US Core Appointment Profile - US Core Implementation Guide v10.0.0-ballot

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 10.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core Appointment Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-appointment		Version: 10.0.0-ballot
Standards status: Trial-use	Maturity Level: 2	Computable Name: USCoreAppointmentProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.72

The US Core Appointment Profile inherits from the FHIR Appointment resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) Appointment Data Element of the Encounter Information Data Class. It sets minimum expectations for the Appointment resource to record, search, and fetch information about a healthcare event scheduled for a past, current, or future date and time. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

This artifact is new for US Core Version 10.0.0-ballot

Example Usage Scenarios:

The following are example usage scenarios for the US Core Appointment Profile:

Query for Appointment resources belonging to a Patient
Query for a Patient's Appointment resources by date or status
Record or update a Patient Appointment

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Appointment Must Have:

a status
a participant
who or what is participating in the appointment (a patient, a practitioner, or a location)
the participation status of that participant

Each Appointment Must Support:

an appointment identifier
the specific service to be performed during the appointment¹
when the appointment starts²
when the appointment ends²
the role of the participant in the appointment

^1,2 see guidance below

Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

¹Service type codes are typically drawn from a local service catalog, and instances are not expected to draw from a specified value set. Therefore, Appointment.serviceType uses an example binding.

²The base FHIR invariant app-2 requires that either both the start and end time or neither are supplied. When a system knows only when an appointment starts, follow the Missing Data guidance and supply the end time with the DataAbsentReason Extension using the code "unknown":

{
  "resourceType" : "Appointment",
       ...
       "start" : "2026-09-15T14:00:00Z",
       "_end" : {
         "extension" : [
           {
             "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
             "valueCode" : "unknown"
           }
         ]
       }
       ...
}

Usages:

Refer to this Profile: US Core Encounter Profile
Examples for this Profile: Appointment/booked-physical, Appointment/cancelled, Appointment/from-referral, Appointment/fulfilled-followup...
CapabilityStatements using this Profile: US Core Client CapabilityStatement and US Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

Changes since version 9.0.0:

New Content

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Appointment	C	0..*	Appointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s) Constraints: app-2, app-3, app-4
Appointment.implicitRules	This element is a modifier element. This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Appointment.modifierExtension	This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Appointment.identifier	This element must be supported. This element is included in summaries.	0..*	Identifier	External Ids for this item
Appointment.status	This element is a modifier element. This element must be supported. This element is included in summaries.	1..1	code	proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist Binding: AppointmentStatus (required)
Appointment.serviceType	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services (example): Value Sets are typically bound to local service catalogs, and mapping to standard vocabularies can not be expected.
Appointment.start	This element must be supported. This element is included in summaries.	0..1	instant	When appointment is to take place
Appointment.end	This element must be supported. This element is included in summaries.	0..1	instant	When appointment is to conclude
Appointment.participant	This element must be supported. C	1..*	BackboneElement	Participants involved in appointment Constraints: app-1
Appointment.participant.modifierExtension	This element is a modifier element. This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Appointment.participant.type	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible)
Appointment.participant.actor	This element must be supported. This element is included in summaries.	1..1	Reference(US Core Patient Profile This type must be supported. \| US Core Practitioner Profile This type must be supported. \| US Core PractitionerRole Profile \| US Core RelatedPerson Profile \| US Core Device Profile \| HealthcareService \| US Core Location Profile This type must be supported. )	Person, Location/HealthcareService or Device
Appointment.participant.status	This element must be supported. This element is included in summaries.	1..1	code	accepted \| declined \| tentative \| needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Appointment.status	Base	required	AppointmentStatus	📦4.0.1	FHIR Std.
Appointment.serviceType	Base	example	https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services	Not State	Unknown
Appointment.participant.type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Appointment.participant.status	Base	required	ParticipationStatus	📍4.0.1	FHIR Std.

Constraints

Grade

Path(s)

Description

Expression

This structure is derived from Appointment

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Appointment		0..*	Appointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
Appointment.identifier	This element must be supported.	0..*	Identifier	External Ids for this item
Appointment.status	This element must be supported.	1..1	code	proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist Binding: AppointmentStatus (required)
Appointment.serviceType	This element must be supported.	0..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services (example): Value Sets are typically bound to local service catalogs, and mapping to standard vocabularies can not be expected.
Appointment.start	This element must be supported.	0..1	instant	When appointment is to take place
Appointment.end	This element must be supported.	0..1	instant	When appointment is to conclude
Appointment.participant	This element must be supported.	1..*	BackboneElement	Participants involved in appointment
Appointment.participant.type	This element must be supported.	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible)
Appointment.participant.actor	This element must be supported.	1..1	Reference(US Core Patient Profile This type must be supported. \| US Core Practitioner Profile This type must be supported. \| US Core PractitionerRole Profile \| US Core RelatedPerson Profile \| US Core Device Profile \| HealthcareService \| US Core Location Profile This type must be supported. )	Person, Location/HealthcareService or Device
Appointment.participant.status	This element must be supported.	1..1	code	accepted \| declined \| tentative \| needs-action
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Appointment.status	Base	required	AppointmentStatus	📦4.0.1	FHIR Std.
Appointment.serviceType	Base	example	https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services	Not State	Unknown
Appointment.participant.type	Base	extensible	Participant type	📦4.0.1	FHIR Std.

Description & Constraints Filter:

Appointment

0..*

Appointment

A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
Constraints: app-2, app-3, app-4

0..1

Logical id of this artifact

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Appointment.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Appointment.status	Base	required	AppointmentStatus	📦4.0.1	FHIR Std.
Appointment.cancelationReason	Base	example	Appointment cancellation reason	📍4.0.1	FHIR Std.
Appointment.serviceCategory	Base	example	Service category	📍4.0.1	FHIR Std.
Appointment.serviceType	Base	example	https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services	Not State	Unknown
Appointment.specialty	Base	preferred	Practice Setting Code Value Set	📍4.0.1	FHIR Std.
Appointment.appointmentType	Base	preferred	hl7VS-appointmentReasonCodes	📦3.0.0	THO v7.4
Appointment.reasonCode	Base	preferred	Encounter Reason Codes	📍4.0.1	FHIR Std.
Appointment.participant.type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Appointment.participant.required	Base	required	ParticipantRequired	📍4.0.1	FHIR Std.
Appointment.participant.status	Base	required	ParticipationStatus	📍4.0.1	FHIR Std.

Constraints

Grade

Path(s)

Description

Expression

This structure is derived from Appointment

Summary

Mandatory: 4 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Maturity: 2

Key Elements View

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Appointment	C	0..*	Appointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s) Constraints: app-2, app-3, app-4
Appointment.implicitRules	This element is a modifier element. This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Appointment.modifierExtension	This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Appointment.identifier	This element must be supported. This element is included in summaries.	0..*	Identifier	External Ids for this item
Appointment.status	This element is a modifier element. This element must be supported. This element is included in summaries.	1..1	code	proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist Binding: AppointmentStatus (required)
Appointment.serviceType	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services (example): Value Sets are typically bound to local service catalogs, and mapping to standard vocabularies can not be expected.
Appointment.start	This element must be supported. This element is included in summaries.	0..1	instant	When appointment is to take place
Appointment.end	This element must be supported. This element is included in summaries.	0..1	instant	When appointment is to conclude
Appointment.participant	This element must be supported. C	1..*	BackboneElement	Participants involved in appointment Constraints: app-1
Appointment.participant.modifierExtension	This element is a modifier element. This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Appointment.participant.type	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible)
Appointment.participant.actor	This element must be supported. This element is included in summaries.	1..1	Reference(US Core Patient Profile This type must be supported. \| US Core Practitioner Profile This type must be supported. \| US Core PractitionerRole Profile \| US Core RelatedPerson Profile \| US Core Device Profile \| HealthcareService \| US Core Location Profile This type must be supported. )	Person, Location/HealthcareService or Device
Appointment.participant.status	This element must be supported. This element is included in summaries.	1..1	code	accepted \| declined \| tentative \| needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Appointment.status	Base	required	AppointmentStatus	📦4.0.1	FHIR Std.
Appointment.serviceType	Base	example	https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services	Not State	Unknown
Appointment.participant.type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Appointment.participant.status	Base	required	ParticipationStatus	📍4.0.1	FHIR Std.

Constraints

Grade

Path(s)

Description

Expression

Differential View

This structure is derived from Appointment

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Appointment		0..*	Appointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
Appointment.identifier	This element must be supported.	0..*	Identifier	External Ids for this item
Appointment.status	This element must be supported.	1..1	code	proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist Binding: AppointmentStatus (required)
Appointment.serviceType	This element must be supported.	0..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services (example): Value Sets are typically bound to local service catalogs, and mapping to standard vocabularies can not be expected.
Appointment.start	This element must be supported.	0..1	instant	When appointment is to take place
Appointment.end	This element must be supported.	0..1	instant	When appointment is to conclude
Appointment.participant	This element must be supported.	1..*	BackboneElement	Participants involved in appointment
Appointment.participant.type	This element must be supported.	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible)
Appointment.participant.actor	This element must be supported.	1..1	Reference(US Core Patient Profile This type must be supported. \| US Core Practitioner Profile This type must be supported. \| US Core PractitionerRole Profile \| US Core RelatedPerson Profile \| US Core Device Profile \| HealthcareService \| US Core Location Profile This type must be supported. )	Person, Location/HealthcareService or Device
Appointment.participant.status	This element must be supported.	1..1	code	accepted \| declined \| tentative \| needs-action
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Appointment.status	Base	required	AppointmentStatus	📦4.0.1	FHIR Std.
Appointment.serviceType	Base	example	https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services	Not State	Unknown
Appointment.participant.type	Base	extensible	Participant type	📦4.0.1	FHIR Std.

Snapshot View

Description & Constraints Filter:

Appointment

0..*

Appointment

0..1

Logical id of this artifact

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Appointment.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Appointment.status	Base	required	AppointmentStatus	📦4.0.1	FHIR Std.
Appointment.cancelationReason	Base	example	Appointment cancellation reason	📍4.0.1	FHIR Std.
Appointment.serviceCategory	Base	example	Service category	📍4.0.1	FHIR Std.
Appointment.serviceType	Base	example	https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services	Not State	Unknown
Appointment.specialty	Base	preferred	Practice Setting Code Value Set	📍4.0.1	FHIR Std.
Appointment.appointmentType	Base	preferred	hl7VS-appointmentReasonCodes	📦3.0.0	THO v7.4
Appointment.reasonCode	Base	preferred	Encounter Reason Codes	📍4.0.1	FHIR Std.
Appointment.participant.type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Appointment.participant.required	Base	required	ParticipantRequired	📍4.0.1	FHIR Std.
Appointment.participant.status	Base	required	ParticipationStatus	📍4.0.1	FHIR Std.

Constraints

Grade

Path(s)

Description

Expression

This structure is derived from Appointment

Summary

Mandatory: 4 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

Notes:

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

See the Scopes Format section for a description of the SMART scopes syntax.
See the Search Syntax section for a description of the US Core search syntax.
See the General Requirements section for additional rules and expectations when a Server requires status parameters.
See the General Guidance section for additional guidance on searching for multiple patients.

US Core Scopes

Servers providing access to appointment data SHALL support these US Core SMART Scopes:

resource level scopes: <patient|user|system>/Appointment.rs ^§

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

SHALL support both read Appointment by id AND Appointment search using the _id search parameter

GET [base]/Appointment?_id=[id]' or 'GET [base]/Appointment/[id]

Examples:
1. GET [base]/Appointment/12354
2. GET [base]/Appointment?_id=12354
Implementation Notes: Fetches a single US Core Appointment Profile or a search Bundle containing an US Core Appointment Profile resource matching the id (see Parameters for all resources).
SHALL support searching for all appointments for a patient using the patient search parameter

GET [base]/Appointment?patient={Patient/}[id]

Example:
1. GET [base]/Appointment?patient=Patient/1137192
Implementation Notes: Fetches a bundle of all US Core Appointment Profile resources for the specified patient ( see how to search by reference).

Optional Search Parameters:

The following search parameters and search parameter combinations SHOULD be supported

SHOULD support searching for all appointments for a patient by date using the combination of the patient and date search parameters
- Including optional support for AND search on date (e.g.date=[date]&date=[date]&...)
- Including support for these date comparators: "gt", "lt", "ge", "le"
GET [base]/Appointment?patient={Patient/}[id]&date={gt|lt|ge|le}[dateTime]{&date={gt|lt|ge|le}[dateTime]&...}

Example:
1. GET [base]/Appointment?patient=Patient/1137192&date=ge2026-01-01T00:00:00Z
Implementation Notes: Fetches a bundle of all US Core Appointment Profile resources matching the specified date and patient ( see how to search by reference and how to search by date).
SHOULD support searching for all appointments for a patient by status (for example, all booked appointments) using the combination of the patient and status search parameters

GET [base]/Appointment?patient={Patient/}[id]&status={system|}[search_code]

Example:
1. GET [base]/Appointment?patient=Patient/1137192&status=booked
Implementation Notes: Fetches a bundle of all US Core Appointment Profile resources matching the specified patient and status ( see how to search by reference and how to search by token).