I-693 Immigration Medical Exam

Under the rule effective November 1, 2023, a Form I-693 signed by a civil surgeon on or after November 1, 2023, is valid only while the associated I-485 application is pending. If the I-485 is withdrawn or denied, the I-693 becomes invalid, and a new medical exam is required for any subsequent I-485 filing. Additionally, as of December 2, 2024, Form I-693 must be submitted concurrently with the I-485. Starting July 3, 2025, USCIS will accept only the 01/20/25 edition of Form I-693.

Costs vary by region and provider, typically ranging from $200 to $500. This generally covers the exam and basic blood work. Vaccinations, if needed, cost an additional $50–$200 per vaccine. Some insurance plans may cover vaccinations but not the exam fee itself. It is advisable to confirm pricing and accepted payment methods when scheduling your appointment.

No. As of January 20, 2025, USCIS removed the COVID-19 vaccine from the list of required immunizations for the immigration medical exam. Applicants are no longer required to provide proof of COVID-19 vaccination, and civil surgeons will not require it during the examination. This change applies to all new and pending I-485 applications.

If the TB blood test (IGRA) is positive, the civil surgeon will order a chest X-ray. If the X-ray shows no signs of active tuberculosis, you can generally proceed with completing the I-693. If the X-ray is abnormal, further sputum testing and treatment may be required. For Chinese applicants who received the BCG vaccine, the IGRA blood test is more accurate than the traditional tuberculin skin test (TST/PPD), as IGRA is not affected by prior BCG vaccination. Request that your civil surgeon use the IGRA test.

You should bring: (1) a valid passport or government-issued ID; (2) Form I-693 with Part 1 pre-completed; (3) your vaccination record booklet; (4) any prior medical records or X-rays (if you have a history of TB or related treatment); (5) a list of current prescription medications; and (6) glasses or contact lenses (if applicable). Having complete vaccination records can help avoid unnecessary revaccinations and additional costs.

USCIS provides an online Civil Surgeon Locator tool (https://www.uscis.gov/tools/find-a-civil-surgeon) where you can search for designated civil surgeons by ZIP code. Only USCIS-designated civil surgeons are authorized to perform the immigration medical exam and sign Form I-693. Regular family physicians or emergency room doctors are not qualified. It is recommended to choose a doctor with extensive immigration medical exam experience to ensure the form is completed accurately.