HL7 FHIR® Implementation Guide: Coverage Requirements Discovery, Release 1.1

Product Family


Specification Type

This specification provides a mechanism for healthcare providers to discover guidelines, pre-authorization requirements and other expectations from payor organizations related to a proposed medication, procedure or other service associated with a patient's insurance coverage. It supports both patient-specific and patient-independent information retrieval.

This specification is listed by the U.S. Centers for Medicare and Medicaid Services as a “supported IG”.

HL7 Project Insight ID: 1428

Specification Status

Status Date: 04/25/2022
Target Publication Date: 06/11/2022

Project Contacts

Robert Dieterle

Lenel James

Project home page