USMLE Exam Fees 2026: Step 1, Step 2 CK and Step 3 Costs
Written by Dr Zartasha Ali, MBBS, FCPS (Medicine). Reviewed by Dr Ammar Hussain, MBBS, FCPS (Pediatrics), MRCPCH.
The USMLE exam fees for 2026 and 2027 are $695 for Step 1, $695 for Step 2 CK and $955 for Step 3, according to the “Apply for Exams” page on usmle.org. The fee is the same whether you apply through NBME or through FSMB. If you sit Step 1 or Step 2 CK outside the US and Canada, a region fee is added.
All figures on this page are in US dollars. They were read from usmle.org and nbme.org on 14 October 2026.
USMLE exam fees for 2026 and 2027
| Exam | 2026 application fee | 2027 application fee | Source |
|---|---|---|---|
| Step 1 | $695 | $695 | usmle.org, Apply for Exams |
| Step 2 CK | $695 | $695 | usmle.org, Apply for Exams |
| Step 3 | $955 | $955 | usmle.org, Apply for Exams |
| All three Steps, application fees only | $2,345 | $2,345 | Our sum of the three rows above |
The fees did not change between 2026 and 2027. The usmle.org page lists them under one heading, “2026 & 2027 Application Fee”.
Which year’s fee you pay depends on your eligibility period, not on the day you apply. NBME lists the 2026 fees for three-month eligibility periods starting from 1 November 2025 – 31 January 2026 through 1 October 2026 – 31 December 2026.
The 2027 fees cover periods from 1 November 2026 – 31 January 2027 through 1 October 2027 – 31 December 2027. Because both years cost the same, the boundary makes no difference to your payment this time.
USMLE Step 1 fees and total cost
The USMLE Step 1 fee is $695 in 2026 and 2027. If you test in the US or Canada, that is the whole exam fee.
If you test anywhere else, usmle.org states: “For Step 1, there is a $210 region fee for exams taken outside of the U.S. and Canada.” The page adds that this is not a USMLE fee.
| Where you sit Step 1 | Application fee | Region fee | Total |
|---|---|---|---|
| US or Canada | $695 | None | $695 |
| Outside the US and Canada | $695 | $210 | $905 |
The totals are our addition of the two official figures. They do not include any local tax. See the India note below.
USMLE Step 2 CK cost
The Step 2 CK application fee is $695 in 2026 and 2027. The region fee is higher than for Step 1. The usmle.org page says there is a region fee of $235 for Step 2 CK exams taken outside the US and Canada.
| Where you sit Step 2 CK | Application fee | Region fee | Total |
|---|---|---|---|
| US or Canada | $695 | None | $695 |
| Outside the US and Canada | $695 | $235 | $930 |
USMLE Step 3 fee
The Step 3 application fee is $955 in 2026 and 2027. There is no region fee, because Step 3 is given only in the US and its territories. That is stated on the USMLE common questions page.
International medical graduates need ECFMG Certification to be eligible for Step 3, according to usmle.org. That certification has its own fees, which are separate from the exam fee.
USMLE fees for international students and graduates
If you study at, or graduated from, a medical school outside the US, three things about cost are different for you.
1. You pay FSMB, not ECFMG. Since 12 January 2026, all USMLE Step exam services for international medical graduates have been managed by FSMB. The USMLE service transition page records this change. The usmle.org apply page now sends applicants from schools outside the US to FSMB, with the same $695 and $955 fees as US applicants.
2. You will probably pay a region fee. The region fee applies to where you sit the exam, not to your nationality. An international graduate who travels to a US test center pays no region fee. A US student who tests abroad pays it.
3. Tax may apply in India. The usmle.org apply page states that an 18% tax applies to Steps 1 and 2 taken in India, and that the tax is collected and remitted directly to India. The page does not show the final amount, so check the figure in your application before you pay.
| Cost for international graduates | Amount | Status |
|---|---|---|
| Step 1 application fee, 2026 and 2027 | $695 | Confirmed on usmle.org |
| Step 1 region fee outside the US and Canada | $210 | Confirmed on usmle.org |
| Step 2 CK application fee, 2026 and 2027 | $695 | Confirmed on usmle.org |
| Step 2 CK region fee outside the US and Canada | $235 | Confirmed on usmle.org |
| Step 3 application fee, 2026 and 2027 | $955 | Confirmed on usmle.org |
| Tax on Steps 1 and 2 taken in India | 18% | Confirmed on usmle.org |
| ECFMG Certification fees | Set by ECFMG | See the current list at ecfmg.org/fees |
The international test delivery surcharge, now called the region fee
Many older guides call the extra charge for testing abroad the “international test delivery surcharge”. The usmle.org apply page now calls it a “region fee”. The current figures on that page are $210 for Step 1 and $235 for Step 2 CK, for exams taken outside the US and Canada.
The page gives one figure per Step for all regions outside the US and Canada. If your application shows a different amount for your region, the amount in your application is the one you will be charged.
USMLE reschedule fee
Changing your appointment is free if you do it early. The fee rises as the test day gets closer.
The USMLE “Reschedule an Exam” page lists the fees below. They took effect on 1 July 2026 and apply to all testing regions.
| Days before the first day of your test | Step 1 | Step 2 CK | Step 3 |
|---|---|---|---|
| 46 or more | No fee | No fee | No fee |
| 31 to 45 | $35 | $35 | $35 |
| 6 to 30 | $100 | $100 | $100 |
| 5 or fewer | $158 | $178 | $317 |
The fee applies when you reschedule, cancel or change test center. Prometric charges it. Days are counted in local time at the Regional Registration Center for your Prometric testing region.
If you miss your appointment and still have time left in your eligibility period, USMLE says you contact Prometric and pay the late rescheduling fee to book again.
Other USMLE costs to plan for
| Item | Amount | Source and year |
|---|---|---|
| Eligibility period extension, Step 1 and Step 2 CK, US school applicants | $70 | nbme.org, 2026 and 2027 |
| Eligibility period extension, FSMB applicants | Set by FSMB | See the current amount at fsmb.org/usmle |
| Returned payment charge | $25 | nbme.org, 2026 and 2027 |
| Score recheck | A service fee applies | usmle.org does not publish the amount. Your registration body states it when you ask for a recheck |
| Test accommodations request | No fee | usmle.org, Common Questions |
Eligibility period extension. USMLE allows a one-time, contiguous three-month extension if you cannot test in your original period. The request must be received no later than 25 days after the original period ends.
Reapplying. If you do not test in your original or extended eligibility period, USMLE requires a new application and a new fee. That means paying the full $695 or $955 again.
Retakes. A retake after a fail also needs a new application and fee. A second attempt at Step 1 therefore costs at least another $695.
Travel, accommodation and study materials are extra and vary by person. USMLE publishes free practice materials on usmle.org.
Paid resources are optional. RecallsGuru sells USMLE Step 1 recalls written by its own authors, with access for 1, 3 or 6 months.
Are USMLE fees refundable?
No. The USMLE Bulletin of Information says fees are non-refundable and non-transferable. The common questions page adds that an application cannot be cancelled after it is submitted.
In practice this means:
- Choose your eligibility period with care. Our page on USMLE Step 1 exam dates explains how the periods work.
- Book your Prometric date early, so that any change falls in the free window of 46 days or more.
- Pay for an extension rather than letting the period end. An extension costs far less than a new application.
Help with USMLE exam fees
NBME runs a fee assistance program for the USMLE. The usmle.org apply page links to the 2026 program announcement on nbme.org.
Questions people ask
How much does USMLE Step 1 cost in 2026?
$695, according to usmle.org. Add a $210 region fee if you take it outside the US and Canada, for a total of $905 before any local tax.
How much do all three USMLE Steps cost?
The three application fees add up to $2,345 in 2026 and 2027: $695, $695 and $955. A candidate who sits Step 1 and Step 2 CK outside the US and Canada also pays $210 and $235 in region fees, which brings the total to $2,790. These sums are our own addition of the official figures.
Did USMLE fees go up for 2027?
No. The usmle.org apply page lists one set of fees for both 2026 and 2027.
Who do I pay?
Students and graduates of US medical schools accredited by the LCME or COCA pay NBME through the MyUSMLE portal. Students and graduates of schools outside the US pay FSMB. Prometric collects reschedule fees.
Is the Step 1 fee worth risking on an early attempt?
Only you can judge your readiness, but the numbers are clear. A fail costs another $695, plus any region fee, and uses one of your four attempts. See the USMLE Step 1 pass rate by group before you set a date.
Does the fee include a practice exam?
The pages we read do not list a practice exam as part of the application fee. USMLE publishes free sample test questions and a testing experience tool on usmle.org.
Sources
Pages opened on 14 October 2026:
- USMLE, Apply for Exams: https://www.usmle.org/apply-exams
- USMLE, Reschedule an Exam: https://www.usmle.org/reschedule-exam
- USMLE, Common Questions: https://www.usmle.org/common-questions/general
- USMLE, Common Questions, Cancelling and Rescheduling: https://www.usmle.org/common-questions/cancelling-rescheduling
- USMLE, Bulletin of Information 2027, Applying and Scheduling: https://www.usmle.org/bulletin-information/applying-scheduling
- USMLE, Score Rechecks: https://www.usmle.org/scores-transcripts/score-rechecks
- USMLE, Service Transition Information Hub: https://www.usmle.org/usmle-service-transition
- NBME, USMLE fees and eligibility periods: https://www.nbme.org/examinees/united-states-medical-licensing-exam-usmle/