- 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 questions, 2 hours, $146, passing score 162 on a 100-200 scale.
- Assessment is the heaviest content area at 35% of the exam.
- ETS administers the exam through 2026; PSI takes over administration on January 11, 2027, with the same content and passing point.
What Does CCC-A Stand For?
CCC-A stands for Certificate of Clinical Competence in Audiology. It is the national clinical certification that identifies an audiologist as having met a standardized set of academic, clinical, and examination requirements recognized across the profession in the United States. When you see "CCC-A" after an audiologist's name, it signals that the practitioner has completed a doctoral-level program, logged supervised clinical practicum hours, demonstrated the required knowledge and skills, and passed a national examination specific to audiology.
It's worth pausing on this because the same four letters get attached to other credentials in unrelated fields. This article - and every resource on this site - refers exclusively to the audiology certification described above. If you're comparing job postings, licensure boards, or continuing education requirements, always confirm you're looking at the Certificate of Clinical Competence in Audiology and not a similarly abbreviated credential from a different discipline.
Who Awards the CCC-A
The CCC-A is awarded by ASHA's Council for Clinical Certification in Audiology and Speech-Language Pathology. This council sets the eligibility standards, reviews applications, and maintains the certification once granted. It's a separate function from state licensure - many states use CCC-A eligibility criteria as a foundation for licensing, but the certificate itself is a national credential rather than a state-issued license.
To qualify, applicants must satisfy four categories of standards: a doctoral degree, defined knowledge-and-skills competencies, supervised clinical practicum hours, and a passing score on the required national examination. If you want the full breakdown of each prerequisite, see the detailed walkthrough in CCC-A Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Breaking Down the Acronym: What Each Word Means in Practice
Understanding what each word in "Certificate of Clinical Competence in Audiology" actually implies helps clarify what the credential does - and doesn't - certify.
- Certificate - This is a credentialing document, not a license to practice. Many states require it as part of licensure, but it is issued and maintained by ASHA's certification council, not a government licensing board.
- Clinical - The certificate is tied directly to hands-on patient care competencies, verified through supervised practicum hours completed during doctoral training.
- Competence - Competence is demonstrated through a combination of coursework, supervised practice, and a standardized examination score, not simply years of experience.
- Audiology - The certificate is specific to the audiology scope of practice: hearing and balance assessment, diagnosis, and intervention - distinct from speech-language pathology certification, which is a separate credential under the same council.
The Exam Behind the Credential
The national examination required for the CCC-A is Praxis Audiology (5343), owned and administered by ETS. It is a computer-delivered, selected-response test consisting of 120 questions to be completed in 2 hours, and it may include unscored field-test items mixed in with scored questions. The exam fee is $146.
ASHA's required passing score is 162 on the 100-200 scaled scoring range used for this exam. That number is the single most important figure for any candidate to know, and it's worth understanding exactly how the scaling works before test day - see CCC-A Passing Score 2026: Exactly What You Need to Pass for a full explanation.
A meaningful administrative change is coming: starting January 11, 2027, exam administration transitions from ETS to PSI. The content of the exam and the required passing score are staying the same - only the testing vendor changes. If your target test date falls near that transition, check current scheduling windows before registering; details are tracked in CCC-A Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Key Takeaway
Register and study based on the exam's current ETS administration if your test date is before January 11, 2027. After that date, expect PSI-administered testing with identical content and the same 162 passing score.
The Five Domains Tested Under the CCC-A Umbrella
Praxis Audiology (5343) draws its 120 questions from five content domains, each carrying a different weight. Knowing these weights lets you allocate study time proportionally instead of spreading effort evenly across topics that aren't tested evenly.
Domain 1: Foundations of Audiology (20%)
Covers the anatomical, physiological, and acoustic principles underlying hearing and balance function.
- Auditory and vestibular system anatomy and physiology
- Acoustics and psychoacoustic principles
- Genetics and etiologies of hearing loss
Domain 2: Prevention and Screening (10%)
Focuses on identifying risk and catching hearing or balance issues early.
- Newborn and school-age hearing screening protocols
- Occupational and environmental noise exposure risk
- Referral criteria and preventive counseling
Domain 3: Assessment (35%)
The largest domain by far, covering the full diagnostic workflow candidates must master.
- Pure-tone, speech, and immittance audiometry
- Otoacoustic emissions and auditory evoked potentials
- Vestibular and balance function testing
- Interpreting test batteries to reach differential diagnoses
Domain 4: Intervention (25%)
Covers treatment planning and management once a diagnosis is established.
- Hearing aid selection, fitting, and verification
- Cochlear implant candidacy and post-implant management
- Aural rehabilitation and counseling strategies
Domain 5: Professional and Ethical Responsibilities (10%)
Tests knowledge of scope of practice, ethics, and interprofessional collaboration.
- ASHA Code of Ethics application to clinical scenarios
- Documentation, billing, and regulatory compliance
- Supervision and interprofessional team roles
Because Assessment alone accounts for over a third of the exam, it deserves the largest share of your study calendar. For a domain-by-domain breakdown with example question styles and prioritized topic lists, see CCC-A Exam Domains 2026: Complete Guide to All 5 Content Areas.
What It Costs to Earn and Keep the CCC-A
Beyond the $146 exam fee, initial ASHA certification carries its own cost: $490 with ASHA membership or $446 without membership. These fees fund the application review and initial certification process itself, separate from the examination fee paid to ETS.
| Item | Cost / Requirement |
|---|---|
| Praxis Audiology (5343) exam fee | $146 |
| Initial certification, with ASHA membership | $490 |
| Initial certification, without membership | $446 |
| Passing score required | 162 (scale of 100-200) |
| Ongoing PD requirement | 30 hours every 3 years, including 1 ethics hour |
Maintaining the CCC-A once earned isn't a one-time event. Holders pay annual dues or certification fees and complete 30 professional-development hours every three years, including 1 hour of ethics content. Starting in 2026, that requirement also includes 2 hours in designated person-centered, reflective, or collaborative-practice topics. For a complete cost breakdown across the entire certification lifecycle - not just the exam - see CCC-A Certification Cost 2026: Complete Pricing Breakdown.
Who Actually Requires the CCC-A
Because the CCC-A verifies a standardized, nationally recognized level of clinical competence, it functions as a baseline credential expected across most audiology employment settings - hospitals, ENT and audiology private practices, school districts, hearing aid dispensing clinics, and Veterans Affairs or other federal health systems. Many state licensure boards align their own requirements closely with CCC-A eligibility standards, which is one reason the credential carries weight even outside ASHA membership circles.
If you're evaluating whether pursuing the certification makes sense for your career path - including how it interacts with job postings, licensure, and long-term practice options - the return-on-investment analysis in Is the CCC-A Certification Worth It? Complete ROI Analysis 2026 and the job-market overview in CCC-A Jobs go into more depth than a definitions article can.
How to Prepare Without Wasting Time
Because Assessment (35%) and Intervention (25%) together make up 60% of the exam, an efficient study plan front-loads those two domains rather than treating all five equally. A simple way to structure preparation:
Assessment (Domain 3)
- Drill audiometric test batteries and interpretation scenarios
- Review evoked potential and OAE result patterns
Intervention (Domain 4)
- Work through hearing aid fitting and verification cases
- Review cochlear implant candidacy criteria
Foundations (Domain 1)
- Refresh anatomy, physiology, and acoustics fundamentals
Prevention/Screening & Ethics (Domains 2 & 5)
- Cover screening protocols and Code of Ethics scenarios together, since both are lighter-weight domains
Techniques like spaced repetition for terminology and timed practice blocks matter less than making sure your practice time mirrors the actual exam: 120 selected-response questions in a strict 2-hour window, with the awareness that some items may be unscored field-test questions you can't identify in advance. Running full-length timed simulations on our practice test platform is the most direct way to build that pacing instinct before you sit for the real Praxis Audiology exam.
For a structured, week-by-week plan built specifically around passing on the first attempt, see the CCC-A Study Guide 2026: How to Pass on Your First Attempt. And if you're still deciding how much time to budget overall, How Hard Is the CCC-A Exam? Complete Difficulty Guide 2026 and CCC-A Pass Rate 2026: What the Data Shows both offer useful context before you set a test date.
Frequently Asked Questions
CCC-A stands for Certificate of Clinical Competence in Audiology, the national certification awarded by ASHA's Council for Clinical Certification in Audiology and Speech-Language Pathology.
It's a certification, not a state license. Many state licensing boards use similar or aligned requirements, but the CCC-A itself is issued and maintained by ASHA's certification council.
Praxis Audiology (5343), a 120-question, 2-hour computer-delivered exam administered by ETS through 2026 and by PSI starting January 11, 2027. The content and required passing score of 162 stay the same across the transition.
Budget $146 for the Praxis Audiology exam plus $490 for initial ASHA certification with membership, or $446 without membership.
Yes. Maintenance requires ongoing annual dues or certification fees plus 30 professional-development hours every three years, including 1 ethics hour and, starting in 2026, 2 hours in designated person-centered, reflective, or collaborative topics.