Version difference

hl7.fhir.us.core 3.1.1 → 6.1.0

Three major releases apart, and the profile set nearly doubles: 29 profiles exist in both versions, 30 only in 6.1.0, and 1 only in 3.1.1.

← All version differences · Download the evidence pack (markdown — this page as one citable file)

Version gap report — hl7.fhir.us.core 3.1.1 → 6.1.0

5 newly required78 potentially breaking20 new must-support96 strengthened38 binding changes

Informational only — readiness is judged against the target version and never changes with this report.

Read the element counts as a floor

30 profiles exist only in 6.1.0, and 1 only in 3.1.1. Those have no counterpart to compare against, so they contribute no element-level rows to the counts above — the element comparison covers the 29 profiles present in both versions. Both numbers are below; neither is a total on its own.

The 364 mandatory or must-support elements attributed to added profiles are counted from each profile’s effective element list. Where a profile ships no snapshot that list is reconstructed by merging its differential onto its base, so treat the figure as indicative rather than audited. Each row states its own basis.

The shape of the change

12 critical66 needs review0 indeterminate84 informational

162 element-level requirement changes, each graded to exactly one tier — so every view below sums to the same total.

Most breaking changes

where the migration work concentrates

us-core-smokingstatus3 of 13
us-core-pulse-oximetry2 of 11
us-core-medicationrequest1 of 17

Most sharply changed

share of a profile's changes that break · profiles with at least 5 changes

us-core-smokingstatus23% of 13
us-core-pulse-oximetry18% of 11
us-core-documentreference17% of 6

Slice the findings

filtershowing 162 of 162

Profile coverage

Profiles present in only one of the two versions. These carry no element-level rows in the catalog above, because there is nothing on the other side to compare them against.

Compared in both versions: 29
Added in target: 30
Removed from baseline: 1
Element obligations carried by added profiles: 364

PROFILE_ADDED · Coverage · OBSERVED_ONLY
us-core-coverage is new in the target version, carrying 23 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage
PROFILE_ADDED · Condition · OBSERVED_ONLY
us-core-condition-encounter-diagnosis is new in the target version, carrying 11 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-body-temperature is new in the target version, carrying 20 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-temperature
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-simple-observation is new in the target version, carrying 9 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-simple-observation
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-vital-signs is new in the target version, carrying 15 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-heart-rate is new in the target version, carrying 20 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-respiratory-rate is new in the target version, carrying 20 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-respiratory-rate
PROFILE_ADDED · RelatedPerson · OBSERVED_ONLY
us-core-relatedperson is new in the target version, carrying 7 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-observation-sexual-orientation is new in the target version, carrying 6 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sexual-orientation
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-bmi is new in the target version, carrying 20 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi
PROFILE_ADDED · Extension · OBSERVED_ONLY
uscdi-requirement is new in the target version, carrying 2 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-sex is new in the target version, carrying 2 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-jurisdiction is new in the target version, carrying 2 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-jurisdiction
PROFILE_ADDED · ServiceRequest · OBSERVED_ONLY
us-core-servicerequest is new in the target version, carrying 9 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-tribal-affiliation is new in the target version, carrying 7 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-observation-screening-assessment is new in the target version, carrying 13 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessment
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-genderIdentity is new in the target version, carrying 1 mandatory or must-support element. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity
PROFILE_ADDED · Condition · OBSERVED_ONLY
us-core-condition-problems-health-concerns is new in the target version, carrying 11 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-observation-occupation is new in the target version, carrying 13 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-occupation
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-extension-questionnaire-uri is new in the target version, carrying 1 mandatory or must-support element. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-extension-questionnaire-uri
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-body-height is new in the target version, carrying 20 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-height
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-blood-pressure is new in the target version, carrying 31 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-body-weight is new in the target version, carrying 20 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-observation-pregnancyintent is new in the target version, carrying 10 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancyintent
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-head-circumference is new in the target version, carrying 20 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-head-circumference
PROFILE_ADDED · MedicationDispense · OBSERVED_ONLY
us-core-medicationdispense is new in the target version, carrying 15 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationdispense
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-observation-pregnancystatus is new in the target version, carrying 10 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-observation-clinical-result is new in the target version, carrying 9 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result
PROFILE_ADDED · Specimen · OBSERVED_ONLY
us-core-specimen is new in the target version, carrying 2 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-specimen
PROFILE_ADDED · QuestionnaireResponse · OBSERVED_ONLY
us-core-questionnaireresponse is new in the target version, carrying 15 mandatory or must-support elements. None of them appear in the element-level change list, because there is no baseline profile to compare against.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse
PROFILE_REMOVED · Condition · OBSERVED_ONLY
us-core-condition exists in the baseline version and not in the target. Nothing in the target replaces it under a matching canonical URL.
http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition

What is shown, and what is left out

Every count in the explorer is complete — computed over all 162 element changes. The example rows a node expands to draw on a bounded, deterministic sample of 40, chosen so every kind of change and the most-affected profiles are each represented. The full set is reproducible from the two packages named below.

Provenance

Baseline	`hl7.fhir.us.core#3.1.1` sha256 `c96f3f8893277bb81791c067a8e87d5cfe8816dcc4c7938ec6a13be9585b37a0` 30 profiles · 32 value sets · 1 operations · CC0-1.0
Target	`hl7.fhir.us.core#6.1.0` sha256 `ec096f29bc4ce8f04117dfc4ef82e7289c67a7e2188892e86288c45389d158d9` 59 profiles · 36 value sets · 1 operations · CC0-1.0
Engines	comparison 1.0.0 · normalization 1.3.0

The digests identify the exact archives compared. There is no generation timestamp on purpose: the report is a pure function of those two archives, so regenerating it from the same inputs produces identical bytes.

Where rules we track mention this guide

Context only, quoted from our mandate register. None of it changes the comparison above, which depends on the two packages and nothing else.

CMS-0057-F (by 2027-01-01)Underlying US content profilescompliance 2027-01-01CMS Interoperability & Prior Authorization Final Rule (CMS-0057-F) · in our library
CMS-0062-P (proposed — no adopted date)Underlying US content profiles; not itself the subject of the proposal.PROPOSED 2026-04-14, comments closed 2026-06-15 — not final as of 2026-07-26, no adopted compliance dateFederal Register: Interoperability Standards and Prior Authorization for Drugs (proposed rule) · CMS: 2026 Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS-0062-P)

Who maintains this guide, per our register

Where standards work on this guide actually happens — the room a ballot comment or a question should go to. Quoted from our workgroup register; each claim carries the source it was read from.

Cross-Group Projects WG (owner)Owns US Core, the base profile set nearly every US guide builds on; the published footer attributes this committee.HL7 committee page · US Core footer attributionreviewed 2026-07-26 · next expected: US Core's next published release attributing a different committee in its footer.