Screening · Required
Tuberculosis Screening (IGRA)
USCIS requires TB screening for every I-693 applicant aged 2 or older. We use the modern IGRA blood test — single draw, 24-72 hour results, no skin test.
Important: Effective October 2018, USCIS requires the IGRA blood test — not the older Mantoux skin test — for all I-693 TB screening. If a clinic offers a Mantoux skin test for an I-693 exam, they're not following current Technical Instructions.
What is the IGRA?
The Interferon-Gamma Release Assay (IGRA — typically QuantiFERON-TB Gold or T-SPOT) is a blood test that measures your immune response to TB antigens. Single venipuncture, results from the reference lab in 24-72 hours. Unlike the skin test, it's not affected by prior BCG vaccination (common in countries like India, the Philippines, Brazil, China) so it doesn't give false positives in BCG-vaccinated patients.
Two possible outcomes
~94% of patients
IGRA Negative
Your I-693 TB section is signed off. No further testing, no return visit. Civil Surgeon completes the form, seals the envelope.
~6% of patients
IGRA Positive
A positive IGRA does not mean you have active TB. We coordinate a chest X-ray ($95, usually within 5 business days) to rule out active disease.
If your chest X-ray is normal
You're diagnosed with latent TB infection (LTBI). LTBI is not a Class A condition — your I-693 can be completed and your green card application proceeds normally. CDC strongly recommends LTBI treatment for your own long-term health, but it is NOT required for USCIS purposes. Your local health department typically offers free LTBI treatment (12-week 3HP regimen or 4-month rifampin).
If your chest X-ray is abnormal
We refer you for a sputum culture (typically 3 mornings of sputum samples). Active TB IS a Class A inadmissibility condition, but it's fully treatable. A complete 6-9 month TB treatment course resolves the inadmissibility and your green card application can resume after documented cure.
Ready to book?
Same-week appointments. Sealed envelope in 5 business days. Transparent pricing — $295 base I-693 exam.
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