowledge and skills outcomes tied to coursework
- Completed supervised clinical practicum hours
- A passing score on the required examination (Praxis Audiology 5343)
The exam is often the final hurdle after years of coursework and clinical rotations, which is exactly why so many candidates underestimate how much dedicated review it still requires. If you're earlier in the process and want the full eligibility checklist, CCC-A Requirements 2026: Eligibility, Prerequisites & How to Qualify lays out each prerequisite in sequence.
On the financial side, initial ASHA certification costs $490 with ASHA membership or $446 without membership, in addition to the $146 exam fee. Candidates budgeting for the full path - application, exam, and certification fees together - should review CCC-A Certification Cost 2026: Complete Pricing Breakdown for a line-item picture of what to expect.
Keeping the CCC-A Active
Passing the exam and receiving the certificate isn't the end of the story - the CCC-A has to be maintained. Holders keep their certification active through:
- Annual dues or certification fees paid to ASHA
- 30 hours of professional development every three years
- At least 1 hour of that total dedicated to ethics
- Starting in 2026, at least 2 hours in designated person-centered, reflective, or collaborative practice topics
Who Looks for CCC-A After Your Name
Because the CCC-A reflects ASHA's national standard for clinical competence in audiology, it functions as a baseline credential that hospitals, private audiology practices, school districts, ENT clinics, and hearing aid dispensing groups commonly expect from audiologists they hire. Many state licensure boards also reference ASHA's certification standards when reviewing applications, even though licensure and certification are technically separate processes.
If you're weighing whether the credential is worth pursuing given the time and fees involved, two resources go deeper on that calculus: Is the CCC-A Certification Worth It? Complete ROI Analysis 2026 and CCC-A Salary Guide 2026: Complete Earnings Analysis. And if you're already certified and job-hunting, CCC-A Jobs covers where audiologists with this credential typically find openings.
Mapping Study Time to Domain Weight
Generic study advice rarely accounts for the fact that the Praxis Audiology exam is not evenly distributed across topics. A smarter approach is to let the domain percentages dictate your calendar rather than splitting time equally across all five areas.
Assessment (35%) and Foundations (20%)
- Drill audiometric and immittance interpretation daily
- Review auditory system anatomy tied to test findings, not in isolation
Intervention (25%)
- Work through amplification and cochlear implant candidacy scenarios
- Practice aural rehabilitation and counseling case questions
Prevention/Screening and Professional/Ethical Responsibilities (10% each)
- Review screening protocols and hearing conservation standards
- Study the ASHA Code of Ethics as applied to case vignettes
Full Timed Review
- Take full-length practice sets under the 2-hour limit
- Revisit weak domains identified from missed questions
This sequencing front-loads the two domains worth 60% of the exam before moving to the lighter-weighted sections. For a more complete week-by-week plan with specific resource recommendations, see CCC-A Study Guide 2026: How to Pass on Your First Attempt. If you're still calibrating how much overall preparation the exam demands relative to your background, How Hard Is the CCC-A Exam? Complete Difficulty Guide 2026 and CCC-A Pass Rate 2026: What the Data Shows are useful starting points.
Whichever schedule you build, timed practice under exam-like conditions is what exposes pacing problems before test day. You can run full-length, domain-weighted practice sessions on the main practice test platform to see how your timing holds up across all five domains, and return to the practice test homepage whenever you want a fresh timed set.
For a compact, last-week reference of the numbers covered in this article - fees, domain weights, passing score, and maintenance hours - bookmark CCC-A Cheat Sheet 2026: One-Page Review of Must-Know Facts.
Frequently Asked Questions
CCC-A stands for Certificate of Clinical Competence in Audiology, a certification awarded by ASHA's Council for Clinical Certification in Audiology and Speech-Language Pathology.
No. The CCC-A is a national clinical certification from ASHA, separate from state licensure, though many state boards reference ASHA's certification standards when evaluating license applications.
Praxis Audiology (5343), a 120-question, 2-hour computer-delivered exam owned and administered by ETS, with administration moving to PSI on January 11, 2027 while content and the passing score stay the same.
ASHA's required passing score on Praxis Audiology is 162 on the 100-200 scale.
It must be actively maintained through annual dues or certification fees and 30 hours of professional development every three years, including at least 1 ethics hour and, starting in 2026, 2 hours in person-centered, reflective, or collaborative topics.