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Requirement for Proof of Negative COVID-19 Test or Documentation of Recovery from COVID-19 for Air Passengers Traveling to the United States from China, Hong Kong, or Macau

Requirement for Proof of Negative COVID-19 Test or Documentation of Recovery from COVID-19 for Air Passengers Traveling to the United States from China, Hong Kong, or Macau
Updated Dec. 30, 2022
What You Need to Know
  • If you plan to travel by air to the United States from China, Hong Kong, or Macau, you will need to get a COVID-19 viral test no more than 2 days before your flight. You must show your negative result to the airline before you board your flight.
    • This requirement also applies if you have been in China, Hong Kong, or Macau in the past 10 days and you are traveling to the United States from one of the following airports: Incheon International Airport (ICN) in Seoul, Republic of Korea; Toronto Pearson International Airport (YYZ) in Canada; and Vancouver International Airport (YVR) in Canada (referred to as Designated Airports).
    • The requirement does not apply if you transited through an airport in China, Hong Kong, or Macau en route to the United States from another country, or if you spent less than 24 hours in China, Hong Kong, or Macau.
  • If you recently recovered from COVID-19, you may instead travel with one of the following forms of documentation of recovery from COVID-19:
    • Your positive COVID-19 viral test result on a sample taken more than 10 days but fewer than 91 days before your flight, or
    • Your positive COVID-19 viral test result on a sample taken 10 or fewer days before your flight PLUS a letter from a licensed healthcare provider or a public health official stating that your COVID-19 symptoms started more than 10 days before your flight.
  • These requirements apply to passengers 2 years of age and older regardless of citizenship or vaccination status.

On December 30, 2022, CDC issued an Order titled, “Requirements for Negative Pre-Departure COVID-19 Test Result or Documentation of Recovery from Covid-19 for All Airline or Other Aircraft Passengers Traveling to the United States from the People’s Republic Of China.”

Starting 12:01am EST (5:01am GMT) on January 5, 2023, all air passengers 2 years of age and older traveling to the United States from China, Hong Kong, or Macau will need to get a COVID-19 viral test no more than 2 days before their flight and show their negative result, or show proof documentation of having recovered from COVID-19 in the past 90 days, to the airline before boarding. This requirement also applies to passengers who have been in China, Hong Kong, or Macau in the past 10 days and are traveling to the United States from one of the following airports: Incheon International Airport (ICN) in Seoul, South Korea; Toronto Pearson International Airport (YYZ) in Canada; and Vancouver International Airport (YVR) in Canada (referred to as Designated Airports).

These air passengers will also be required to confirm in the form of an attestation that the information they present is true.

For the full list of requirements and exceptions, please review the language in the Order.

Visit the following pages for additional recommendations and requirements before, during, and after international travel.

Travel Assessment

A tool to help you know the requirements to board a flight to the United States.

Aircraft Operators/ Airlines/ Crew

For additional information, resources, and FAQs please visit the following webpages:

Frequently Asked Questions

What are you looking for?

Overview

Yes, this Order applies to U.S. citizens and lawful permanent residents (Green Card holders), unless they meet the criteria for an exception.

No, the Order does not apply if you transited through an airport in China, Hong Kong, or Macau en route to the United States from another country, or if you spent less than 24 hours in China, Hong Kong, or Macau.

The date you left China, Hong Kong, or Macau is Day 0. The requirements no longer apply on Day 11, which is a full 10 days after you left China, Hong Kong, or Macau. For example, if you left China, Hong Kong, or Macau on January 1 (Day 0), the requirements no longer apply on January 12 (Day 11). 

No, the requirements of this Order only apply to air travel to the U.S. from China, Hong Kong, Macau, or a Designated Airport 

Yes, the requirement to present a negative COVID-19 viral test result or documentation recovery from COVID-19 also applies to air travel to US territories. U.S. territories include American Samoa, Guam, the Northern Mariana Islands, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands.

Test and Documentation Requirements

You must be tested with a viral test to look for current infection – these include an antigen test or a nucleic acid amplification test (NAAT).

Phrases indicating a test is an antigen test could include, but not are not limited to:

  • Rapid antigen test
  • Viral antigen test
  • Antigen Chromatographic Digital Immunoassay
  • Antigen Chemiluminescence Immunoassay
  • Antigen Lateral Flow Fluorescence

Examples of available NAATs for SARS-CoV-2 include but are not restricted to:

  • Reverse transcription polymerase chain reaction (RT-PCR)
  • Isothermal amplification including:
    • Nicking endonuclease amplification reaction (NEAR)
    • Transcription mediated amplification (TMA)
    • Loop-mediated isothermal amplification (LAMP)
    • Helicase-dependent amplification (HDA)
    • Clustered regularly interspaced short palindromic repeats (CRISPR)
    • Strand displacement amplification (SDA)

The test used must be authorized for detection of SARS-CoV-2 by the U.S. Food and Drug Administration or the relevant national authority in the country where the test is administered.

A viral test conducted for U.S. Department of Defense (DOD) personnel, including DOD contractors, dependents, and other U.S. government employees, and tested by a DOD laboratory located in a foreign country also meets the requirements of the Order.

Rapid tests are acceptable if they are a viral test that meet the requirements under the Order.

You can use a self-test (sometimes referred to as home test) that meets the following criteria:

  • The test must be a SARS-CoV-2 viral test (nucleic acid amplification test [NAAT] or antigen test) with Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) OR the relevant national authority where the test is administered.
  • The testing procedure must include a telehealth service affiliated with the manufacturer of the test that provides real-time supervision remotely through an audio and video connection. Some FDA-authorized self-tests that include a telehealth service may require a prescription.
  • The telehealth provider must confirm your identity, observe the sample collection and testing procedures, confirm the test result, and issue a report that meets the requirements of CDC’s Order (see “What information must be included in the test result?” below).
  • Airlines and other aircraft operators must be able to review and confirm your identity and the test result details. You must also be able to present the documentation of test results to U.S. officials at the port of entry and local/state health departments, if requested.

Some countries may restrict importation of tests that are not authorized or registered there. If you are considering bringing a U.S.-authorized test with you for use outside of the United States, contact authorities at your destination for information before you travel.

A test result must be in the form of written documentation (paper or digital copy). The documentation must include:

  1. Type of test (indicating it is a NAAT or antigen test)
  2. Entity issuing the result (e.g., laboratory, healthcare entity, or telehealth service)
  3. Sample collection date
    • A negative test result must show the sample was taken no more than 2 days before the flight.
    • A positive test result for documentation of recovery from COVID-19 must show the sample was taken within the 90 days before the flight.
  4. Information that identifies the person (full name plus at least one other identifier such as date of birth or passport number)
  5. Test result

Before boarding a flight to the U.S., you will need to show a paper or digital copy of your test result for review by the airline and may be requested to show to public health officials after you arrive in the U.S.

CDC is not able to reimburse you for COVID-19 testing fees. You may wish to contact your insurance provider or the location that provided your test about payment options.

If you had a positive viral test result in the past 90 days, you can show one of the following forms of documentation of recovery from COVID-19:

  • A positive viral test result from a sample collected more than 10 days and fewer than 91 days before your flight, OR
  • A positive result dated 10 or fewer days before your flight PLUS a letter signed by a licensed healthcare provider stating that your symptoms started more than 10 days before your flight. The letter must:
    • list the date your symptoms started;
    • have information that identifies you personally (e.g., name and date of birth) that matches the personal identifiers on your passport or other travel documents; and
    • be signed and dated on official letterhead that contains the name, address, and phone number of the healthcare provider or public health official who signed the letter.

Also see “What information must be included on the test result?” above.

If you have recovered from COVID-19 but are not able to obtain documentation of recovery that fulfills the requirements, you will need to show a negative COVID-19 viral test result from a sample taken no more than 2 days before your flight departs.

Airlines must refuse to board anyone who does not present a negative test result for COVID-19 or documentation of recovery.

The date your positive test was taken or the date your symptoms started is Day 0. You can travel on or after Day 11, which is 10 full days after Day 0. For example, if your test was taken or your symptoms started on January 1 (Day 0), you can travel on January 12 (Day 11).

Yes, the requirements of this Order apply regardless of vaccination or antibody status.

Airlines and other aircraft operators must be able to confirm the test result and review other required information and should determine when translation is necessary for these purposes. If your documents are in a language other than English, you should check with your airline or aircraft operator before travel. 

You are required to retain a paper or digital copy of your negative test result or documentation of recovery for the entirety of your itinerary to the United States as federal public health officials may request to see these documents when you arrive. State, territorial, tribal and/or local health departments in the United States may also request them under their own public health authorities. 

Timing Requirements

If you are 2 years of age or older and traveling to the U.S., you must get tested no more than 2 days before your flight to the departs from China, Hong Kong, Macau, or a Designated Airport.

The 2-day period is 2 calendar days before the flight’s departure. The Order uses a 2-day time frame instead of 48 hours to provide more flexibility to the air passenger and aircraft operator. By using a 2-day window, test acceptability does not depend on the time of the flight or the time of day that the test sample was taken. 

For example, if your flight is at 1pm on a Friday, you could board with a negative test that was taken any time on the prior Wednesday. 

If a trip is shorter than 2 days, a viral test taken in the United States can be used to fulfill the requirements of the Order as long as the specimen was taken no more than 2 days before your return flight to the U.S. departs. If your return travel is delayed longer than 2 days after the test, you will need to be retested before your return flight.

If you are considering this option, you should additionally consider, as a contingency when making your travel plans, the availability of testing capacity at your destination and the time frame needed to obtain results.

When making plans for travel, you should consider the availability of testing capacity and the time frame needed to obtain results.

For more information on where to obtain a test overseas, you should review the relevant U.S. Embassy website.

If you cannot find a place to get a test with a turnaround time of less than 2 days, you may consider using a self-test that includes a telehealth service affiliated with the manufacturer of the test that provides real-time supervision remotely through an audio and video connection. See Does a self-test meet the conditions of the Order?

You may also consider contacting the airline regarding options for changing your departure date to allow time for a test or see if the airline has identified options for testing.

Connecting or Delayed Flights

If your itinerary starts in China, Hong Kong, or Macau, you will need to show your negative test result or documentation of recovery before boarding the flight that leaves China, Hong Kong or Macau.

  • This applies even if you are connecting to the United States through a Designated Airport. You do not need to show your documents again at the Designated Airport as long as your flights were all booked on the same ticket.

If your travel to the U.S. starts at a Designated Airport, but you were in China, Hong Kong, or Macau in the past 10 days, you will need to show your negative test result or documentation of recovery before boarding the flight that leaves the Designated Airport.

Yes.  The Order applies to passengers departing from China, Hong Kong, or Macau, or from a Designated Airport if they have been in China, Hong Kong, or Macau, in the past 10 days, if their destination is in the U.S. or if they are connecting through the U.S. to another country. 

If your flight is delayed past the 2-day limit of testing due to a situation outside of your control (e.g., delays because of severe weather or aircraft mechanical problem), and that delay is 24 hours or less past the 2-day limit for testing, you do not need to be retested. If the delay is more than 24 hours past the 2- day limit, then you will need to be retested.

CDC does not reimburse and is unable to help travelers get reimbursements for travel expenses because of canceled or delayed travel due to COVID-19 or testing requirements for air passengers flying to the US. While some companies may base their policies on CDC’s travel recommendations or requirements, each company establishes its own refund policies.

In some cases, trip cancellation insurance may protect your financial investment in a trip if you need to change your itinerary in the event of an international outbreak. Visit CDC’s Travelers’ Health website if you would like to learn more about travel insurance, including trip cancellation insurance.

Attestations

An attestation is a statement, writing, entry, or other representation under 18 U.S.C. § 1001 that confirms that the information provided is true. Willingly providing false or misleading information may lead to fines and other criminal penalties.

As required by United States federal law, all airlines or other aircraft operators will provide and collect the passenger attestation on behalf of the U.S. Government prior to boarding.

As required by United States federal law, all airlines or other aircraft operators will provide and collect the passenger attestation on behalf of the U.S. Government prior to boarding. Please check with the airline or aircraft operator for your flight to learn how the airline or aircraft operator will collect your attestation.

The attestation should be submitted to and retained by the airline or aircraft operator. If you are an air passenger, you are required to retain a paper or digital copy of your negative test result or documentation of recovery but are not required to retain a copy of your attestation.

Exceptions

Exceptions may be granted on an extremely limited basis when emergency travel (like an emergency medical evacuation) must occur to preserve someone’s life, health against a serious danger, or physical safety and testing cannot be completed before travel.

CDC may grant a humanitarian exception in very limited circumstances only when an individual must travel to the United States to preserve health (e.g., emergency medical evacuations) or safety (e.g., violence) and is unable to access or complete the testing requirement before travel.

Individuals who fit the exception criteria described in CDC’s Order may contact the nearest U.S. embassy or consulate. The embassy will then transmit this information to the CDC for consideration.

Please review the procedures for applying for a humanitarian exception as listed on the webpage of the embassy or consulate where you will apply. This link will lead you to the relevant embassy or consulate: https://www.usembassy.gov.

To facilitate the review of a humanitarian exception request, individuals should submit the following information to the embassy or consulate for transmission to the CDC. All information needs to be completed in full and in English for the request to be sent to CDC.

  • Name (family name/surname, given name)
  • Age
  • U.S. Citizen, U.S. National, Lawful Permanent Resident?
    • If no:
      • Nationality
      • Indicate Visa Type or if passenger has Electronic System for Travel Authorization (ESTA)
  • Cell phone number (including country code) of passenger or head of household if family unit
  • Email address of passenger or head of household if family unit
  • US destination address
    • Is US destination home address?
  • Flight itinerary, including any connecting flights
    • Airline
    • Flight #
    • Departure airport and date of departure
    • Arrival airport and date of arrival
  • Any COVID-19 vaccines received to date, if applicable (list product name and date for each dose)
  • Purpose of travel to the US and a brief explanation of why urgent travel is needed
  • Justification for humanitarian exception for testing requirement (e.g., no testing available where passenger is located)
  • Documentation to support justification (e.g., medical records, orders for emergency evacuation)
  • Information regarding any other solutions that were sought prior to application (e.g., flight changes, assistance in obtaining testing, etc.)

Private flights or general aviation aircraft may transport a person who has tested positive for COVID-19 and does not meet criteria for documentation of recovery if they obtain authorization from CDC and use infection control measures to prevent onboard transmission consistent with relevant CDC guidance.

Crew on passenger or cargo flights are excepted from the requirements of the Order under certain circumstances. For more information, see FAQs for airlines.

U.S. federal law enforcement officers on official travel are excepted from the requirements of the Order if:

  1. Officers are carrying out a law enforcement function (e.g., for security purposes) on the aircraft; AND
  2. The urgent need to travel does not allow time for testing.

CDC expects that U.S. federal law enforcement agencies will determine whether their employees’ travel meets the requirements of the exception.  CDC recommends that employees travel with a copy of their travel orders and a signed letter (paper or electronic) from their agency stating that the employee’s travel meets the requirements of the exception.

U.S. military personnel, civilian employees, dependents, contractors, and other U.S. government employees are excepted from the requirements of the CDC Order if they are traveling on official military travel orders and observing applicable U.S. Department of Defense force health protection guidance to prevent the transmission of COVID-19. This exception applies to persons on official military orders on U.S. military flights (including whole aircraft contract charter operators) and non-U.S. military flights (e.g., commercial flights).

In addition, U.S. military personnel are excepted from the requirements of Order if they are traveling under official U.S. government travel orders, i.e., issued by other government agencies.

CDC expects that U.S. military services will determine what is considered “official military or U.S. government travel orders” that meet the requirements of this exception.

CDC recommends that U.S. military personnel, civilian employees, dependents, contractors, and other U.S. government employees traveling under official military travel orders on non-military aircraft, such as commercial flights, carry their applicable travel orders with them to present to air carrier/operator personnel or public health authorities. Airlines only need to verify U.S. military personnel, civilian employees, dependents, contractors, and other U.S. government employees are traveling on official military travel orders.

U.S. military personnel, civilian employees, U.S. military personnel dependents, contractors, and other U.S. government employees not traveling on official military travel orders or U.S. government travel orders remain subject to CDC’s testing Order requirements.

No, diplomats and special visa holders are not excepted from the requirements of this Order.