Da Vinci publishes a portfolio of FHIR Implementation Guides covering provider-payer interactions. CMS-0057-F anchors on a few of them (CRD, DTR, PAS) but several others matter for the broader provider-side workflow. EHR integration teams need to understand which IGs are required for compliance, which are emerging standards, and which are experimental but worth watching. For payer-provider FHIR integration reading on this site, here are six worth knowing in 2026.
1. Da Vinci CRD IG STU 2.0.1
Coverage Requirements Discovery (CRD) is the order-time decision support IG. The CRD service responds to CDS Hooks calls from the EHR with information about whether PA is required, what documentation is needed, and what comes next. CMS-0057-F requires CRD as part of the Prior Authorization API.
For EHR integration teams, CRD is the entry point. A clinician's order triggers the CRD call; everything downstream depends on whether CRD fires reliably and returns useful information.
2. Da Vinci DTR IG STU 2.0.1
Documentation Templates and Rules (DTR) is the questionnaire-rendering IG. The DTR SMART app launches inside the EHR (typically from a CRD card), renders the payer-specific Questionnaire, runs CQL rules to drive conditional logic, and collects the supporting documentation needed for the PA decision.
DTR is where the provider workflow lives. If DTR is awkward to use, providers abandon the workflow and submit PAs through legacy channels regardless of what the rest of the stack does.
3. Da Vinci PAS IG STU 2.0.1
Prior Authorization Support (PAS) is the submission and response IG. The completed Bundle from DTR is sent to PAS, the payer renders a decision, and the response flows back. PAS often round-trips through X12 278 / 275 inside the payer back office.
PAS is the layer most often confused with the entire ePA workflow. In practice, PAS is the submission endpoint that closes the loop the CRD-DTR sequence opened. All three IGs operate together; isolating any one of them produces an incomplete picture.
4. Da Vinci PDex IG STU 2.1.0
Payer Data Exchange (PDex) is the IG that governs clinical data exchange between payers and providers, including the broader Patient Access API scope. PDex is referenced by CMS-0057-F for Provider Access and Payer-to-Payer flows, and it carries the clinical resource profiles (Condition, Procedure, Observation) that PDex Plan Net and CARIN BB do not cover.
For EHR integration teams, PDex Patient Access is the IG that defines what clinical data the EHR can expect when consuming the Patient Access API.
5. Da Vinci HRex IG
Health Record Exchange (HRex) is a foundation IG that PDex and the other Da Vinci IGs reference for shared profiles and patterns. Most implementations do not directly target HRex but pull profiles from it through the IGs that use it.
For deep implementation work, HRex is worth understanding because changes there ripple through PDex, PAS, and others.
6. Da Vinci Risk-Based Contract IG (Emerging)
The Risk-Based Contract IG is newer Da Vinci work that addresses value-based care contract data exchange between payers and providers. It is not part of CMS-0057-F but signals where the Da Vinci portfolio is heading.
For payers and EHRs that participate in risk-based contracts (which is most large US payers and many health systems), the Risk-Based Contract IG is worth tracking. Production deployments are limited in 2026 but expected to grow.
How to Read Da Vinci IG Maturity
Da Vinci IGs use the standard HL7 maturity ladder: Draft, Trial Use (STU), and Normative. STU 2.0.1 or later for CRD, DTR, and PAS represents maturity adequate for CMS-0057-F production work. Earlier versions exist but should not be the integration target for new work in 2026.
A useful pattern during integration planning is to verify which IG versions the target EHR and the payer's platform actually support, because mismatches surface as conformance failures during testing.
For the CDS Hooks layer that powers CRD specifically, the Top 5 EHRs with strong CDS Hooks support for Da Vinci CRD covers the EHR-side picture. For the SMART App patterns that power DTR, the Best DTR SMART app patterns for provider workflows covers the implementation side.