Hearing test: what to expect
A hearing test is painless and needs no preparation. You wear headphones, often in a sound-treated room, and signal each time you hear a tone, then repeat words back. The results go on a graph called an audiogram that shows how loud each pitch had to be for you to hear it. Your doctor or audiologist decides what it means for you. (MedlinePlus, 2023) (ASHA, 2026) (ASHA, 2026)
Hearing loss that comes on suddenly needs medical attention right away, not a routine appointment. (ASHA, 2026)
Who gets a hearing test
For adults 50 and older who have not noticed any trouble hearing, the USPSTF found the evidence insufficient to weigh the benefits and harms of screening (I statement, 2021). (USPSTF, 2021) MedlinePlus lists reasons to get tested, such as trouble hearing on the phone or in noise, turning the TV up so loud that others complain, thinking others mumble, or ringing in the ears (tinnitus). People with noisy jobs may need a check every year. (MedlinePlus, 2023) When to get checked at each age: hearing tests by age.
At your primary care visit
Your primary care provider may start with a short screening, such as a questionnaire, a whisper test in each ear, a tuning fork or tones played through an ear scope. (MedlinePlus, 2023) (MedlinePlus, 2026) If it suggests a problem, or you notice trouble hearing, you may be sent to an audiologist, who tests hearing and fits hearing devices, or to an ear, nose and throat doctor (otolaryngologist). (MedlinePlus, 2023)
What happens during a full hearing test
- Ear check first: before tympanometry, the provider looks inside your ear to make sure nothing is blocking the eardrum. (MedlinePlus, 2026)
- Pure-tone test: you wear headphones in a soundproof room. High and low tones, some very soft, play in one ear at a time, and you raise your hand, press a button or say "yes" each time you hear one. It usually covers pitches from 250 Hz (low, like a tuba) to 8,000 Hz (high, like a flute). (MedlinePlus, 2023) (ASHA, 2026)
- Bone conduction: a small device behind your ear or on your forehead sends vibrations straight to the inner ear, skipping the outer and middle ear. Comparing this with the headphone results shows the type of hearing loss. (ASHA, 2026)
- Speech test: you hear simple words at different loudness levels, some over background noise, and repeat them. It shows how well you understand speech and can show how much a hearing aid might help. (MedlinePlus, 2023) (ASHA, 2026)
- Tympanometry: a small probe, like an earbud, gently changes the air pressure in your ear and records how your eardrum moves on a graph called a tympanogram. You may feel pressure and hear a loud tone. It can show fluid behind the eardrum, a hole in it, earwax or a stiff eardrum. (MedlinePlus, 2026) (ASHA, 2026)
- Other tests: some people also have an acoustic reflex test or an otoacoustic emissions (OAE) test, which checks the hair cells in the inner ear with a small device in the ear. (ASHA, 2026) (MedlinePlus, 2023)
A first screening may take 5 to 10 minutes; detailed audiometry about 1 hour. There is no discomfort in audiometry and no risk. (MedlinePlus, 2026) (MedlinePlus, 2023)
How to read your audiogram
- Across the top: pitch (frequency) in hertz, low on the left and high on the right, usually 125 to 8,000 Hz. (ASHA, 2026)
- Down the side: loudness in decibels, soft sounds (0 dB) at the top and loud sounds (120 dB) at the bottom. (ASHA, 2026)
- The marks: red O marks usually show the right ear and blue X marks the left. Each is the softest level you heard at that pitch. The farther down a mark sits, the louder the tone had to be. (ASHA, 2026)
- The "speech banana": a shaded area where the sounds of English speech fall, roughly 250 to 4,000 Hz and 20 to 60 dB. (ASHA, 2026)
- The shape: for example, normal hearing for low pitches but not for high pitches is called high-frequency hearing loss, and it can make speech less clear. The audiogram also shows whether one or both ears are affected and whether they match. (ASHA, 2026)
The audiogram also shows the type of hearing loss: conductive (sound cannot reach the inner ear, for example because of wax, fluid or a hole in the eardrum), sensorineural (damage to the inner ear or hearing nerve) or mixed. (MedlinePlus, 2023) (ASHA, 2026)
Degree of hearing loss: two scales
Degree is measured in decibels hearing level (dB HL): how loud a sound has to be for you to hear it. Sources draw the lines in different places, so both common scales are shown. (ASHA, 2026) (Olusanya et al., 2019)
| Hearing level (dB HL) | Degree |
|---|---|
| -10 to 15 | Normal (ASHA, 2026) |
| 16 to 25 | Slight (ASHA, 2026) |
| 26 to 40 | Mild (ASHA, 2026) |
| 41 to 55 | Moderate (ASHA, 2026) |
| 56 to 70 | Moderately severe (ASHA, 2026) |
| 71 to 90 | Severe (ASHA, 2026) |
| 91 and above | Profound (ASHA, 2026) |
| Hearing level (dB HL) | Grade |
|---|---|
| Under 20 | No hearing loss (Olusanya et al., 2019) |
| 20 to under 35 | Mild (Olusanya et al., 2019) |
| 35 to under 50 | Moderate (Olusanya et al., 2019) |
| 50 to under 65 | Moderately severe (Olusanya et al., 2019) |
| 65 to under 80 | Severe (Olusanya et al., 2019) |
| 80 to under 95 | Profound (Olusanya et al., 2019) |
| 95 and above | Complete or total (Olusanya et al., 2019) |
- Where "normal" ends differs: ASHA uses 15 dB HL and notes some professionals use 20 or 25. (ASHA, 2026) The WHO grades start hearing loss at 20 dB HL, lowered from 26 in WHO's older system. (Olusanya et al., 2019) (Holube et al., 2024) MedlinePlus describes hearing tones at 25 dB or lower as normal. (MedlinePlus, 2026)
- One ear: the WHO scale adds unilateral hearing loss, under 20 dB HL in the better ear and 35 or more in the worse ear. (Olusanya et al., 2019)
- A number is not the whole picture: the WHO Bulletin authors note that some people with normal pure-tone results still report real trouble hearing, so results are read together with how you hear day to day. (Olusanya et al., 2019)
WHO calls hearing loss greater than 35 dB in the better ear "disabling", and says over 25% of people older than 60 have it. (WHO, 2026)
What comes next
MedlinePlus says conductive hearing loss can often be treated at its cause, while sensorineural hearing loss is usually permanent but may be helped by hearing aids or implanted devices, and assistive devices help with phones, doorbells and alarms. More tests may be needed to find the cause. (MedlinePlus, 2023) Your doctor or audiologist decides the next step with you. This page does not recommend any treatment or product.
Since October 17, 2022, the FDA has had a category of over-the-counter hearing aids for adults 18 and older with perceived mild to moderate hearing loss, sold without a prescription or exam. The FDA says they are not meant for severe or profound hearing loss, and that people under 18 need prescription hearing aids through a doctor. (FDA, 2023) Your audiogram shows which range you are in. See also after an abnormal screening result.
Cost and coverage
Medicare Part B covers diagnostic hearing and balance exams when your doctor or other provider orders them; you pay 20% of the approved amount after the deductible. You can see an audiologist once every 12 months without an order for non-acute hearing loss, such as loss that came on over many years. Original Medicare does not cover hearing aids or exams to fit them. (Medicare.gov) For private plans, see preventive screenings covered by insurance.
Questions people ask
How long does a hearing test take?
MedlinePlus says a first screening may take 5 to 10 minutes and a detailed audiometry test about 1 hour. You usually get the results right after the tests. (MedlinePlus, 2026) (MedlinePlus, 2023)
Do I need to prepare for a hearing test?
No special preparation is needed, and there is no risk. During tympanometry you are asked not to move, speak or swallow, because that can change the pressure in the middle ear and the result. (MedlinePlus, 2023) (MedlinePlus, 2026)
What is a normal result on a hearing test?
It depends on the cutoff used. ASHA lists -10 to 15 dB HL as normal and notes that some professionals use 20 or 25. The WHO grades count under 20 dB HL as no hearing loss. MedlinePlus describes normal as hearing tones from 250 to 8,000 Hz at 25 dB or lower. Your audiologist explains which one they use. (ASHA, 2026) (Olusanya et al., 2019) (MedlinePlus, 2026)
What do the X and O marks on an audiogram mean?
ASHA says red O marks usually show the right ear and blue X marks the left ear. Each mark is the softest level you heard at that pitch. The lower a mark sits on the graph, the louder the sound had to be. (ASHA, 2026)
Does Medicare cover hearing tests?
Medicare Part B covers diagnostic hearing and balance exams when your doctor or other provider orders them. You can see an audiologist once every 12 months without an order for hearing loss that came on slowly. Original Medicare does not cover hearing aids or exams to fit them. (Medicare.gov)