Version difference

hl7.fhir.us.core 6.1.0 → 9.0.0

The second leg of the US Core walk: 924 requirement changes across the 58 profiles present in both versions, with only 12 profiles added and 1 removed.

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

Version gap report — hl7.fhir.us.core 6.1.0 → 9.0.0

0 newly required441 potentially breaking45 new must-support555 strengthened447 binding changes

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

Read the element counts as a floor

12 profiles exist only in 9.0.0, and 1 only in 6.1.0. Those have no counterpart to compare against, so they contribute no element-level rows to the counts above — the element comparison covers the 58 profiles present in both versions. Both numbers are below; neither is a total on its own.

The 107 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

46 critical395 needs review0 indeterminate483 informational

924 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-immunization3 of 23
us-core-careplan2 of 28
us-core-observation-lab2 of 28

Most sharply changed

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

us-core-provenance17% of 12
us-core-diagnosticreport-lab14% of 14
us-core-allergyintolerance14% of 7

Slice the findings

filtershowing 924 of 924

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: 58
Added in target: 12
Removed from baseline: 1
Element obligations carried by added profiles: 107

PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-authentication-time 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-authentication-time
PROFILE_ADDED · DocumentReference · OBSERVED_ONLY
us-core-adi-documentreference is new in the target version, carrying 16 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-adi-documentreference
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-average-blood-pressure is new in the target version, carrying 30 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-average-blood-pressure
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-treatment-intervention-preference is new in the target version, carrying 8 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-treatment-intervention-preference
PROFILE_ADDED · FamilyMemberHistory · OBSERVED_ONLY
us-core-familymemberhistory is new in the target version, carrying 5 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-familymemberhistory
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-interpreter-needed 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-interpreter-needed
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-familymemberhistory-recorder 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-familymemberhistory-recorder
PROFILE_ADDED · Device · OBSERVED_ONLY
us-core-device 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-device
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-observation-adi-documentation is new in the target version, carrying 12 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-adi-documentation
PROFILE_ADDED · Observation · OBSERVED_ONLY
us-core-care-experience-preference is new in the target version, carrying 8 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-care-experience-preference
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-individual-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-individual-sex
PROFILE_ADDED · Extension · OBSERVED_ONLY
us-core-medication-adherence 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-medication-adherence
PROFILE_REMOVED · Device · OBSERVED_ONLY
us-core-implantable-device 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-implantable-device

What is shown, and what is left out

Every count in the explorer is complete — computed over all 924 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#6.1.0` sha256 `ec096f29bc4ce8f04117dfc4ef82e7289c67a7e2188892e86288c45389d158d9` 59 profiles · 36 value sets · 1 operations · CC0-1.0
Target	`hl7.fhir.us.core#9.0.0` sha256 `d7b54d2ec2a48cea94ffea5d939ad67a681f80b94d69594a08cebac36da9e059` 70 profiles · 21 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.