Implementation Guides
Payerbox implements the HL7 FHIR R4 base specification and a set of Implementation Guides recommended by CMS for CMS-0057-F and CMS-9115-F compliance.
CMS does not lock IG versions in regulation. The versions below match the CMS APIs and Implementation Guides page as of this release.
Base
| Standard | Version | Spec |
|---|---|---|
| HL7 FHIR | R4 (4.0.1) | hl7.org/fhir/R4 |
Authorization
| IG | Version | Spec | Used by |
|---|---|---|---|
| SMART App Launch | 2.2.0 | hl7.org/fhir/smart-app-launch/STU2.2 | Patient Access (member-authorized apps) |
| SMART Backend Services Authorization | 2.2.0 | hl7.org/fhir/smart-app-launch/STU2.2/backend-services.html | Provider Access, Payer-to-Payer, PAS |
Clinical data
| IG | Version | Spec | Used by |
|---|---|---|---|
| US Core | 6.1.0 | hl7.org/fhir/us/core/STU6.1 | USCDI v3 alignment, all clinical APIs |
Patient Access and Payer-to-Payer
| IG | Version | Spec | Used by |
|---|---|---|---|
| CARIN Consumer-Directed Payer Data Exchange (Blue Button) | STU 2.1.0 | hl7.org/fhir/us/carin-bb/STU2.1 | Patient Access — claims and encounters |
| Da Vinci PDex | STU 2.1.0 | hl7.org/fhir/us/davinci-pdex/STU2.1 | Patient Access — clinical, prior-auth data; Provider Access; Payer-to-Payer |
| Da Vinci PDex US Drug Formulary | STU 2.1.0 | hl7.org/fhir/us/davinci-drug-formulary/STU2.1 | Patient Access — formulary (MA-PD) |
Provider Directory
| IG | Version | Spec | Used by |
|---|---|---|---|
| Da Vinci PDex Plan Net | STU 1.2.0 | hl7.org/fhir/us/davinci-pdex-plan-net/STU1.2 | Provider Directory |
Bulk export
| IG | Version | Spec | Used by |
|---|---|---|---|
| HL7 FHIR Bulk Data Access | 2.0.0 | hl7.org/fhir/uv/bulkdata/STU2 | Provider Access, Payer-to-Payer (Group/$export) |
Prior Authorization (ePA)
CMS recommends these IGs but does not mandate them. The regulation requires functional behavior; the IGs are the industry path of least resistance.
| IG | Version | Spec | Used by |
|---|---|---|---|
| Da Vinci Coverage Requirements Discovery (CRD) | STU 2.1.0 | hl7.org/fhir/us/davinci-crd/STU2.1 | CRD |
| Da Vinci Documentation Templates and Rules (DTR) | STU 2.1.0 | hl7.org/fhir/us/davinci-dtr/STU2.1 | DTR |
| Da Vinci Prior Authorization Support (PAS) | STU 2.1.0 | hl7.org/fhir/us/davinci-pas/STU2.1 | PAS |
| Da Vinci Clinical Data Exchange (CDex) | STU 2.1.0 | hl7.org/fhir/us/davinci-cdex/STU2 | PAS attachments ($submit-attachment) |
| CDS Hooks | 2.0 | cds-hooks.hl7.org/2.0 | CRD (transport) |
Version pinning policy
Payerbox aligns by default with the versions CMS lists as recommended. The admin Aidbox loads the bundled IG packages through BOX_BOOTSTRAP_FHIR_PACKAGES:
BOX_BOOTSTRAP_FHIR_PACKAGES: "hl7.fhir.r4.core#4.0.1:hl7.fhir.us.core#6.1.0:hl7.fhir.us.carin-bb#2.1.0:hl7.fhir.us.davinci-pdex#2.1.0:hl7.fhir.us.davinci-drug-formulary#2.1.0:hl7.fhir.us.davinci-pdex-plan-net#1.2.0:hl7.fhir.us.davinci-hrex#1.2.0:hl7.fhir.us.davinci-crd#2.1.0:hl7.fhir.us.davinci-dtr#2.1.0:hl7.fhir.us.davinci-pas#2.1.0:hl7.fhir.us.davinci-cdex#2.1.0"
Besides the IGs in the tables above, the list loads Da Vinci Health Record Exchange (HRex) 1.2.0, which PDex and the prior authorization IGs build on. Each package also brings the packages it depends on. Aidbox reads the list only on its first start against an empty database.
Customers who need to support an alternate IG version for a specific use case can change the list at deploy time.