Many nurses from Kerala, Tamil Nadu, Punjab, Karnataka and across India dream of working in American hospitals. The route is real, but it is longer than the UK or the Gulf, and it works differently. There is no single US nursing licence. Each state has its own Board of Nursing, everyone sits the same national exam (the NCLEX-RN), and your green card depends on a monthly government queue that nobody can speed up for you.
This guide sets out the steps in order, with the official fee for each stage and a link to where we checked it. Every figure was checked on 31 Oct 2026. US fees change often, so open each link before you pay anything.
Resumen rápido
| Etapa | Quién lo gestiona | Tarifa oficial (consultada el 31 Oct 2026) |
|---|---|---|
| Evaluación de credenciales | TruMerit (formerly CGFNS) | CES Professional Report $485; TruMerit Certification Program $495 (Tarifas de TruMerit) |
| Solicitud a la Junta Estatal de Enfermería | El estado que elija | Consulte el sitio oficial de su estado |
| Inscripción al NCLEX-RN | NCSBN / Pearson VUE | $200, más $150 de tarifa de programación internacional e IVA donde corresponda (Tarifas del NCLEX) |
| Certificado VisaScreen | TruMerit | $740 (Tarifas de TruMerit) |
| Petición de inmigrante I-140 | USCIS, filed and paid by your employer | $700 filing fee (USCIS I-140), plus an Asylum Program Fee of $600, $300 for small employers or $0 for non-profits (USCIS fee rule) |
| Solicitud de visa de inmigrante | US Department of State | $345 por persona (Tarifas del Departamento de Estado) |
Fee change ahead: NCLEX says its US registration fee rises to $350 from 1 February 2027 (NCLEX fees). NCLEX registration fees and the international scheduling fee are non-refundable.
Step 1: Gather your Indian documents and pick a state
Before you pay anyone, collect your GNM or BSc Nursing certificate and transcripts, your current State Nursing Council registration (for example, Kerala Nurses and Midwives Council), and a valid passport. Keep your name spelled the same way on every document. NCLEX requires the first and last name you register with to match your ID exactly, and at an international test centre the only accepted ID is a passport book or card (NCLEX acceptable ID).
Next, choose a state. Each State Board of Nursing sets its own rules on credentials, English and paperwork. NCSBN links to every board at ncsbn.org. If an employer is already interested in you, ask in writing which state they want you licensed in before you start.
Step 2: Get your credentials evaluated
TruMerit says State Boards of Nursing require you to apply to it for an evaluation of your documents and education (TruMerit US steps). Depending on your state you will order one of these (fee schedule):
- CES Professional Report: $485. TruMerit validates your licences, registrations and diplomas and compares your education with US standards (CES report).
- TruMerit (CGFNS) Certification Program: $495. This adds the TruMerit Qualifying Exam and an English component. TruMerit says some state boards require this exam before you can sit the NCLEX-RN.
Other TruMerit charges to know about: expedited CES review $425, document translation $85 per page, and re-evaluation $295. Your college and State Council usually take the longest to respond, so request records early.
Step 3: Board approval and the NCLEX-RN in India
Apply to your chosen State Board. When it approves you, it makes you eligible to test. You register with Pearson VUE separately:
- Your NCLEX registration stays open for 365 days while you wait for the board. If you are not made eligible in that time, you lose the registration and the fee (NCLEX registration).
- Once eligible, you get an Authorization to Test (ATT) email. You must test within the dates shown on it.
- India is one of 19 international NCLEX locations (testing locations), so you do not need to travel to the US for the exam. Testing outside the US adds the $150 international scheduling fee.
- Under the RN test plan effective April 2026, you answer between 85 and 150 items in up to five hours, including breaks (2026 RN test plan).
Paso 4: examen de inglés y VisaScreen
US law requires foreign-educated nurses to complete a health care worker screening before an occupational visa is issued. TruMerit's VisaScreen meets this rule, and the certificate must be included with every visa or green card petition filed for you (VisaScreen).
- Fee: $740 (fee schedule).
- Nursing knowledge: you show an NCLEX-RN pass or a pass in the TruMerit Nurse Qualifying Exam.
- English: VisaScreen accepts IELTS Academic, OET, TOEFL iBT, PTE Academic, MET and Cambridge English exams. At-home versions are not accepted.
- India is not exempt. The exemption covers only nurses educated in the UK, Australia, Canada (except Quebec), New Zealand, Ireland or the US, with English as the language of instruction.
- Minimum scores: TruMerit changed its requirements on 12 May 2026. We could not read the score table when we checked, so check the official VisaScreen page for the current registered nurse scores before you book a test.
- Processing: TruMerit says 90% of certificates are issued within 3.5 business days after all documents are received and validated.
Step 5: Employer petition, Visa Bulletin and green card
Most nurses from India move on an employment-based green card, usually in the third preference (EB-3) category. TruMerit also mentions the H-1B visa, and says you need a US employer to act as your petitioner.
- Your employer files Form I-140 with USCIS and pays the fees in the summary table.
- You wait for your priority date to become current. The State Department's monthly Visa Bulletin shows which dates can move forward. Read the row for your country of chargeability in the current month, for example the November 2026 bulletin. We could not open the bulletin on 31 Oct 2026, so we are not quoting a date.
- You file your immigrant visa application, pay $345 per person (fees) and attend your interview.
Before you leave India, check your passport status and whether your destination needs emigration clearance on eMigrate. The MEA says nurses need clearance for employment in the 18 ECR countries (MEA recruitment FAQ).
Calendario habitual
These are planning ranges, not promises.
| Etapa | Guía oficial | Rango estimado |
|---|---|---|
| TruMerit evaluation | Expedited CES aims for 10 business days after documents, not guaranteed | 1 to 4 months, mostly waiting for documents |
| Aprobación de la junta y ATT | Varía según el estado | De semanas a meses |
| Preparación y aprobación del NCLEX | Sin cifra oficial | 2 a 6 months |
| VisaScreen | 90% within 3.5 business days after validation | Semanas |
| Del I-140 a la entrevista de visa | Depends on the Visa Bulletin | A menudo mucho más de un año |
Common mistakes and scams to avoid
- Paying for a "guaranteed" US job. A real employer files and pays for its own petition. Walk away from anyone who wants large upfront fees "to block a slot".
- Believing someone can move your priority date. Nobody can jump the Visa Bulletin queue for money.
- Booking the wrong English test. At-home tests are refused for VisaScreen. Check the current scores first.
- Mismatched names. A small spelling difference between your passport and NCLEX registration can stop you testing on the day.
- Signing contracts you have not read. Some US staffing contracts include large fees if you leave early. Ask for the contract in writing and take your time.
- Proxy testing or bought results. Boards and TruMerit verify results at the source. You risk your licence for life.
- Visitor visa "work" offers. You cannot work as a nurse on a tourist visa.
- Unregistered agents. TruMerit says using a recruiter is optional. If you use one, check that an Indian recruiting agent is registered on eMigrate, then run their details through our free fake-agent checker.
Practique gratis
NurseFlyAbroad is free for nurses, always. Try our NCLEX-style clinical cases and English practice, then download a free PDF report card. Ask nurses who have already made the move in our community, and read about settling in on Life abroad.
FAQ
Can I take the NCLEX-RN in India? Yes. India is one of the 19 international NCLEX locations. You pay the $200 registration fee plus a $150 international scheduling fee and any VAT.
Is GNM accepted in the US? There is no single national answer. Your State Board decides, using a TruMerit evaluation that compares your education with US standards. Order the evaluation your state asks for to get a formal answer.
Do Indian nurses need IELTS or OET for the US? Usually yes for VisaScreen, because India is not on its short list of exempt countries. Your state board may have its own English rules too.
How long is the green card wait for Indian nurses? It depends on the Visa Bulletin, which changes every month. Read the current bulletin yourself rather than trusting an agent's estimate.
Who pays the I-140 fees? The I-140 is your employer's petition, and the employer files it. Ask for written confirmation of what your employer pays before you sign anything.
Fuentes (consultadas el 31 Oct 2026)
- NCSBN / NCLEX: Fees and payment, Registration, Acceptable ID, Testing locations, 2026 RN test plan, NCSBN boards
- TruMerit (CGFNS): Fee schedule, VisaScreen, CES Professional Report, Steps to working in the US
- US Government: USCIS I-140, USCIS fee rule, State Department visa fees, Visa Bulletin
- India: MEA recruitment FAQ, eMigrate