The Da Vinci IG portfolio is large. For health plans implementing CMS-0057-F, not all IGs matter equally. Six IGs deserve close tracking in 2026 because they directly drive compliance, vendor selection, or strategic positioning. Here is the priority list with notes on what each one does and why it matters. For more on Da Vinci IGs in practice coverage, this is the entry point.
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 treats CRD as a required component of the Prior Authorization API. Without CRD, the entire ePA workflow loses its first decision point.
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. DTR is where provider workflow lives; CRD without DTR is a notification, DTR without CRD is a form engine.
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. The three IGs (CRD, DTR, PAS) form the ePA stack that CMS-0057-F mandates by January 1, 2027.
4. Da Vinci PDex IG STU 2.1.0
Payer Data Exchange (PDex) governs clinical data exchange between payers and providers. PDex profiles cover clinical resources (Observation, Condition, Procedure, MedicationStatement) and define the clinical-data-side of Patient Access, Provider Access, and Payer-to-Payer Data Exchange. PDex Plan Net (a sub-profile of PDex) defines the Provider Directory layer.
PDex matters because it determines what clinical data flows across the four CMS-0057-F APIs. Implementations that build against older PDex versions need to upgrade to STU 2.1.0 for current conformance.
5. Da Vinci HRex IG
Health Record Exchange (HRex) is a foundation IG that other Da Vinci IGs reference for shared profiles and patterns. Most payer implementations do not directly target HRex but rely on the IGs that build on it. Tracking HRex matters because changes there ripple through PDex, PAS, and others.
For specific HRex use cases that appear in payer implementations, the Top 5 Da Vinci HRex use cases for payer implementations covers the patterns.
6. Da Vinci Risk Adjustment IG
The Risk Adjustment IG is newer Da Vinci work focused on the payer-provider data exchange that supports CMS Hierarchical Condition Category (HCC) risk adjustment workflows. It is not part of CMS-0057-F compliance, but it represents where the Da Vinci portfolio is heading for value-based care.
For Medicare Advantage payers and others running risk-adjusted contracts, the Risk Adjustment IG is worth tracking even though production deployment is limited in 2026.
What Lives Outside This Top Six But Still Matters
The Da Vinci portfolio includes additional IGs that are relevant but lower priority for CMS-0057-F. Notification IG covers ADT-like event notifications. Postable IG covers provider attestation flows. Value-Based Performance Reporting (VBPR) IG covers performance metrics in value-based contracts. Each has specific use cases but is not in the CMS-0057-F critical path.
How to Read IG Version Maturity
Da Vinci IG versions follow HL7's STU (Standard for Trial Use) ladder. STU 2.0.0 or later is generally adequate for CMS-0057-F production work. Earlier versions exist and may even pass conformance for their version, but they should not be the target for new implementations in 2026.
For the FHIR profile development tools that help author IG-conformant resources, the Best FHIR profile development tools for Da Vinci IG authoring covers the tooling layer.