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 2.0.0 | hl7.org/fhir/us/carin-bb/STU2 | 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 2.0.1 | hl7.org/fhir/us/Davinci-drug-formulary/STU2 | Patient Access — formulary (MA-PD) |
Provider Directory
| IG | Version | Spec | Used by |
|---|---|---|---|
| Da Vinci PDex Plan Net | STU 1.1.0 | hl7.org/fhir/us/davinci-pdex-plan-net/STU1.1 | 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/$export) |
Prior Authorization (ePA)
CMS recommends these IGs but does not mandate them. The regulation requires functional behavior; the IGs are the industry path of least resistance.
| IG | Version | Spec | Used by |
|---|---|---|---|
| Da Vinci Coverage Requirements Discovery (CRD) | STU 2.0.1 | hl7.org/fhir/us/davinci-crd/STU2.0.1 | CRD |
| Da Vinci Documentation Templates and Rules (DTR) | STU 2.0.1 | hl7.org/fhir/us/davinci-dtr/STU2 | DTR |
| Da Vinci Prior Authorization Support (PAS) | STU 2.1.0 | hl7.org/fhir/us/davinci-pas/STU2.1 | PAS |
| Da Vinci Clinical Data Exchange (CDex) | STU 2.1.0 | hl7.org/fhir/us/davinci-cdex/STU2 | PAS attachments ($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 bundled IG packages are loaded via Aidbox's BOX_BOOTSTRAP_FHIR_PACKAGES; customers who need to support an alternate IG version for a specific use case can change that list at deploy time.