The Class A or B TB USPHS annotation is a notation on your U.S. immigrant visa that reads “Class A or B (TB)…requires attn of USPHS at POE.” If you’ve seen this on your visa, here’s what it means and what to expect.
This notation refers to a finding related to tuberculosis (“TB”), a communicable disease of public health significance. During the required medical examination, the panel physician assessed whether you may have Class A or Class B tuberculosis. Class A TB applies if you have active, infectious tuberculosis. If so, you are generally inadmissible to the United States until you have completed treatment and no longer pose a public health risk. Class B TB applies if you have a history of tuberculosis, evidence of latent TB infection, or findings suggestive of non-infectious TB that require further evaluation or follow-up.
If you want to learn more about how medical conditions can affect your visa, we recommend reading our guide on Medical Reasons for Visa Rejection.
The annotation “requires attn of USPHS at POE” means that you must be referred to the U.S. Public Health Service (“USPHS”) at the U.S. port of entry for further medical review or instructions. Upon arrival in the U.S., a Customs and Border Protection officer will review your medical documents and may direct you to a designated public health official or agency for further evaluation. This may include:
- Additional medical evaluations.
- Referral to a local health department for monitoring or treatment.
- Submission of medical records to confirm compliance with U.S. health requirements.
This review may take additional time at the port of entry so please plan for your arrival or onward flight connections accordingly.
If your visa is revoked upon arrival by CBP, find out what steps to take in our article Nonimmigrant Visa Is Revoked By CBP At Port-of-Entry.
To avoid confusion on how your name appears in visa or passport records, especially for Vietnamese citizens, see our explanation on How Vietnam Passport Name Order Listed.
If your visa category is immigrant-based, such as family-sponsored or employment-sponsored, read more in our section on Immigrant Visa.
If you are required to submit financial documents during your immigrant visa process, learn about “What is Form I-864 Affidavit of Support?”, which is commonly needed to demonstrate financial sponsorship.
If you have questions or concerns about this annotation, contact Enterline & Partners via info@enterlinepartners.com.
What Happens After USPHS Review at the Port of Entry?
Once CBP refers you to USPHS for additional review, the process and outcome depend on your specific TB classification:
For Class B TB notations: In most cases, this is a documentation and monitoring matter rather than a barrier to entry. You may be asked to follow up with a local health department within a specified timeframe after arrival, but this rarely delays your entry into the United States.
For Class A TB notations: This is more serious and typically means treatment must be completed and verified before travel is permitted. If you’re traveling with this notation, it usually means your case has already been cleared for travel with specific monitoring requirements attached.
In either case, having your complete medical examination records (Form I-693 or DS-2053) readily accessible when you arrive helps the review process move faster.
Frequently Asked Questions About the Class A or B TB USPHS Annotation
What does “USPHS” stand for on my immigrant visa?
USPHS stands for the U.S. Public Health Service. This annotation means that upon arrival at a U.S. port of entry, your medical records related to tuberculosis findings will be reviewed by public health officials before you’re fully admitted.
Does the “Class A or B TB” annotation mean my visa will be denied?
No. This annotation does not mean your visa application was denied – your visa was approved, but with a notation requiring additional medical follow-up at the port of entry. Class B TB findings, in particular, rarely prevent entry and are primarily for monitoring purposes.
How long does USPHS review take at the airport?
Review times vary depending on the port of entry and your specific case, but applicants should budget extra time at arrival – particularly if you have connecting flights. Having complete medical documentation readily available typically speeds up the process significantly.
Will I need follow-up treatment after entering the U.S.?
This depends on your TB classification. Class B notations often require a follow-up visit with a local health department within a set period after arrival, while Class A cases involve more comprehensive treatment verification. Your medical examination documentation will specify what’s required for your situation.
ENTERLINE & PARTNERS CONSULTING
Ho Chi Minh City, Vietnam Office
Level 6 & 7, Friendship Tower, 31 Le Duan Street, Sai Gon Ward, Ho Chi Minh City, Vietnam
Tel: +84 933 301 488
Email: info@enterlinepartners.com
Facebook: Enterline & Partners – Dịch vụ Thị thực và Định cư Hoa Kỳ
YouTube: @EnterlineAndPartnersConsulting
Website: http://enterlinepartners.com
Manila, Philippines Office
LKG Tower 37th Floor
6801 Ayala Avenue
Makati City, Philippines 1226
Tel: +63 917 543 7926
Email: info@enterlinepartners.com
Facebook: Enterline and Partners Philippines
Website: https://enterlinepartners.com/language/en/welcome/
Copyright 2025. This article is for information purposes only and does not constitute legal advice. This article may be changed with or without notice. The opinions expressed in this article are those of Enterline & Partners only.
