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), and (h).
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.
Approved SVAP Versions
All the standards in the table below are currently available for voluntary certification under the Certification Program. Once effective, any newer versions of approved standards replace existing approved standards from previous years.
The SVAP approved standard of HL7® FHIR® US Core Implementation Guide STU 4.0.0, June 2021, will continue to remain available for certification via SVAP while the United States Core Data for Interoperability (USCDI), Version 1, July 2020 Errata remains available for use in the Certification Program as a standard adopted in regulation until it expires on January 1, 2026, as outlined in the HTI-1 Final Rule.
| Certification Criteria | Regulatory Standard Version(s) | SVAP Version(s) Approved |
|---|---|---|
| § 170.315(b)(1) Transitions of care | Applicability Statement for Secure Health Transport, Version 1.2 | Applicability Statement for Secure Health Transport Version 1.3 (2022 SVAP Approved) |
| United States Core Data for Interoperability (USCDI), Version 1 (July 2020 Errata) [Adoption of this standard expires on January 1, 2026] United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025] | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 New 2025 SVAP Approved! United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata New 2025 SVAP Approved! | |
| HL7® CDA® Release 2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1 HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2 [Adoption of this standard expires on January 1, 2026]HL7 CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 [This standard is required by December 31, 2025] | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm New 2025 SVAP Approved! | |
| § 170.315(b)(2) Clinical information reconciliation and incorporation | United States Core Data for Interoperability (USCDI), Version 1 (July 2020 Errata) [Adoption of this standard expires on January 1, 2026] United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025] | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 New 2025 SVAP Approved! United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata New 2025 SVAP Approved! |
| HL7® CDA® Release 2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1 HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2 [Adoption of this standard expires on January 1, 2026]HL7 CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 [This standard is required by December 31, 2025] | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm New 2025 SVAP Approved! | |
| § 170.315(b)(7)- Security tags- summary of care- send | HL7® CDA® Release 2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1 | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm New 2025 SVAP Approved! |
| § 170.315(b)(8)- Security tags- summary of care- receive | HL7® CDA® Release 2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1 | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm New 2025 SVAP Approved! |
| § 170.315(b)(9) – Care plan | HL7® CDA® Release 2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1 HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2 [Adoption of this standard expires on January 1, 2026]HL7 CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 [This standard is required by December 31, 2025] | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm New 2025 SVAP Approved! |
| §170.315(b)(11) Decision support interventions | United States Core Data for Interoperability (USCDI), Version 1 (July 2020 Errata) [Adoption of this standard expires on January 1, 2026] United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025] | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 New 2025 SVAP Approved! United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata New 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 | 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 | 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, Version 1.1 | 2025 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated May 2024) New 2025 SVAP Approved! |
| CMS Implementation Guide for Quality Reporting Document Architecture: Category III; Eligible Clinicians and Eligible Professionals Programs; Implementation Guide for 2020, Version 1.2.1 | 2025 CMS QRDA III Implementation Guide for Eligible Clinicians (Updated December 2024) New 2025 SVAP Approved! | |
| § 170.315(e)(1) View, download, and transmit to 3rd party | Web Content Accessibility Guidelines (WCAG) 2.0 | Web Content Accessibility Guidelines (WCAG) 2.2, October 5, 2023 (2024 SVAP Approved) |
| United States Core Data for Interoperability (USCDI), Version 1 (July 2020 Errata) [Adoption of this standard expires on January 1, 2026] United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025] | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 New 2025 SVAP Approved! United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata New 2025 SVAP Approved! | |
| HL7® CDA® Release 2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1 HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2 [Adoption of this standard expires on January 1, 2026]HL7 CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 [This standard is required by December 31, 2025] | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm New 2025 SVAP Approved! | |
| § 170.315(f)(1) Transmission to immunization registries | HL7® Version 2.5.1 Implementation Guide for Immunization Messaging, Release 1.5HL7® Version 2.5.1 Implementation Guide for Immunization Messaging (Release 1.5)—Addendum | 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 | PHIN Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent Care, Inpatient and Ambulatory Care Settings, Release 2.0, April 21, 2015 | 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 (USCDI), Version 1 (July 2020 Errata) [Adoption of this standard expires on January 1, 2026] United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025] | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 New 2025 SVAP Approved! United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata New 2025 SVAP Approved! |
| § 170.315(f)(6) Transmission to public health agencies – antimicrobial use and resistance reporting | HL7® Implementation Guide for CDA® Release 2: Healthcare Associated Infection (HAI) Reports, Release 1 | 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® 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 (USCDI), Version 1 (July 2020 Errata) [Adoption of this standard expires on January 1, 2026] United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025] | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 New 2025 SVAP Approved! United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata New 2025 SVAP Approved! |
| HL7® CDA® Release 2 Implementation Guide: Consolidated CDA Templates for Clinical Notes, Release 2.1 HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2 [Adoption of this standard expires on January 1, 2026]HL7 CDA® R2 Implementation Guide: C-CDA® Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 [This standard is required by December 31, 2025] | HL7 CDA® R2 Implementation Guide: Consolidated -CDA Templates for Clinical Notes Edition 4.0 – US Realm New 2025 SVAP Approved! | |
| § 170.315(g)(10) – Standardized API for patient and population services | HL7 FHIR® US Core Implementation Guide STU3, Release 3.1.1 [Adoption of this standard expires on January 1, 2026]HL7 FHIR® US Core Implementation Guide v6.1.0 – STU6 [This standard is required by December 31, 2025] | HL7 FHIR® US Core Implementation Guide STU 4.0.0, June 2021 (2022 SVAP Approved) HL7 FHIR® US Core Implementation Guide STU 8.0.0, (June 2025) New 2025 SVAP Approved! |
| HL7 FHIR® Bulk Data Access (Flat FHIR®) (v1.0.0: STU 1) | HL7 FHIR® Bulk Data Access (Flat FHIR®) (v2.0.0: STU 2), November 26, 2021(2022 SVAP Approved) | |
| HL7 FHIR® SMART Application Launch Framework Implementation Guide Release 1.0.0 [Adoption of this standard expires on January 1, 2026]HL7 FHIR® IG: SMART App Launch Framework v2.0.0, 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” [This standard is required by December 31, 2025] | HL7 FHIR® SMART Application Launch Framework Implementation Guide Release 2.2.0, April 30, 2024 (2024 SVAP Approved) | |
| United States Core Data for Interoperability (USCDI), Version 1 (July 2020 Errata) [Adoption of this standard expires on January 1, 2026] United States Core Data for Interoperability (USCDI), Version 3 (October 2022 Errata) [This standard is required by December 31, 2025] | United States Core Data for Interoperability (USCDI), Version 3.1, June 2025 New 2025 SVAP Approved! United States Core Data for Interoperability (USCDI), Version 5, March 2025 Errata New 2025 SVAP Approved! | |
| § 170.315(h)(1) Direct Project | Applicability Statement for Secure Health Transport, Version 1.2 | Applicability Statement for Secure Health Transport Version 1.3 (2022 SVAP Approved) |
| § 170.315(h)(2) Direct Project, Edge Protocol, and XDR/XDM | Applicability Statement for Secure Health Transport, Version 1.2 | Applicability Statement for Secure Health Transport Version 1.3 (2022 SVAP Approved) |
SVAP Resources
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