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I-693 Immigration Medical Exam Cost & Timeline
Every cost, published. Every turnaround time, stated. The I-693 exam is $390, flat — and your sealed form is issued as soon as your paperwork, testing, and immunizations are complete.
Form I-693 exam fees
| Service | What it covers | Fee |
|---|---|---|
| Initial I-693 examination | History & physical, vaccination record review, form completion and sealing per USCIS guidelines. $100 non-refundable scheduling fee at booking; $290 due at the visit. | $390 |
| Follow-up visit (only if required) | Additional in-person evaluation, per visit. Charged only when a further visit is actually needed — either for medical reasons (lab results that arrived late, a communicable disease such as TB or syphilis needing treatment or further evaluation, or a serious condition requiring an independent consultant’s report) or because you arrived without complete paperwork, testing, or immunization records. If your initial presentation is fully complete, there are no follow-up fees. Your Form I-693 is completed and sealed at whichever visit your paperwork, testing, and immunizations are all complete — the initial visit for applicants who arrive fully prepared, or a later visit if anything is still outstanding. | $190 |
| Laboratory testing | IGRA tuberculosis blood test, syphilis blood test, gonorrhea urine test. Which tests you need depends on your age and history, so the cost differs from applicant to applicant. Self-pay, or use your own insurance at their negotiated rate. | Quoted at your visit |
| Chest X-ray (only if needed) | Required only when the initial tuberculosis blood test is positive or borderline | Quoted if required |
| Vaccinations | Only doses you’re genuinely missing; county health departments offer low-cost options | Per dose |
There is no USCIS filing fee for Form I-693 itself. Payment accepted: cash, check, or card. Specialty consultations, if medically required, are billed separately.
Processing timeline
Day 0 — Your exam visit
History & physical, vaccine review, and any lab draws happen in one appointment (plan 2–6 hours).
You can leave with your sealed envelope the same day. If you arrive with your paperwork complete, your required testing already done, and full immunization records, Dr. Padda completes and seals your Form I-693 at this visit — no return trip. Applicants who close their vaccination gaps and bring their records in order are the ones who finish in a single visit.
Days 2–5 — Laboratory results
The IGRA tuberculosis blood test and syphilis/gonorrhea screens typically result within 2–5 business days. Positive or borderline TB results may require a chest X-ray, which adds several days.
Days 3–7 — If anything was still pending
If lab results, vaccine records, or other documentation were outstanding at your visit, the form is completed once everything returns. Dr. Padda reviews the results with you in person, validates your official photo ID, and directly observes your wet signature on Form I-693. He completes his own validation signature at the same time, makes two copies, and seals the original — signing across the outside of the seal. You leave with the sealed original for USCIS and an unsealed copy for your records. We are prohibited from accepting a signature completed in advance, so this step is always in person. We text you the moment your form is ready. What changed on the I-693, including the sealed envelope rule.
Understand your required lab tests
Dr. Padda explains exactly what the labs are, why USCIS requires them, and what happens if a result comes back positive.
How much does the immigration medical exam cost?
The USCIS immigration medical exam (Form I-693) costs $390 at our St. Louis office. That is the complete professional fee for the examination — there is no separate facility charge and no consultation fee on top of it.
You pay it in two parts: a $100 non-refundable scheduling fee when you book, and the remaining $290 at your visit. Splitting it that way means the appointment is genuinely held for you, and you are not asked for the full amount before you have met the physician.
Two costs sit outside that $390, because they are not ours to set:
- Laboratory testing — the IGRA tuberculosis blood test, syphilis blood test and gonorrhea urine test. Not every applicant needs the full panel — what USCIS requires depends on your age and history, so this cost differs from person to person and is quoted once we know what you need. If you would rather use your own insurance, you pay the rate your insurer has negotiated.
- Chest X-ray — needed only if your initial tuberculosis blood test comes back positive or borderline. Most applicants never need one. Quoted at the time it is ordered, or billed to your own insurance at their negotiated rate.
- Vaccinations — charged per dose, and only for doses you are genuinely missing. County health departments in the St. Louis area offer low-cost options, and bringing complete records is the single most effective way to keep this number at zero.
There is no USCIS filing fee for Form I-693 itself. Payment accepted: cash, check, or card. Specialty consultations, if medically required, are billed separately.
Form N-648 disability waiver fees
The N-648 medical certification is a separate, far more involved evaluation than the I-693 — it is a records-driven medical opinion, not a checklist exam, and it is priced accordingly.
| Service | What it covers | Fee |
|---|---|---|
| Records review | Structured review of your medical history to determine whether the case can be certified at all. Non-refundable — but credited toward the evaluation if we accept the case. | $400 |
| N-648 evaluation | Full evaluation, cognitive assessment in your own language where needed, and completion of Form N-648. | from $1,400 |
| Revisions | Amendments or responses to a USCIS request, within 12 months of the evaluation. | $190 |
Common questions about cost
How much does the immigration medical exam cost?
$390 for the Form I-693 examination at our St. Louis office — a $100 non-refundable scheduling fee at booking plus $290 at the visit. Laboratory testing and any vaccinations you actually need are billed separately, because those are set by the lab and by the vaccine supplier rather than by us.
Is the $390 the total cost, or are there hidden fees?
$390 is the complete professional fee for your exam. Laboratory testing is billed at lab rates and vaccinations per dose, and those apply only where USCIS requires them for your age and vaccination history.
A $190 follow-up visit fee applies only if an additional visit is actually needed — either for medical reasons (a finding that needs treatment or further evaluation, or a condition requiring an independent consultant’s report) or because you arrived without complete paperwork, testing, or immunization records. If your initial presentation is fully complete, there are no follow-up fees.
There is no facility fee, no separate consultation fee, and no USCIS filing fee for Form I-693.
Are the lab tests included in the exam fee?
No, they are billed separately — and the amount genuinely varies. Which tests USCIS requires depends on your age and history, so some applicants need the full panel and others need less. We quote your laboratory cost once we know which tests apply to you. All samples are collected during your visit at our on-site draw station, so there is no separate trip.
Can I use my own insurance for the labs and X-ray?
Yes. Patients who choose to use their own insurance for laboratory testing or imaging pay the rate their insurer has negotiated, rather than our self-pay price. The $390 examination fee itself is not billed to insurance.
Do I have to pay the whole amount up front?
No. $100 is due when you book, which holds the appointment and is non-refundable. The remaining $290 is due at the visit.
What if I need a second visit?
A follow-up visit is $190 per visit, and most applicants never need one. When everything is already complete at your first appointment — all required vaccinations documented, blood work consistent with the published guidelines, no documented communicable disease exposure, and no major life-threatening illness — we complete the entire process on that single visit. If your initial presentation is fully complete, there are no follow-up fees.
A follow-up visit is charged only when a further visit is genuinely required:
- You arrived without complete records — missing paperwork, required testing not yet done, or incomplete immunization records.
- Results or records arrived late — lab results that came back after your exam, or a vaccine dose you completed afterward.
- A communicable disease finding — initial testing suggesting a condition such as tuberculosis or syphilis that needs treatment or further evaluation. These are reportable conditions, so we notify your local county health department, and reporting flows on to the CDC.
- A serious underlying illness — if your history and examination suggest a major life-threatening condition, we are required to engage an independent consultant to cross-validate the condition and provide a consultative report.
Your Form I-693 is completed and sealed at whichever visit your paperwork, testing, and immunizations are all complete — the initial visit for applicants who arrive fully prepared, or a later visit if anything is still outstanding.
How much does the N-648 disability waiver cost?
$400 for the records review, which is non-refundable but credited toward the evaluation if the case is accepted. The evaluation itself starts at $1,400. Revisions within 12 months are $190.
How long until I get my sealed Form I-693?
It can be the same day. If you present at your initial visit with your paperwork complete, your required testing already done, and full immunization records, Dr. Padda completes and seals your Form I-693 at that visit and you leave with the sealed envelope.
If anything is still outstanding, the form is sealed once it is resolved. Lab results typically return in 2–5 business days. A positive or borderline TB result requires a chest X-ray, which adds several days, and a finding that needs treatment or an independent consultant’s report can take longer.
Signing and sealing is always done in person: Dr. Padda reviews your results with you, validates your official photo ID, directly observes your wet signature, and seals the original in your presence.