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HL7 FHIR® Implementation Guide: Coverage Requirements Discovery, Release 2.0.1

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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.

CMS Interoperability and Prior Authorization Final Rule

  • Recommended Implementation Guides

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: 01/08/2024
Target Publication Date: 06/11/2022


This is a prior edition.

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