Speech-language pathologist in the USA: ASHA CCC-SLP (2026)

• You hold a master's, doctoral or other recognized post-baccalaureate degree in speech-language pathology or communication sciences and disorders. A bachelor's degree alone does not meet ASHA's Standard I.
• Your graduate coursework was completed at an institution that is regionally accredited or recognized by the appropriate regulatory authority in your country, as ASHA's international provision requires.
• A NACES-member credential evaluation agency on ASHA's list can produce a course-by-course evaluation in US semester hours that marks graduate-level courses and states the highest level of education you completed.
• Your training covered the ASHA knowledge areas, including speech sound production, fluency, voice and resonance, language, hearing, swallowing and feeding, cognitive and social aspects of communication and augmentative and alternative communication.
• You completed at least 400 clock hours of supervised clinical practicum (25 hours of guided observation and 375 hours of direct client contact, with at least 250 hours on site and in person).
• You can complete a Clinical Fellowship of at least 36 weeks and 1,260 hours, with at least 80 percent in direct clinical contact, under an ASHA-certified mentor, within 48 months.
• If you are a certified member of RCSLT or Speech Pathology Australia, a full member of IASLT or NZSTA, or a certified member of SAC, you may apply through the Mutual Recognition Agreement instead.
• For work authorization, you can pass an approved English test at the score set for SLPs and obtain a VisaScreen certificate, with all professional licenses you have ever held verified as valid and unrestricted.

Check your route with the route finder

• CGFNSCGFNS International

  Credentials evaluation and VisaScreen for nurses and allied health

  How to register with the CGFNS

1. 1

   Check your degree level and choose your route

   Confirm whether your qualification is a master's or higher. If you hold only a bachelor's degree, you will normally need a graduate degree before you can meet ASHA or state standards. If you are certified with RCSLT, IASLT, NZSTA, Speech Pathology Australia or SAC, read the Mutual Recognition Agreement first, as it can remove the credential evaluation and, for most applicants, the Clinical Fellowship.
2. 2

   Order a course-by-course credential evaluation

   Choose an agency from ASHA's list, all of which are NACES members, such as WES, ECE or Josef Silny and Associates. Ask for a course-by-course evaluation in American semester hours that marks graduate-level courses and states your highest level of education. Universities can be slow to send sealed transcripts, so start early, and keep the same evaluation for state boards, which often ask for an ASHA-approved evaluation too.
3. 3

   Map your clinical practicum hours

   Collect signed records of your supervised clinical hours from your university, broken down by observation and direct contact. ASHA requires at least 400 clock hours, including 375 of direct contact. Gaps in particular disorder areas, such as dysphagia or fluency, are a common reason applicants need extra coursework or hours.
4. 4

   Register for and pass the Praxis exam

   Register with ETS for the Praxis Speech-Language Pathology test (5331): 132 selected-response questions in 150 minutes, delivered by computer. ASHA's passing score is 162 on a 100 to 200 scale. Have ETS send your score directly to ASHA; it must be no more than 5 years old when you apply.
5. 5

   Apply for the CCC-SLP and pay the fee

   Submit the ASHA application for your practice area with the required documents and the full fee: $490 for certification with ASHA membership or $446 for certification only. ASHA says to allow about 6 to 8 weeks for the initial review of an international application. Once you apply, you have 2 years to complete the certification process.
6. 6

   Get a temporary or intern state license

   Most states license Clinical Fellows under a provisional or intern license. In Texas, for example, the Intern in Speech-Language Pathology license costs $75, needs a master's degree in communicative sciences or disorders (with an ASHA-approved evaluation for foreign degrees), the Texas Jurisprudence Examination and fingerprints. Check the rules of the state where your job is before you accept it.
7. 7

   Complete your Clinical Fellowship

   Work at least 36 weeks and 1,260 hours, at least 5 hours a week, under a mentor who holds a current CCC-SLP. Your mentor provides at least 6 hours of on-site direct and 6 hours of indirect observation in each of three segments and rates you on the Clinical Fellowship Skills Inventory; you need a score of 2 or better on every skill in the final segment. Finding a mentor and an employer willing to sponsor a visa at the same time is where many plans stall.
8. 8

   Get VisaScreen and your work visa

   Apply to TruMerit (formerly CGFNS International) for VisaScreen. It checks that your education is comparable to a US graduate's, verifies every license you have held, and confirms your English test result. The initial fee is $740. Your employer then files the visa petition; an H-1B is common for SLPs because a master's degree is the normal entry requirement.
9. 9

   Upgrade to a full state license

   After your Clinical Fellowship and CCC-SLP, apply to upgrade to a full license. Texas charges $150 for a two-year initial license and may waive its internship and Praxis requirements for applicants who hold or have held the CCC. Keep your CCC-SLP current with 30 professional development hours every 3 years, including 1 hour in ethics.

• Praxis Speech-Language Pathology (5331)

  Owned and administered by ETS. ETS lists 132 selected-response questions in 150 minutes, computer delivered at test centers or online at home, with a fee of $146. It covers speech sound production, fluency, voice, resonance and motor speech, receptive and expressive language, social communication, cognitive aspects of communication, augmentative and alternative communication, hearing, and feeding and swallowing. ASHA's passing score is 162.

• State jurisprudence examinations

  Some states test you on their own laws and rules. Texas, for example, requires the Texas Jurisprudence Examination for both the intern and full licenses. Check your state board's exam page.

• Clinical Fellowship Skills Inventory

  Not a written exam, but a formal assessment. Your mentor rates your clinical skills in each segment of the Clinical Fellowship, and you must score 2 or better on every skill in the final segment for ASHA to award the CCC-SLP.

• English test for VisaScreen

  VisaScreen requires a passing score on an approved English exam taken at a test center, not an at-home version. TruMerit lists Cambridge English, TOEFL iBT, IELTS, MET, OET and PTE Academic, with scores updated by HRSA from May 12, 2026.

  Read the guide

• ASHA's international certification pages do not set a separate English test score for the CCC-SLP. The Praxis exam and the Clinical Fellowship are both in English, so your clinical English is tested in practice.
• VisaScreen has a federal English requirement. Applicants must show oral and written English by passing an approved test at the score set for their profession.
• From May 12, 2026, TruMerit follows an updated list of tests and scores published by HRSA. The approved tests include Cambridge English, TOEFL iBT, IELTS, MET, OET and Pearson PTE Academic. TOEIC is no longer accepted.
• At-home versions of English tests are not accepted for VisaScreen. Book a test center sitting.
• We could not confirm the exact 2026 minimum scores for speech-language pathologists from an official page we could read. Check the current score table on the TruMerit site before booking.
• Some state boards add their own rules for applicants educated outside the USA, such as an English requirement or a translated transcript evaluation. Check the board in the state where you plan to work.

Estimate your total cost

• Allow several weeks to a few months for your university to send transcripts and for a credential evaluation agency to produce a course-by-course report.
• ASHA says to allow about 6 to 8 weeks for the initial review of an international CCC-SLP application once all materials and payment arrive. MRA applications take about 4 to 6 weeks from receipt of everything.
• Once you apply, ASHA gives you 2 years to complete the certification process, and your Praxis score must be no more than 5 years old.
• The Clinical Fellowship takes at least 36 weeks full time, and must be finished within 48 months if you work part time.
• TruMerit says 90 percent of VisaScreen certificates are issued within 3.5 business days once documentation is validated. The certificate must be used within 5 years of issue under 8 CFR 212.15.
• Plan for a year or more from starting your evaluation to holding a full state license, longer if you need extra coursework or a graduate degree.

There is no national pay scale for SLPs in the USA; pay is set by the employer. The figures below are from the BLS Occupational Outlook Handbook, based on May 2025 Occupational Employment and Wage Statistics. Pay varies widely by state and setting.

Yearly amounts

• All speech-language pathologists (median)

  $97,870

  BLS, May 2025.

• Nursing and residential care facilities (median)

  $109,660

  BLS, May 2025.

• Hospitals (median)

  $103,690

  State, local and private hospitals. BLS, May 2025.

• Offices of therapists and audiologists (median)

  $98,910

  BLS, May 2025.

• Educational services (median)

  $83,120

  State, local and private schools. BLS, May 2025.

• Public and private schools, the largest single setting, where some states also require a school credential or teaching certificate.
• Hospitals, including acute care, neonatal and dysphagia services.
• Skilled nursing and residential care facilities, which BLS shows as the highest-paying setting.
• Inpatient and outpatient rehabilitation centers.
• Private practices and offices of physical, occupational and speech therapists.
• Staffing agencies that place international SLPs, though their visa sponsorship and fee terms vary widely.

• Speech-language pathologists and audiologists are covered health care occupations under 8 CFR 212.15. You need a VisaScreen certificate from TruMerit (formerly CGFNS International) to be admitted, change status or adjust status to work in the profession.
• VisaScreen checks that your education is comparable to a US graduate's, verifies that every professional license you have held is valid and unrestricted, and confirms a passing English test score.
• The H-1B specialty occupation visa is the usual temporary route, because a master's degree is the typical entry requirement. USCIS allows up to 3 years at first, extendable to a total of 6 years.
• USCIS says that if an occupation needs a state license, you generally must hold it before the H-1B petition is approved. A provisional or intern license may be relevant; ask your employer's immigration attorney.
• USCIS says certain H-1B petitions filed on or after September 21, 2025 must include an additional $100,000 payment. Cap-subject H-1B visas are limited to 65,000 a year plus 20,000 for US master's graduates, but universities and nonprofit research organizations are not subject to the cap.
• Permanent residence (a green card) usually needs an employer to sponsor you through an employment-based category. This page does not give immigration legal advice; speak to a licensed US immigration attorney about your case.

1. 1

   A DHA, DOH, MOHAP, SCFHS, QCHP or other GCC license does not transfer to the USA, and the Gulf is not part of ASHA's Mutual Recognition Agreement. You apply through the standard international route.

2. 2

   Many Gulf-based SLPs hold a bachelor's degree, such as an Indian BASLP. ASHA and state boards require a master's or higher, so check your degree level before you spend money on an evaluation.

3. 3

   Gulf work experience does not replace the Clinical Fellowship on the standard route. It does make you a stronger candidate for US employers and gives you real cases for the Praxis.

4. 4

   VisaScreen verifies every license you have ever held. Ask each Gulf authority for a verification or good standing letter while your license is active, and keep a record of license numbers and dates.

5. 5

   If you also hold RCSLT, IASLT or Speech Pathology Australia certification from earlier work, the MRA route may be faster than the standard international route.

• Application plan with every step, fee and deadline

• Document checklist tailored to you, and a review of each document before upload

• Timeline built around the regulator's closure windows and document validity periods

• Help completing the application forms accurately and consistently

• Support with profession-specific evidence, such as the HCPC standards of proficiency mapping

• Guidance on certificates of good standing, references and certified translations

• Preparation for identity checks and declarations on health and character

• Tracking your application and help responding to regulator requests

• Next steps after the decision: exams, adaptation, PIN or licence and your first job

Regulators make all registration decisions and set all fees. Our fee is separate from the regulator's fees, exam fees and translation costs.

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