Facebook

2 Step PPD Test

  • Self pay
    $100

    Price per person

  • Insurance

    $0

    Dependent upon the health insurance

    We accept most insurances

Book within 60:00 min to be seen today or tomorrow

  • Certified PPD testing provider
  • Quick lab results
  • In and out in 30 minutes
  • No referral required
  • +500,000 Satisfied patients
  • Open seven days a week, 365 days a year
  • Awarded Joint Commission Gold Seal of Approval

Service Details

What is a 2 Step test?

A 2-step PPD is when two PPD tests are done sequentially with a gap of 7-10 days between the first and second PPD. A PPD test is not a perfect screening test for TB and in about 20% of patients it can be falsely negative. This means there is a chance that the person has been exposed to TB but the PPD testing did not pick it up.
A 2-step PPD skin test improves the detection of exposure to tuberculosis with more accuracy. A 2-step PPD has a false negative rate of about 5%. Usually, all healthcare facilities and nursing homes require a 2-step PPD test. However, if your employer does not require a 2-step PPD, there is no reason to do a two-step PPD test.

About our urgent care service

With Nao Medical's urgent care, you can either walk in or make an appointment ahead of time. You can visit our urgent care or walk-in medical clinics near you during operating hours. We're open seven days a week and closed only if NYS declares an emergency.

Before booking your appointment please note:

If you are using insurance please ensure that your insurance benefits include urgent care or contact us to confirm if your individual/group insurance plan is eligible for use. Please dial 911 immediately if your medical problem appears to be life-threatening.
Nao Medical accepted insurances

FAQ

What are the risks of getting a TB skin test?

Some people may have significant redness and swelling where the tuberculin protein was injected. This is more common in persons who have previously had a positive PPD test and then get the test again by accident.

In persons who have never been exposed to PPD, this response to tuberculin protein is extremely uncommon.

How is a 2-step PPD read? Is a 2-step read differently that a regular PPD test?

A two-step PPD is read the same way as a 1-step PPD. The redness and the induration are measured and documented. There has to be a 7-10 day gap between the first and the second PPD of the 2 step PPD series.

My first PPD was negative. The second PPD in the 2-step PPD however was positive. Do I still need a chest X-ray?

Yes. You need a Chest X-Ray if any of the PPD turns positive. So, if your first PPD is read as a positive PPD, you don’t need to do the second PPD in the 2-step PPD series. Instead, you will need a Chest X-Ray for the positive PPD reading.

Also, for healthcare workers and other non-immunocompromised patients, a negative PPD reading is any induration 10 mm or less.

However, for Immigration Medical Exam purposes, any PPD more than 4 mm is considered to be a positive PPD reading. A lot of doctors fail to write the mm and the record just shows a positive PPD reading or a negative PPD reading – this is insufficient for Immigration Medical Exam paperwork.

Is there a blood test for TB called Quantiferon? Is it valid?

There is a relatively new and expensive blood test called IGRA, which has been available for testing for TB and screening for exposure to tuberculosis for a few years now. Nao Medical can draw your blood and send it for the IGRA test once you have pre-paid for the test. It is also called a Quantiferon Gold Test.

Tuberculosis screening may be done with any approved test to detect M. tuberculosis infection, such as the tuberculin skin test (TST), or one of the whole blood interferon-gamma release assays (IGRAs) approved by the Food and Drug Administration (FDA).

Interferon-Gamma Release Assays (IGRAs) or Quantiferon Gold Test for TB

As per the CDC “IGRAs are used to determine if a person is infected with M. tuberculosis by measuring the immune response to tuberculosis proteins in whole blood. Specimens are mixed with peptides that simulate antigens derived from M. tuberculosis and controls. In a person infected with M. tuberculosis, the white blood cells recognize the simulated antigens and release interferon-gamma (IFN- γ); results are based on the amount of IFN- γ released.”

The Food and Drug Administration (FDA) has approved the following IGRAs in the United States:

  • QuantiFERON®-TB Gold, 2005
  • QuantiFERON®-TB Gold In-Tube test (QFT-GIT), 2005;
  • T-SPOT® TB test, 2008

Some advantages of IGRAs include the following:

  • IGRA requires just one visit for TB testing. IGRAs are therefore the preferred method of testing for groups of people who have poor rates of return for TST reading and interpretation (e.g., homeless persons).
  • IGRAs do not cause booster phenomenon.
  • IGRA results can be available earlier than 48 hours.
  • IGRA is unaffected by environmental mycobacteria.

Some limitations of IGRAs include the following:

  • The blood sample must be processed within 8-30 hours after collection.
  • Data is limited when used in children younger than 5 years of age, persons recently exposed to TB, immuno-compromised persons, and those who will be tested repeatedly (serial testing).

IGRA Result Interpretation

The interpretation of IGRAs varies by type of IGRA test performed.

  • QFT testing is based on the amount of IFN-γ released.
  • T-SPOT TB testing depends on the number of cells that release IFN-γ.

Labs provide both the qualitative and quantitative IGRA results.

  • Qualitative IGRA results are reported as positive, negative, indeterminate, or borderline.
  • Quantitative IGRA results are reported as numerical values that include a response to the TB antigen and 2 controls, nil and mitogen.

What can I expect for a PPD test-related follow-up visit?

If you have no prior history of the test or have had a negative PPD reading previously, then Nao Medical’s healthcare professionals will inject the tuberculin protein into your forearm skin at the first visit. Once the PPD is administered you will need to return in 48-72 hours for a follow-up visit.

At the second PPD visit, the tuberculin test reaction will be read. When you come back to us, let the front desk staff know why you are here and you will be fast tracked into a room. Your PPD will be recorded right away, and you can get done in the shortest possible time.

If you have a PPD form or a physical exam form that needs to be filled out, please bring it with you. Nao Medical providers will fill out your forms once the PPD has been read (second PPD visit).

If you need a chest X-ray for a positive PPD reading, Nao Medical has X-ray on site at each location. End-to-end PPD testing convenience at one location!

How long will it take to fill my PPD form for school?

Nao Medical does PPD tests all 7 days a week. Nao Medical is open even on holidays. You can walk in and get the PPD test done and return in 2 days for a PPD check. When you return in 48 hours, your forearm will be examined and your form can be completed on the spot. At Nao Medical, you never have to wait!

In my country they gave me a BCG vaccine. Will it affect my PPD test results?

In countries where TB is common, BCG (Bacillus Calmette–Guérin) vaccine is used to protect infants and young children from serious, life-threatening disease, specifically miliary TB and TB meningitis.

BCG vaccination is not given in the United States. The effect of BCG vaccine on tuberculin skin testing (PPD) results may cause confusion. It is thought that the tuberculin skin test reactivity caused by BCG vaccine gets reduced with the passage of time. However, periodic and repeated skin testing may boost the reactivity to PPD.

The CDC recommends that all PPD positive results be interpreted based on risk stratification regardless of BCG vaccination history.

A person with a history of BCG vaccination therefore can be tested and treated for latent TB if they test positive for a PPD.

IGRAs use M. tuberculosis antigens that do not cross-react with BCG, and therefore, do not cause false positive reactions in people who got BCG in their countries. However, IGRA is an expensive blood test and the data in repeatedly tested individuals is lacking. IGRA is therefore not routinely recommended as a testing modality to screen for TB.

Does an abnormal PPD Test mean I have disease?

An abnormal or a positive PPD reading only means you have been exposed to the bacteria that cause TB. It does not mean you have disease. You may need further investigation with a chest X-ray to identify if there is any evidence of active disease in the lungs.

After that, treatment may be given to lower your risk of eventually getting TB (reactivation of the disease). A positive skin test for tuberculin does not mean that you have active tuberculosis disease. It only shows that you were exposed to the bacteria that cause TB. More tests need to be done to identify if there is active TB disease.

What if I have a positive PPD at the second visit? When is PPD test called a positive PPD test?

If you have a newly positive PPD, you will need a chest X-ray. Not to worry, we can do the chest X-ray right away and have it read by a radiologist as well.

Nao Medical does more PPD tests than most other medical offices and all our providers understand the various cutoffs for a positive PPD.

A 5-mm induration is considered to be positive PPD test result for:

  • Persons with HIV infection
  • Recent contacts of persons with active TB disease
  • Persons with evidence of old, healed TB lesions on chest X-rays
  • Persons with organ transplants and other immunosuppressed persons, including those receiving prolonged corticosteroid therapy (the equivalent of >15 mg/d of prednisone for one month or more) and TNF-a blockers

A 10-mm induration is considered to be positive PPD test result for:

  • Persons who have immigrated within the past 5 years from areas with high TB rates*
  • Injection drug users
  • Persons who live or work in institutional settings where exposure to TB may be likely, such as hospitals, prisons, homeless shelters, SROs, and nursing homes
  • Mycobacteriology laboratory personnel
  • Persons with clinical conditions associated with increased risk of progression to active TB, including: silicosis; chronic renal failure; diabetes; more than 10% below ideal weight or BMI < 18.5; gastrectomy/jejunoileal bypass; some hematologic disorders (such as leukemia and lymphomas); and certain cancers (such as carcinoma of the head, neck, or lung, leukemias, and lymphomas)
  • Children < 5 years, and children or adolescents exposed to adults in high-risk categories
  • Persons with prolonged stay in areas with high TB rates*

A 15-mm induration is considered to be positive PPD test result for:

  • Persons at low risk for active TB disease for whom testing is not generally indicated

* Countries with high rates of TB include China, Dominican Republic, Ecuador, Haiti, Honduras, India, Mexico, Pakistan, Peru, Philippines, South Korea, and all of Africa.

What if I have a history of a positive PPD previously?

You must alert your provider regarding a prior positive PPD result because you may not need any repeat PPD testing for TB and may qualify for a waiver. You will still need to be seen at Nao Medical, as we cannot determine this over the phone.

If you have ever had a positive PPD skin test and/or have a chest X-ray report, please bring it with you. Our front desk staff cannot answer your medical questions. Save them for the provider when you come for the visit.

My PPD reading was positive even though it was small. Can a small PPD reading also be considered to be a positive PPD test?

Yes. As discussed earlier, a PPD test can have different cutoffs based on size and be read as a positive PPD reading or a negative PPD reading. This is why going to the right place can make all the difference.

A positive PPD reading or a negative PPD reading depends on your medical condition, age, risk factors, and also the reason the PPD test was done. For example, USCIS has a different cutoff for immigration purposes. NYC Department of Health has its own guidelines for NYC as tuberculosis is more common in NYC.

You can review the CDC publishes for PPD reading based on the medical diagnosis, age, and other risk factors.

Will my PPD be covered under my health insurance plan?

PPD tests are usually for pre-employment purposes and are not covered by health insurance plans. Nao Medical charges $40 for performing the PPD skin test for TB as well as reading the TB test results ($40 covers the two visits). We accept cash and credit card payments.

Should I make an appointment for urgent care?

Not necessarily. Most urgent cares accept walk-in patients. But if you want shorter wait times, you can book an appointment through phone or online.

Can I go to urgent care for non-emergency?

Yes. You can go to urgent care for consultations, physicals, primary care, lab tests, and more.

Can I pay for urgent care appointment without insurance?

If you have no insurance, we provide our services without insurance for self-pay patients, giving you the care when you need it most.

Why people love

At Nao Medical, we go the extra mile for our patients. When you or your loved one is unwell, we are a provider that you can trust to take the time to treat you with the attention and care you deserve.

Committed to providing excellent service

  • customer support
    24/7 customer support
  • customer service
    Top tier customer service
  • medical concierge
    Dedicated medical concierge

Verified Customer Reviews

  • February 01, 2023 02:02 PM

I went there one day and they took real good care of me although I was sent to the er the care that I got before hand was quick and knowledgeable there was a nurse I forgot her name but she was the one who seen me walking past the clinic and had the right mind asking me if I was ok it end with me in hospital for a clot but I owe my life that loving lady because honestly I could have died I had a clot in my lung which I had to get treated for

- Jessica

  • February 01, 2023 02:02 PM

The wait wasn't too long, the staff were very friendly and i walked out feeling like i got the answers i was looking for. They could've uncharged me for the other reasons i went to get checked, but my doctor referred me to more affordable clinics. Overall a great experience.

- Primetime

  • February 01, 2023 02:02 PM

Nothing but good words for this place. The staff are very nice. The doctor is very professional and knowledgeable. Service is superb. I would recommend this place to all my family and friends.

- Marylou

  • February 01, 2023 02:02 PM

Polite and quick

- Annette

  • February 01, 2023 02:02 PM

I was treated very quickly and super friendly, the staff was informative, especially Masuda helped me and made my visit a nice experience.

- Erwin

  • February 01, 2023 02:02 PM

The doctor gave us a great …customized consultation on both occasions . The first time for my husband , this time for me . He took the time to explain everything and was extremely helpful.Answering all of our questions until we left feeling better ! Just what this community needed.

- Yvette

  • February 01, 2023 02:02 PM

They’re amazing!

- Alecia

  • February 01, 2023 02:02 PM

Beautiful office and friendly staff! A great option for local urgent care, but also offers much more: primary care, COVID tests, women's health, STD testing, and pediatric services to name a few.

- Kassia

  • February 01, 2023 02:02 PM

First there’s no real waiting, 2nd I was treated professionally and respectfully the entire visit. The medical team here was on point, attentive, and sympathetic towards what I was going through. All in all I love coming to this Urgent Care.

- Kyarna

  • February 01, 2023 02:02 PM

Very nice service, very kind and sweet staff

- Moises

  • February 01, 2023 02:02 PM

The nurse who attended me was very good and help.. all nurses should be like her her name is Cargent Diaz

- Doris

  • February 01, 2023 02:02 PM

The easiest and fastest experience

- Juan

  • February 01, 2023 02:02 PM

i didn't even go in this place yet and i was amazed at the telephone service i received i spoke with the sweetest nurse who went above and beyond to get me the information i needed she was so polite and had so much patience due the millions of crazy questions i asked , i believe her name was Stephanie she than transferred me to the doctor where i ask a few more crazy questions and guess what i got the help i needed over the phone so i decided to give the place a visit that same day and i will say i walked in and i was completely at ease the care i got was impeccable and so outstanding i called my wife to come and be seen the same day as well they ROCK !!!

- NIXON

  • February 01, 2023 02:02 PM

Location was easy to find. Facility very clean! The office staff were very nice, informative and accommodating. We saw the doctor right away, wait time was less than 15 minutes. Dr. Moise was very nice, knowledgeable and treated my daughters symptoms appropriately. I will definitely come back again.

- M3LOdicJaZZ

  • February 01, 2023 02:02 PM

Execelent service front desk and nurse very polite i recoment any one to visit thanks Nao medical

- Roopchan

  • February 01, 2023 02:02 PM

Excellent job.

- FAMILY

  • February 01, 2023 02:02 PM

I went to this urgent care at 3:40pm. When I entered the urgent care it was very spacious and clean. I checked in and gave all the necessary information, I was the only one in the office. Within minutes I was called to see the doctor. I was out of the office by 4:10pm. This will be my go to place when my doctors office is closed.

- Keniesha

  • February 01, 2023 02:02 PM

Just the best ever! I’m traveling from Brooklyn to queens! That’s how great this place from the nurse to doctors! Great customer service! You’ll be happy with this place! Don’t go anywhere else but here!

- Mr Midnight

  • February 01, 2023 02:02 PM

Clean, friendly facility and I was taken care of in a timely manner. Thank you Denise, Dr. Corey and Desiree.

- TaY

  • February 01, 2023 02:02 PM

PA Syed was very good. I appreciated his professionalism. i would recommend anyone here. thanks for evcerything. sincerely Denise Durant

- Denise

Top articles related to this service

Signing your child up to play sports is an incredible opportunity for them. No matter which sport they play, they learn the importance of teamwork, diligence and confidence. Physical activity is the perfect balance to a day spent learning in the classroom. However, there are some risks involved with organized...

Francesca Lim

Tuberculosis is a contagious infection that primarily affects the lungs but could potentially affect the brain, kidneys, and spine at its worst. When an infected person sneezes, coughs or speaks, the bacteria called Mycobacterium tuberculosis could infect nearby people who breathe it in. In the early 1900s, TB was the...

Gladys Anne Labsan

What is a TB test? Are PPD skin tests and TB test results important? What does a positive TB test look like? Get answers to questions about PPD tests here. First of all, what is tuberculosis? TB is a potentially infectious disease that usually occurs in the lungs. Mycobacterium Tuberculosis,...

Gladys Anne Labsan

The TB skin test (TST), which is performed using the Mantoux method, is the most commonly used test in the United States for diagnosing Tuberculosis. There are two types of TB disease: latent and active. Interferon-gamma release assays (IGRA) or TB blood tests specifically check if you have TB bacteria...

Gladys Anne Labsan