Standards Version Advancement Process (SVAP)
The Standards Version Advancement Process (SVAP) permits health IT developers to voluntarily update health IT products certified under the ONC Health IT Certification Program (Certification Program) to newer versions of adopted standards as part of the Real World Testing Condition and Maintenance of Certification requirement (§ 170.405) of the 21st Century Cures Act.
Using SVAP, Certified Health IT developers are permitted to voluntarily use a newer approved version of a standard than is adopted in regulation. Currently, this flexibility is limited to standards that are adopted in the certification criteria required to meet the “Real World Testing” Condition of Certification, which include § 170.315(b), (c)(1) through (c)(3), (e)(1), (f), (g)(7) through (g)(10), (g)(31) through (g)(33), (h), (j)(20), and (j)(21).
Certified Health IT developers taking advantage of the SVAP flexibility must ensure that their Real World Testing plans and results of the Certified Health IT Modules address these updated standards. Additionally, developers updating their already Certified Health IT Modules are required to provide advance notice to their clients and ONC-Authorized Certification Body (ONC-ACB) before adopting a newer approved version of a standard.
Working with industry stakeholders, ONC has developed a collaborative public comment process to identify newer versions of standards that are ready for use in the Certification Program. For additional information on the annual process, including the list of standards and versions eligible for consideration, please visit the SVAP process page.
Note: The Real World Testing enforcement discretion issued on June 30, 2025 does not impact the Standards Version Advancement Process (SVAP) and associated developer requirements beyond not requiring developers to report Real World Testing results for certification criteria outlined in 170.405(a) except for 170.315(g)(7-10); nor does this enforcement discretion result in added SVAP requirements. For more information, please see the SVAP section in the Real World Testing resource guide.
Note: Consistent with EO 14168 and OPM guidance, ONC is exercising enforcement discretion and issuing certification guidance for conformance to the USCDI v3 standard.
2026 SVAP Versions
The 2026 approved SVAP versions were announced June 30, 2026, and will be available for voluntary certification under the Certification Program beginning August 29, 2026, alongside previously SVAP approved standards. Updated test tools and test procedures for the criteria that leverage these standards will be made available by December 2026.
| Certification Criteria | Regulatory Standard Version(s) | SVAP Version(s) Approved |
|---|---|---|
| § 170.315(b)(1) Transitions of care | United States Core Data for Interoperability (USCDI) Version 3, (October 2022 Errata) | United States Core Data for Interoperability (USCDI), Version 6 |
| HL7® Implementation Guide for CDA® Release 2: Consolidated CDA Templates (C-CDA) for Clinical Notes (US Realm), Draft Standard for Trial Use, August 2015, June 2019 (with Errata) HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 | HL7® Consolidated CDA® (C-CDA), Release 5.0.0 – US Realm (June 2026) | |
| § 170.315(b)(2) Clinical information reconciliation and incorporation | United States Core Data for Interoperability (USCDI) Version 3, (October 2022 Errata) | United States Core Data for Interoperability (USCDI), Version 6 |
| HL7® Implementation Guide for CDA® Release 2: Consolidated CDA Templates (C-CDA) for Clinical Notes (US Realm), Draft Standard for Trial Use, August 2015, June 2019 (with Errata) HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 | HL7® Consolidated CDA® (C-CDA), Release 5.0.0 – US Realm (June 2026) | |
| § 170.315(b)(9) – Care plan | HL7® Implementation Guide for CDA® Release 2: Consolidated CDA Templates (C-CDA) for Clinical Notes (US Realm), Draft Standard for Trial Use, August 2015, June 2019 (with Errata) HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 | HL7® Consolidated CDA® (C-CDA), Release 5.0.0 – US Realm (June 2026) |
| §170.315(b)(11) Decision support interventions | United States Core Data for Interoperability (USCDI) Version 3, (October 2022 Errata) | United States Core Data for Interoperability (USCDI), Version 6 |
| § 170.315(c)(3) Clinical quality measures (CQMs) — report | CMS Implementation Guide for Quality Reporting Document Architecture: Category I; Hospital Quality Reporting; Implementation Guide for 2020 | 2026 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated May 2025) |
| CMS Implementation Guide for Quality Reporting Document Architecture: Category III; Eligible Clinicians and Eligible Professionals Programs; Implementation Guide for 2020 | 2026 CMS QRDA III Implementation Guide for Eligible Clinicians (Updated December 2025) | |
| § 170.315(e)(1) View, download, and transmit to 3rd party | United States Core Data for Interoperability (USCDI) Version 3, (October 2022 Errata) | United States Core Data for Interoperability (USCDI), Version 6 |
| HL7® Implementation Guide for CDA® Release 2: Consolidated CDA Templates (C-CDA) for Clinical Notes (US Realm), Draft Standard for Trial Use, August 2015, June 2019 (with Errata) HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 | HL7® Consolidated CDA® (C-CDA), Release 5.0.0 – US Realm (June 2026) | |
| § 170.315(f)(5) Transmission to public health agencies – electronic case reporting | United States Core Data for Interoperability (USCDI) Version 3, (October 2022 Errata) | United States Core Data for Interoperability (USCDI), Version 6 |
| § 170.315(g)(9) Application access – all data request | United States Core Data for Interoperability (USCDI) Version 3, (October 2022 Errata) | United States Core Data for Interoperability (USCDI), Version 6 |
| HL7® Implementation Guide for CDA® Release 2: Consolidated CDA Templates (C-CDA) for Clinical Notes (US Realm), Draft Standard for Trial Use, August 2015, June 2019 (with Errata) HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 | HL7® Consolidated CDA® (C-CDA), Release 5.0.0 – US Realm (June 2026) | |
| § 170.315(g)(10) – Standardized API for patient and population services | HL7 FHIR® US Core Implementation Guide v6.1.0 –STU 6 | United States Core Data for Interoperability (USCDI), Version 6 |
| United States Core Data for Interoperability (USCDI) Version 3, (October 2022 Errata) | HL7® FHIR® US Core Implementation Guide STU 9.0.0, (June 2026) | |
| § 170.315(g)(31) – Provider prior authorization API – coverage requirements discovery | HL7® FHIR® Da Vinci – Coverage Requirements Discovery (CRD) Implementation Guide, Version 2.0.1—STU 2, January 8, 2024 | HL7® FHIR® Da Vinci – Coverage Requirements Discovery (CRD) Implementation Guide, Version 2.2.1—STU 2.2 |
| § 170.315(g)(32) – Provider prior authorization API -documentation templates and rules | HL7® FHIR® Da Vinci – Documentation Templates and Rules (DTR) Implementation Guide, Version 2.0.1—STU 2, January 11, 2024 | HL7® FHIR® Da Vinci – Documentation Templates and Rules (DTR) Implementation Guide, Version 2.2.0—STU 2.2 |
| §170.315(g)(33) – Provider prior authorization API – prior authorization support | HL7® FHIR® Da Vinci – Prior Authorization Support (PAS) FHIR Implementation Guide, Version 2.0.1—STU 2, December 1, 2023 | HL7® FHIR® Da Vinci – Prior Authorization Support (PAS) FHIR Implementation Guide, Version 2.2.1—STU 2 |
Approved SVAP Versions
The Certification Program will recognize and permit the use of multiple versions of SVAP approved standards across SVAP cycles. Any standards version previously approved by the National Coordinator will remain available for SVAP unless it is superseded by regulatory action or policy update.
This approach gives Certified Health IT developers greater flexibility when planning, developing, and maintaining Certified Health IT Modules. It also supports smoother transitions between standards versions by allowing developers to adopt newer SVAP-approved versions without immediately losing access to versions approved in prior cycles. For a complete list of standards approved through historic SVAP cycles see the SVAP Resources section of the webpage.
| Certification Criteria | Regulatory Standard Version(s) | SVAP Version(s) Approved |
|---|---|---|
| § 170.315(b)(1) Transitions of care | ONC Applicability Statement for Secure Health Transport, Version 1.2 | Applicability Statement for Secure Health Transport Version 1.3, May 2021 (Direct) (2022 SVAP Approved) |
| United States Core Data for Interoperability, Version 3 (USCDI v3) | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 (2025 SVAP Approved) United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata (2025 SVAP Approved) | |
| HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 1—Introductory Material, Release 2.1 and HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 2—Templates and Supporting Material, Release 2.1 HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes STU Companion Guide, Release 4.1—US Realm | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm (2025 SVAP Approved) | |
| § 170.315(b)(2) Clinical information reconciliation and incorporation | United States Core Data for Interoperability, Version 3 (USCDI v3) | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 (2025 SVAP Approved) United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata (2025 SVAP Approved) |
| HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 1—Introductory Material, Release 2.1 and HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 2—Templates and Supporting Material, Release 2.1 HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes STU Companion Guide, Release 4.1—US Realm | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm (2025 SVAP Approved) | |
| § 170.315(b)(7)- Security tags- summary of care- send | HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 1—Introductory Material, Release 2.1 and HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 2—Templates and Supporting Material, Release 2.1 | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm (2025 SVAP Approved) |
| § 170.315(b)(8)- Security tags- summary of care- receive | HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 1—Introductory Material, Release 2.1 and HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 2—Templates and Supporting Material, Release 2.1 | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm (2025 SVAP Approved) |
| § 170.315(b)(9) – Care plan | HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 1—Introductory Material, Release 2.1 and HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 2—Templates and Supporting Material, Release 2.1 HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes STU Companion Guide, Release 4.1—US Realm | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm (2025 SVAP Approved) |
| § 170.315(b)(11) – Decision support interventions | United States Core Data for Interoperability, Version 3 (USCDI v3) | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 (2025 SVAP Approved) United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata (2025 SVAP Approved) |
| § 170.315(c)(1) – Clinical quality measures (CQMs) — record and export | HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture—Category I (QRDA I); Release 1, DSTU Release 3 (US Realm), Volume 1—Introductory Material and HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture—Category I (QRDA I); Release 1, DSTU Release 3 (US Realm), Volume 2—Templates and Supporting Material | HL7® CDA® R2 Implementation Guide: Quality Reporting Document Architecture – Category I (QRDA I); Release 1, STU Release 5.3 with errata – US Realm, December 2022 (2023 SVAP Approved) |
| § 170.315(c)(2) – Clinical quality measures (CQMs) — import and calculate | HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture—Category I (QRDA I); Release 1, DSTU Release 3 (US Realm), Volume 1—Introductory Material and HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture—Category I (QRDA I); Release 1, DSTU Release 3 (US Realm), Volume 2—Templates and Supporting Material | HL7® CDA® R2 Implementation Guide: Quality Reporting Document Architecture – Category I (QRDA I); Release 1, STU Release 5.3 with errata – US Realm, December 2022 (2023 SVAP Approved) |
| § 170.315(c)(3) Clinical quality measures (CQMs) — report | CMS Implementation Guide for Quality Reporting Document Architecture: Category I; Hospital Quality Reporting; Implementation Guide for 2020 | CMS Implementation Guide for Quality Reporting Document Architecture Category I Hospital Quality Reporting; Implementation Guide for 2024 (Updated August 2023) (2024 SVAP Approved) |
| CMS Implementation Guide for Quality Reporting Document Architecture: Category III; Eligible Clinicians and Eligible Professionals Programs; Implementation Guide for 2020 | CMS Implementation Guide for Quality Reporting Document Architecture Category III Eligible Clinicians Programs; Implementation Guide for 2024 (Updated November 2023) (2024 SVAP Approved) | |
| § 170.315(e)(1) View, download, and transmit to 3rd party | Web Content Accessibility Guidelines (WCAG) 2.0, Level A Conformance | Web Content Accessibility Guidelines (WCAG) 2.2, October 5, 2023 (2024 SVAP Approved) |
| United States Core Data for Interoperability, Version 3 (USCDI v3) | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 (2025 SVAP Approved) United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata (2025 SVAP Approved) | |
| HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 1—Introductory Material, Release 2.1 and HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 2—Templates and Supporting Material, Release 2.1 HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes STU Companion Guide, Release 4.1—US Realm | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm (2025 SVAP Approved) | |
| § 170.315(f)(1) Transmission to immunization registries | HL7 2.5.1 (incorporated by reference in § 170.299). Implementation specifications. HL7 2.5.1 Implementation Guide for Immunization Messaging, Release 1.5 (incorporated by reference in § 170.299) and HL7 Version 2.5.1 Implementation Guide for Immunization Messaging (Release 1.5)—Addendum, July 2015 | HL7® Version 2.5.1 Implementation Guide for Immunization Messaging, Release 1.5 2018 Update (2024 SVAP Approved) |
| § 170.315(f)(2) Transmission to public health agencies – syndromic surveillance | HL7 2.5.1. Implementation specifications. PHIN Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent Care, Inpatient and Ambulatory Care Settings, Release 2.0, April 21, 2015 and Erratum to the CDC PHIN 2.0 Implementation Guide, August 2015; Erratum to the CDC PHIN 2.0 Messaging Guide, April 2015 Release for Syndromic Surveillance: Emergency Department, Urgent Care, Inpatient and Ambulatory Care Settings. | HL7® Version 2.5.1 Implementation Guide: Syndromic Surveillance, Release 1 – US Realm Standard for Trial Use, July 2019 (2024 SVAP Approved) |
| § 170.315(f)(5) Transmission to public health agencies – electronic case reporting | United States Core Data for Interoperability, Version 3 (USCDI v3) | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 (2025 SVAP Approved) United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata (2025 SVAP Approved) |
| § 170.315(f)(6) Transmission to public health agencies – antimicrobial use and resistance reporting | HL7 Implementation Guide for CDA® Release 2—Level 3: Healthcare Associated Infection Reports, Release 1, U.S. Realm | HL7® CDA® R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3 – US Realm, December 2020 (2022 SVAP Approved) |
| § 170.315(f)(7) – Transmission to public health agencies — health care surveys | HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys (NHCS), Release 1—US Realm, HL7 Draft Standard for Trial Use, Volume 1—Introductory Material and HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys (NHCS), Release 1—US Realm, HL7 Draft Standard for Trial Use, Volume 2—Templates and Supporting Material | HL7® CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 STU Release 3.1 – US Realm (2024 SVAP Approved) |
| § 170.315(g)(9) Application access – all data request | United States Core Data for Interoperability, Version 3 (USCDI v3) | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 (2025 SVAP Approved) United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata (2025 SVAP Approved) |
| HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 1—Introductory Material, Release 2.1 and HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Volume 2—Templates and Supporting Material, Release 2.1 HL7® CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes STU Companion Guide, Release 4.1—US Realm | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm (2025 SVAP Approved) | |
| § 170.315(g)(10) – Standardized API for patient and population services | HL7® FHIR® US Core Implementation Guide STU 6.1.0 | HL7® FHIR® US Core Implementation Guide STU 4.0.0, June 2021 (2022 SVAP Approved) HL7® FHIR® US Core Implementation Guide STU 7.0.0, May 2024 (2024 SVAP Approved) |
| HL7® FHIR® Bulk Data Access (Flat FHIR®) (v1.0.0: STU 1), including mandatory support for the “group-export” “OperationDefinition” | HL7® FHIR® Bulk Data Access (Flat FHIR®) (v2.0.0: STU 2), November 26, 2021 (2022 SVAP Approved) | |
| HL7® SMART App Launch Implementation Guide Release 2.0.0, including mandatory support for the “Capability Sets” of “Patient Access for Standalone Apps” and “Clinician Access for EHR Launch”; all “Capabilities” as defined in “8.1.2 Capabilities,” excepting the “permission-online” capability; “Token Introspection” as defined in “7 Token Introspection” | HL7® FHIR® SMART Application Launch Framework Implementation Guide Release 2.2.0, April 30, 2024 (2024 SVAP Approved) | |
| United States Core Data for Interoperability, Version 3 (USCDI v3) | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 (2025 SVAP Approved) United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata (2025 SVAP Approved) | |
| § 170.315(h)(1) Direct Project | ONC Applicability Statement for Secure Health Transport, Version 1.2 | Applicability Statement for Secure Health Transport Version 1.3, May 2021 (Direct) (2022 SVAP Approved) |
| § 170.315(h)(2) Direct Project, Edge Protocol, and XDR/XDM | ONC Applicability Statement for Secure Health Transport, Version 1.2 | Applicability Statement for Secure Health Transport Version 1.3, May 2021 (Direct) (2022 SVAP Approved) |
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