Referrals and SDOH Interventions

Datasets

US Core 6.1.0 maps each USCDI element to FHIR.

Dataset	US Core 6.1.0 target profile(s)
`service_requests`	US Core ServiceRequest

service_requests

One row per requested service: a referral, an order, or an SDOH intervention. This dataset carries the Reason for Referral and SDOH Interventions elements of the Procedures data class; the services actually performed go in procedures.

Column	Required	Format / values	Example
`patient_identifier`	Yes	patient key	`MRN-4471903`
`status`	Yes	`draft`, `active`, `on-hold`, `completed`, `revoked`, `entered-in-error`, `unknown` request-status	`active`
`intent`	Yes	`proposal`, `plan`, `directive`, `order`, `original-order`, `reflex-order`, `filler-order`, `instance-order`, `option` request-intent	`order`
`code`	Yes	CPT, HCPCS, or SNOMED CT code, with `code_system`; CPT if omitted US Core Procedure Codes	`103696004` patient referral to specialist
`category`	Recommended	one of the categories below, with `category_system`; SNOMED CT if omitted	`sdoh`
`reason_code`	If available	SNOMED CT or ICD-10-CM code(s), `;`-separated, with `reason_system`; SNOMED CT if omitted US Core Condition Codes	`733423003` food insecurity
`authored_on`	If available	datetime	`2026-05-10`
`occurrence_date`	If available	datetime	`2026-05-24`
`requester_npi`	If available	10 digits	`1407006835`

status and intent are both required bindings, so a value outside these lists is rejected. A referral a payer holds is normally active with intent order.
code says what was requested. It is the one coded field with no fallback: a row without it cannot become a ServiceRequest.
reason_code is why it was requested — the Reason for Referral element. For an SDOH intervention this is the need being addressed, such as food insecurity or lack of transport.
authored_on is when the request was written; occurrence_date is when the service should happen.
requester_npi must match a row in practitioners.

Categories

category is a required binding, so it takes one of these eleven values. Send category_system to say which system a code came from.

Code	Meaning	`category_system`
`sdoh`	SDOH	`http://hl7.org/fhir/us/core/CodeSystem/us-core-category`
`functional-status`	Functional Status	`http://hl7.org/fhir/us/core/CodeSystem/us-core-category`
`cognitive-status`	Cognitive Status	`http://hl7.org/fhir/us/core/CodeSystem/us-core-category`
`disability-status`	Disability Status	`http://hl7.org/fhir/us/core/CodeSystem/us-core-category`
`386053000`	Evaluation procedure	`http://snomed.info/sct`
`410606002`	Social service procedure	`http://snomed.info/sct`
`409063005`	Counselling	`http://snomed.info/sct`
`409073007`	Education	`http://snomed.info/sct`
`363679005`	Imaging	`http://snomed.info/sct`
`108252007`	Laboratory procedure	`http://snomed.info/sct`
`387713003`	Surgical procedure	`http://snomed.info/sct`

Send sdoh on interventions that address a social need, whatever the service is. It is what marks the row as an SDOH intervention for the APIs that report on them.

These resources are served by Patient Access, Provider Access, Payer-to-Payer, and Prior Auth.