2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## Extension: US Quality Core USCDI+ Quality Extension

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality | Version: 0.5.0
Active as of 2026-05-15 | Computable Name: USQualityCoreUSCDIQualityExtension

This extension is only used in the US Quality Core Implementation Guide's Profile StructureDefinition elements.

Context of Use

This extension may be used on the following element(s)

- Element ID: `ElementDefinition`
- Element ID: `ElementDefinition.type.targetProfile`
- Element ID: `ElementDefinition.type`

Usage info

Usages:

- Examples for this Extension: USQualityCoreAdverseEvent, USQualityCoreAllergyIntolerance, USQualityCoreCarePlan, USQualityCoreCareTeam... Show 38 more, USQualityCoreClaim, USQualityCoreConditionEncounterDiagnosis, USQualityCoreConditionProblemsHealthConcerns, USQualityCoreCoverage, USQualityCoreDeviceNotRequested, USQualityCoreDeviceRequest, USQualityCoreDiagnosticReportLab, USQualityCoreDiagnosticReportNote, USQualityCoreEncounter, USQualityCoreFamilyMemberHistory, USQualityCoreGoal, USQualityCoreImagingStudy, USQualityCoreImmunization, USQualityCoreImmunizationNotDone, USQualityCoreLocation, USQualityCoreMedication, USQualityCoreMedicationAdministration, USQualityCoreMedicationAdministrationNotDone, USQualityCoreMedicationDispense, USQualityCoreMedicationDispenseDeclined, USQualityCoreMedicationNotRequested, USQualityCoreMedicationRequest, USQualityCoreObservationClinicalResult, USQualityCoreLaboratoryResultObservation, USQualityCoreObservationScreeningAssessment, USQualityCoreObservationCancelled, USQualityCoreOrganization, USQualityCorePatient, USQualityCorePractitioner, USQualityCorePractitionerRole, USQualityCoreProcedure, USQualityCoreProcedureNotDone, USQualityCoreRelatedPerson, USQualityCoreServiceNotRequested, USQualityCoreServiceRequest, USQualityCoreSimpleObservation, USQualityCoreTask and USQualityCoreTaskRejected

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

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

- Differential Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | USCDI+ Quality Element Flag: ONLY USED FOR US Quality Core Profile StructureDefinitions
url |  | 1..1 | uri | "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality"
value[x] |  | 1..1 | boolean | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | USCDI+ Quality Element Flag: ONLY USED FOR US Quality Core Profile StructureDefinitions
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality"
value[x] |  | 1..1 | boolean | Value of extension
Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type boolean: This extension is only used in the US Quality Core Implementation Guide's Profile StructureDefinition elements.

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | USCDI+ Quality Element Flag: ONLY USED FOR US Quality Core Profile StructureDefinitions
url |  | 1..1 | uri | "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality"
value[x] |  | 1..1 | boolean | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..1 | Extension | USCDI+ Quality Element Flag: ONLY USED FOR US Quality Core Profile StructureDefinitions
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality"
value[x] |  | 1..1 | boolean | Value of extension
Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type boolean: This extension is only used in the US Quality Core Implementation Guide's Profile StructureDefinition elements.

Other representations of profile: CSV, Excel, Schematron

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`