The I-485 biometrics and medical exam are two mandatory components of the adjustment of status process that every green card applicant must complete. Biometrics support identity verification and criminal background checks. Medical exams verify health admissibility and vaccination compliance. Both are required regardless of visa category, and neither can be waived. Beyond Border helps employment-based green card applicants understand these requirements and prepare for them correctly.
Book a consultation with Beyond Border today
Biometrics appointments are scheduled automatically by USCIS and typically occur within four to eight weeks of filing. The appointment notice specifies the date, time, and Application Support Centre location. Applicants must attend with the appointment notice and a government-issued photo ID.
The collection process takes approximately 20 to 30 minutes. ASC staff verify identity, capture digital photographs, scan all ten fingerprints using electronic equipment, and record a digital signature. The process is straightforward and non-invasive. The biometric data feeds into FBI criminal background checks and identity verification systems.
If fingerprint quality is poor due to worn prints, skin conditions, or age-related changes, USCIS schedules a follow-up appointment for another capture attempt. Missing or rescheduling a biometrics appointment without cause can add weeks to overall processing. Applicants should treat the appointment as a fixed commitment. If rescheduling is genuinely necessary, contact USCIS promptly using the instructions on the appointment notice rather than simply not attending.
The biometric fee of $85 is included in the I-485 filing fee. No additional payment is required at the appointment.
The I-485 medical exam must be completed by a USCIS-designated civil surgeon listed in the official directory at uscis.gov. Regular physicians are not authorised to complete Form I-693. Costs range from $200 to $500 depending on the civil surgeon's location and the vaccinations required.
The exam includes a physical examination, a medical history review, a chest X-ray for applicants aged 15 and older, blood tests for applicants aged 15 and older, vaccination record verification, and screening for communicable diseases of public health significance. The civil surgeon verifies vaccination records against USCIS requirements. Required vaccines include mumps, measles, rubella, polio, tetanus, diphtheria, pertussis, hepatitis A and B, varicella, influenza, and others depending on the applicant's age. Missing vaccines are administered at the appointment or shortly after, with documentation added to the form.
Applicants should bring vaccination records, documentation of any chronic conditions, a list of current medications, a government-issued photo ID, and payment. The appointment typically takes one to two hours including waiting time.
After the exam, the civil surgeon completes Form I-693, seals it in a designated envelope, and signs across the seal. The applicant receives the sealed envelope and submits it to USCIS. If the envelope is opened at any point, the form is invalid and the exam must be repeated. The sealed envelope must be kept intact until it reaches USCIS.
Timing the medical exam submission is a strategic decision that depends on the applicant's expected processing timeline and country of birth.
Submitting Form I-693 with the initial I-485 filing means USCIS has all required documentation immediately, which can reduce processing time. However, if the I-485 takes longer than two years to adjudicate, the medical results expire and the exam must be repeated at full cost. This is a real risk for applicants from countries with priority date backlogs or for cases delayed by background checks or service centre workload.
Waiting for a USCIS Request for Evidence before completing the medical exam extends the validity period to four years from the civil surgeon signature date. This protects applicants against expiration during extended processing. The tradeoff is that the RFE response cycle adds two to four months to the total timeline. For applicants with current priority dates and straightforward cases, submitting the exam upfront is often the better choice. For applicants expecting long waits, the RFE strategy is more appropriate.
Beyond Border helps applicants assess their specific situation and choose the timing approach that fits their processing outlook. Explore Beyond Border's EB-2 NIW visa page for guidance on concurrent I-485 filing strategy for self-sponsored green card applicants.
Certain medical findings can affect I-485 admissibility and require additional steps before USCIS can approve the application.
Class A conditions including active tuberculosis, untreated syphilis, and other communicable diseases of public health significance render an applicant inadmissible. The civil surgeon documents these conditions on Form I-693 and provides referrals for treatment. After successful treatment, a follow-up exam with an updated Form I-693 documenting medical clearance allows the application to proceed. Class A findings delay approval but do not permanently bar it once treatment is complete and documented.
Class B conditions such as controlled diabetes, managed hypertension, or mental health conditions treated with medication generally do not create inadmissibility. They are documented on the form but do not prevent approval in most cases.
Incomplete vaccination records are the most common complication. When an applicant cannot locate childhood vaccination documentation, the civil surgeon can order antibody titer blood tests to confirm immunity through past vaccination or natural infection. If titers show no immunity, the required vaccines are administered at the appointment.
Applicants with prior histories of substance abuse, mental health treatment, or tuberculosis diagnosis may require specialist evaluations or additional documentation. Criminal convictions related to substance abuse can trigger psychological evaluation requirements. Pregnant applicants can defer chest X-rays until after delivery, with the medical exam remaining valid once the X-ray is completed.
Identifying potential medical complications early gives applicants time to gather documentation, complete treatment, and obtain clearance before the exam. Beyond Border provides consultation on navigating complex medical situations within the broader I-485 process.
USCIS government fees are paid directly to USCIS. Medical exam costs are paid to the civil surgeon separately.
As of 2026, The I-485 filing fee is $1,440, which includes the $85 biometric fee. No additional payment is required at the biometrics appointment itself. The Form I-485 fee also covers concurrent Form I-765 (Employment Authorisation Document) and Form I-131 (Advance Parole) when filed together with the I-485.
The medical exam fee is paid directly to the civil surgeon and ranges from $200 to $500 depending on location and the vaccinations required. Immigration medical exams are typically not covered by health insurance as they are classified as elective procedures. Applicants should budget for the full exam cost plus any required vaccinations not covered by insurance.
Use the Beyond Border USCIS Fee Calculator to estimate your total government fees before filing.
[Check the USCIS processing times page for the most current estimates, as USCIS updates these weekly.]
Beyond Border specialises exclusively in high-skilled U.S. employment-based immigration, with a 98% approval rate across 4,000+ cases and a client base spanning professionals from Salesforce, Google, Yelp, Chime, Visa, and Mastercard across both high-growth technology companies and established financial services firms.
The biometric fee is $85, included in the I-485 filing fee of $1,440. No additional payment is collected at the Application Support Centre appointment. Biometrics appointments are scheduled automatically by USCIS within four to eight weeks of filing and require a government-issued photo ID and the appointment notice.
The exam includes a physical examination, medical history review, chest X-ray for applicants aged 15 and older, blood tests for applicants aged 15 and older, vaccination record verification, and disease screening. Only USCIS-designated civil surgeons may complete Form I-693. Costs range from $200 to $500 depending on location and required vaccinations.
No. Form I-693 sealed by a designated civil surgeon is a mandatory requirement. USCIS will not approve an adjustment of status application without completed medical exam results. There are no exceptions or waivers to this requirement.
Results are valid for two years from the civil surgeon signature date if submitted with the initial I-485 filing, or four years if submitted later in response to a USCIS Request for Evidence. Applicants facing extended processing timelines should consider the RFE strategy to avoid expiration and repeat exam costs.
Bring the USCIS appointment notice (Form I-797C) and a valid government-issued photo ID such as a passport, driver's licence, or state identification card. Arrive 15 minutes early. No payment is required at the appointment. If fingerprint quality is poor, USCIS will schedule a follow-up appointment.
