# US Core ServiceRequest Profile - US Core Implementation Guide v8.0.1

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Core ServiceRequest Profile**

## Resource Profile: US Core ServiceRequest Profile 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest | *Version*:8.0.1 | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](http://hl7.org/fhir/versions.html#maturity): 3 | *Computable Name*:USCoreServiceRequestProfile |
| *Other Identifiers:*OID:2.16.840.1.113883.4.642.40.2.42.68 | | |
| **Copyright/Legal**: Used by permission of HL7 International, all rights reserved Creative Commons License | | |

 
The US Core ServiceRequest Profile inherits from the FHIR [ServiceRequest](https://hl7.org/fhir/R4/servicerequest.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for recording, searching, and fetching the ServiceRequest information. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. 

**Example Usage Scenarios:**

The following are example usage scenarios for this profile:

* Query for a specific procedure or test request, such as an electrocardiogram (ECG) order or a referral to a support program.
* Query for a specific service offered to a patient, such as a referral to a support program.
* Query for a category of service request (e.g., all cardiology requests)

### Mandatory and Must Support Data Elements

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

**Each Service Request Must Have:**

1. a status
1. an intent code indicating whether the request is a proposal, plan, or order.
1. a code defining what is being requested
1. a patient

**Each Service Request Must Support:**

1. a category
1. the encounter in which the request was created
1. when requested service should happen
1. when the request was made
1. the requester*

**Additional USCDI Requirements:**

This [Additional USCDI Requirements](must-support.md#additional-uscdi-requirements) element is not Mandatory or Must Support but is required for ASTP Health IT certification testing and is included in the formal definition of the profile and the ServiceRequest examples.

1. plain text representation of what is being requested
1. a reason or indication for referral or consultation*

*see guidance below

**Profile Specific Implementation Guidance:**

* For more information on exchanging Social Determinants of Health (SDOH) service requests, See the [Screening and Assessments](screening-and-assessments.md) guidance page.
* The Must Support `ServiceRequest.category` is bound, **at a minimum**, to the [US Core ServiceRequest Category Codes](ValueSet-us-core-servicerequest-category.md), and other category codes can be used. API consumers can query by category when accessing patient information. For the USCDI **Laboratory Order**, **Imaging Order**, **Clinical Test Order**, and **Procedure Order** Data Elements, implementers **SHOULD** use the corresponding category codes listed in the table below. For example, laboratory orders would have the category code "108252007" (Laboratory procedure).
* The `ServiceRequest.code` is bound to US Core Procedure Codes, a broadly defined value set that accommodates many healthcare domains. However, implementers **SHOULD** constrain the value set to a subset for a particular domain. The table below identifies additional value set bindings for the USCDI Laboratory Order, Imaging Order, and Clinical Test Order Data Elements. Implementers **SHOULD** conform to the binding strengths listed for each USCDI Order context. For example, laboratory orders are [extensibly] bound to the [LOINC Common Laboratory Orders Value Set](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1267.21/expansion). Note that the USCDI Class Procedure Order Data Element has no additional binding.
* *Servers and Clients **SHALL** support both US Core ServiceRequest and US Core Procedure Profiles for communicating the reason or justification for a referral as Additional USCDI Requirements. Typically, the reason or justification for a referral or consultation is communicated through `Procedure.basedOn` linking the Procedure to the US Core ServiceRequest Profile that includes either `ServiceRequest.reasonCode` or `ServiceRequest.reasonReference`. When the Procedure does not have an associated ServiceRequest, it is communicated through the US Core Procedure Profile's `Procedure.reasonCode` or `Procedure.reasonReference`. Depending on the procedure being documented, a Server will select the appropriate Profile to use. 
* Although both `ServiceRequest.reasonCode` and `ServiceRequest.reasonReference` are marked as Additional USCDI Requirements, the certifying Server system is not required to support both, but **SHALL** support at least one of these elements. The certifying Client application **SHALL** support both elements. 
* when using `ServiceRequest.reasonReference`: 
* Servers **SHALL** support **at least one** target resource in `ServiceRequest.reasonReference`. Clients **SHALL** support all target resources.
* The referenced resources **SHOULD** be a US Core Profile as documented in [Referencing US Core Profiles](general-guidance.md#referencing-us-core-profiles).
 
 
 

* *The profile element `ServiceRequest.requester` communicates the [individual level provenance](basic-provenance.md#individual-level-provenance) author data corresponding to the U.S. Core Data for Interoperability (USCDI) Provenance Author Data Elements.

**Usages:**

* Refer to this Profile: [US Core Procedure Profile](StructureDefinition-us-core-procedure.md)
* Examples for this Profile: [ServiceRequest/bmp](ServiceRequest-bmp.md), [ServiceRequest/cbc](ServiceRequest-cbc.md), [ServiceRequest/chest-xray](ServiceRequest-chest-xray.md), [ServiceRequest/ekg](ServiceRequest-ekg.md)... Show 2 more, [ServiceRequest/foodpantry-referral](ServiceRequest-foodpantry-referral.md) and [ServiceRequest/rehab](ServiceRequest-rehab.md)
* CapabilityStatements using this Profile: [US Core Client CapabilityStatement](CapabilityStatement-us-core-client.md) and [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.us.core|current/StructureDefinition/us-core-servicerequest)

**Changes since version 7.0.0:**

* The data elements list has changed

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-core-servicerequest.csv), [Excel](StructureDefinition-us-core-servicerequest.xlsx), [Schematron](StructureDefinition-us-core-servicerequest.sch) 

### 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](CapabilityStatement-us-core-server.md) for a complete list of supported RESTful interactions for this IG.

* See the [Scopes Format](scopes.md#scopes-format) section for a description of the SMART scopes syntax.
* See the [Search Syntax](general-guidance.md#search-syntax) section for a description of the US Core search syntax.
* See the [General Requirements](general-requirements.md) section for additional rules and expectations when a Server requires status parameters.
* See the [General Guidance](general-guidance.md) section for additional guidance on searching for multiple patients.

#### US Core Scopes

Servers providing access to order and referral data **SHALL** support these [US Core SMART Scopes](scopes.md#smart-scopes):

* [resource level scopes](http://hl7.org/fhir/smart-app-launch/STU2.2/scopes-and-launch-context.html#scopes-for-requesting-clinical-data): `<patient|user|system>/ServiceRequest.rs`

Servers providing access to order and referral data **MAY** support these [US Core SMART Scopes](scopes.md#smart-scopes):

* [granular scopes](http://hl7.org/fhir/smart-app-launch/STU2.2/scopes-and-launch-context.html#finer-grained-resource-constraints-using-search-parameters): `<patient|user|system>/ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh`

#### Mandatory Search Parameters:

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

1. **SHALL** support searching for all servicerequests for a patient using the **[`patient`](SearchParameter-us-core-servicerequest-patient.md)** search parameter:`GET [base]/ServiceRequest?patient={Type/}[id]`Example:
1. GET [base]/ServiceRequest?patient=1137192
**Implementation Notes:** Fetches a bundle of all ServiceRequest resources for the specified patient ([how to search by reference](http://hl7.org/fhir/R4/search.html#reference))
1. **SHALL** support both read ServiceRequest by `id` **AND** ServiceRequest search using the **[`_id`](SearchParameter-us-core-servicerequest-id.md)** search parameter:`GET [base]/ServiceRequest/[id]` or `GET [base]/ServiceRequest?_id=[id]`Example:
1. GET [base]/ServiceRequest/1032702
1. GET [base]/ServiceRequest?_id=1032702
**Implementation Notes:** ([how to search by the logical id](http://hl7.org/fhir/R4/references.html#logical) of the resource)
1. **SHALL** support searching using the combination of the **[`patient`](SearchParameter-us-core-servicerequest-patient.md)** and **[`category`](SearchParameter-us-core-servicerequest-category.md)** search parameters:`GET [base]/ServiceRequest?patient={Type/}[id]&category={system|}[code]`Example:
1. GET [base]/ServiceRequest?patient=f201&category=http://loinc.org|LG41762-2
**Implementation Notes:** Fetches a bundle of all ServiceRequest resources for the specified patient and a category code ([how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token))
1. **SHALL**support searching using the combination of the**[`patient`](SearchParameter-us-core-servicerequest-patient.md)**and**[`code`](SearchParameter-us-core-servicerequest-code.md)**search parameters:
* including optional support for **OR** search on `code` (e.g.`code={system|}[code],{system|}[code],...`)
`GET [base]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}`Example:
1. GET [base]/ServiceRequest?patient=1032702&code=http://snomed.info/sct|35637008
**Implementation Notes:** Fetches a bundle of all ServiceRequest resources for the specified patient and report code(s). SHOULD support search by multiple report codes. ([how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token))
1. **SHALL**support searching using the combination of the**[`patient`](SearchParameter-us-core-servicerequest-patient.md)**and**[`category`](SearchParameter-us-core-servicerequest-category.md)**and**[`authored`](SearchParameter-us-core-servicerequest-authored.md)**search parameters:
* including support for these `authored` comparators: `gt,lt,ge,le`
* including optional support for **AND** search on `authored` (e.g.`authored=[date]&authored=[date]]&...`)
`GET [base]/ServiceRequest?patient={Type/}[id]&category={system|}[code]&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}`Example:
1. GET [base]/ServiceRequest?patient=f201&category=http://loinc.org|LG41762-2&date=ge2010-01-14T00:00:00Z
**Implementation Notes:** Fetches a bundle of all ServiceRequest resources for the specified patient and date and a category code ([how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token) and [how to search by date](http://hl7.org/fhir/R4/search.html#date))

#### Optional Search Parameters:

The following search parameter combinations **SHOULD** be supported:

1. **SHOULD**support searching using the combination of the**[`patient`](SearchParameter-us-core-servicerequest-patient.md)**and**[`status`](SearchParameter-us-core-servicerequest-status.md)**search parameters:
* including support for **OR** search on `status` (e.g.`status={system|}[code],{system|}[code],...`)
`GET [base]/ServiceRequest?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}`Example:
1. GET [base]/ServiceRequest?patient=1137192&status=completed
**Implementation Notes:** Fetches a bundle of all ServiceRequest resources for the specified patient and status ([how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token))
1. **SHOULD**support searching using the combination of the**[`patient`](SearchParameter-us-core-servicerequest-patient.md)**and**[`code`](SearchParameter-us-core-servicerequest-code.md)**and**[`authored`](SearchParameter-us-core-servicerequest-authored.md)**search parameters:
* including optional support for **OR** search on `code` (e.g.`code={system|}[code],{system|}[code],...`)
* including support for these `authored` comparators: `gt,lt,ge,le`
* including optional support for **AND** search on `authored` (e.g.`authored=[date]&authored=[date]]&...`)
`GET [base]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}`Example:
1. GET [base]/ServiceRequest?patient=f201&code=http://snomed.info/sct|35637008&date=ge2019-01-14T00:00:00Z
**Implementation Notes:** Fetches a bundle of all ServiceRequest resources for the specified patient and date and service code(s). SHOULD support search by multiple report codes. ([how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token) and [how to search by date](http://hl7.org/fhir/R4/search.html#date))



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-core-servicerequest",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cgp"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 3,
    "_valueInteger" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.2.42.68"
  }],
  "version" : "8.0.1",
  "name" : "USCoreServiceRequestProfile",
  "title" : "US Core ServiceRequest Profile",
  "status" : "active",
  "date" : "2025-04-28",
  "publisher" : "HL7 International / Cross-Group Projects",
  "contact" : [{
    "name" : "HL7 International / Cross-Group Projects",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cgp"
    },
    {
      "system" : "email",
      "value" : "cgp@lists.HL7.org"
    }]
  }],
  "description" : "The US Core ServiceRequest Profile inherits from the FHIR [ServiceRequest](https://hl7.org/fhir/R4/servicerequest.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for recording, searching, and fetching the ServiceRequest information. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "copyright" : "Used by permission of HL7 International, all rights reserved Creative Commons License",
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "quick",
    "uri" : "http://siframework.org/cqf",
    "name" : "Quality Improvement and Clinical Knowledge (QUICK)"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "ServiceRequest",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/ServiceRequest",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "ServiceRequest",
      "path" : "ServiceRequest",
      "mustSupport" : false
    },
    {
      "id" : "ServiceRequest.status",
      "path" : "ServiceRequest.status",
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.intent",
      "path" : "ServiceRequest.intent",
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.category",
      "path" : "ServiceRequest.category",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "$this"
        }],
        "rules" : "open"
      },
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.category:us-core",
      "path" : "ServiceRequest.category",
      "sliceName" : "us-core",
      "mustSupport" : true,
      "binding" : {
        "strength" : "required",
        "description" : "Note that other codes are permitted, see [Required Bindings When Slicing by Value Sets](general-requirements.html#required-bindings-when-slicing-by-valuesets)",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category"
      }
    },
    {
      "id" : "ServiceRequest.code",
      "path" : "ServiceRequest.code",
      "min" : 1,
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"
      }
    },
    {
      "id" : "ServiceRequest.code.text",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.code.text",
      "short" : "𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: The name of the test, procedure, or service to be performed."
    },
    {
      "id" : "ServiceRequest.subject",
      "path" : "ServiceRequest.subject",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
        "http://hl7.org/fhir/StructureDefinition/Group",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location",
        "http://hl7.org/fhir/StructureDefinition/Device"],
        "_targetProfile" : [{
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : true
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        }]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.encounter",
      "path" : "ServiceRequest.encounter",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.occurrence[x]",
      "path" : "ServiceRequest.occurrence[x]",
      "type" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
          "valueBoolean" : true
        }],
        "code" : "Period"
      },
      {
        "code" : "dateTime"
      },
      {
        "code" : "Timing"
      }],
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.authoredOn",
      "path" : "ServiceRequest.authoredOn",
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.requester",
      "path" : "ServiceRequest.requester",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson",
        "http://hl7.org/fhir/StructureDefinition/Device"],
        "_targetProfile" : [{
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : true
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        }]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ServiceRequest.reasonCode",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.reasonCode",
      "short" : "𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service",
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code"
      }
    },
    {
      "id" : "ServiceRequest.reasonReference",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.reasonReference",
      "short" : "𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service"
    }]
  }
}

```
