Tinnitus and Hyperacusis

Misophonia (Annoyance Hyperacusis) and Loudness Hyperacusis

The initial visit will be a 90 minute in person visit. This visit will include getting to know you as well as obtaining hearing and hyperacusis measurements. The second visit will be a one hour in person visit and will include a sound generator fitting, discussing the mechanisms of hyperacusis, its impact, and tools you can employ to manage your hyperacusis including a sound plan. The third visit will be a 45 minute video visit (can change to in-person if preferred), which will consist of reviewing the sound plan and discuss additional options to manage your hyperacusis.

Please note that sound therapy through the use of ear-level sound generators is an integral part of hyperacusis management. Many hearing aids have built in sound generators. If you have hearing aids from Oticon, Phonak, GN Resound, Widex, or Starkey they most likely have a sound generator that we can activate and program. If you have health insurance coverage for hearing aids, we encourage you to obtain your hearing aids under your insurance coverage.

If you are a parent of an older child or adolescent with misophonia, please contact Dr. Douglas directly at tinnitus@csd.wisc.edu.


Per licensure laws, in order to receive services via video visit, you must be located in Wisconsin. We may deliver part of this program through the use of videoconferencing software and dedicated videoconferencing hardware and secure web-based programs. This information is transmitted over a web-based connection. Network connection speed affects overall quality of video and audio clarity. Upload and download speeds should be no less than 5 MB. To determine if you meet these requirements, go to www.speedtest.net  You can also use your mobile network on your smartphone, but know that streaming video can use a good amount of data so WiFi is preferred. If videoconferencing is not an option, we can implement a plan over the telephone. It is still recommended you have access to a computer to view the visual aids.

Cost of the Program

Our facility is a teaching clinic and your management plan will be done by doctoral graduate students in Audiology under the supervision of a licensed Audiologist. The cost for the initial visit is up to $239. If appropriate, the cost for ear level sound generators are $1240 (for two) and the cost for hearing aids with sound generators are $2375 (for two). If you have hearing aids from the manufacturers listed above, the cost to program the sound generators is $200. The cost for the second visit is $150. The cost for each additional visit is $50. If cost is an issue, please don’t let that be a barrier and contact us for alternative options. There is a reduced rate if you have a Medicaid card and/or qualify for free lunch at school. See the link at the bottom of the page to submit your application.

This is a self-pay clinic and if you wish to bill your insurance directly for Out-of-Network reimbursement you will be provided the procedure codes. The University of Wisconsin Tinnitus and Hyperacusis Program does not bill insurance and is not responsible for the amount of reimbursement or the difference in the reimbursement and the cost of services. Medicare and many insurance companies do not cover audiological treatment options for tinnitus such as hearing aids, sound therapy devices, tinnitus maskers, tinnitus treatment, or counseling.

PLEASE READ: Before Completing the Materials

Please go to Emergency Care or Ear, Nose, and Throat (ENT) immediately if you experience the following:

  • Injury to your body
  • Weakness or paralysis of any muscles in your face
  • Sudden unexplained hearing loss in one or both ears

Please go to Emergency Care or a Mental Health Clinic if you experience the following:

  • Extreme anxiety or depression
  • A current plan to end your life or a way to do it

Please contact your physician for a referral if any of the following apply to you:

  • Symptoms of Meniere’s disease
  • Tinnitus that pulsates with your heartbeat (pulsatile tinnitus)
  • Ear drainage
  • Ear pain
  • Dizziness
  • Newly onset tinnitus, hyperacusis or hearing loss
  • Progressive tinnitus or hyperacusis
  • Conductive hearing loss
  • Hearing loss worse in one ear

Although a medical exam is always in your interest, it is reasonable to consider forgoing an ENT exam if ALL the conditions are met:

  • Bothersome tinnitus or hyperacusis that is in both ears and does not pulsate
  • Tinnitus or hyperacusis following a history noise exposure
  • Stable and long duration (greater than 6 months)
  • Sensorineural hearing loss that is the same in both ears OR typical hearing thresholds in both ears

If you have debilitating tinnitus and are interested in creating a tinnitus management plan, please complete the confidential survey: https://uwmadison.co1.qualtrics.com/jfe/form/SV_0SQPjro4ZQRAejz

If you have debilitating loudness hyperacusis or annoyance hyperacusis (misophonia) and are interested in creating a hyperacusis management plan, please complete the confidential survey: https://uwmadison.co1.qualtrics.com/jfe/form/SV_cOzuPGZAQ86Ly29

Alternatively, you can complete, print, and mail (or email:tinnitus@csd.wisc.edu) the forms, which are available here:


  1. Otologic History
  2. Tinnitus Handicap Inventory
  3. Tinnitus Functional Index
  4. Informed Consent for Teletherapy


  1. Otologic History
  2. Detailed Trigger Inventory
  3. Misophonia Assessment Questionnaire (MAQ)
  4. Inventory of Hyperacusis Symptoms