On Oct. 20, 2025, U.S. Citizenship and Immigration Services (USCIS) published additional guidance regarding H-1B petitions following the issuance of a proclamation by President Donald Trump on Sept. 19, 2025 that orders prospective employers to pay an additional $100,000 fee for new H-1B petitions for workers abroad, effective Sept. 21, 2025. There is no exception for physicians.
The updated guidance clarifies the proclamation applies to new H-1B petitions and does not prevent any holder of a current H-1B visa, or any alien beneficiary following petition approval, from traveling in and out of the United States.
The proclamation grants the Secretary of Homeland Security the authority to grant exceptions to the fee in “extraordinarily rare” circumstances. In September, ASGE joined a letter to Secretary Kristi Noem stating that all physicians, including medical residents, fellows, researchers, and those working in non-clinical settings, are critical to our national interest and should therefore be exempt from the proclamation.