CMS Interoperability & Prior Authorization Final Rule

The CMS-0057-F prior authorization deadline, entity by entity.

A free, always-current calendar of every CMS-0057-F obligation — which requirements apply to which payer type, by what date, under which date semantics — each row traced to the Federal Register.

days
hours
minutes
until the January 1, 2027 Patient Access & Prior Authorization API compliance date for most impacted payers.
20+tracked obligations
10impacted payer types
Every rowtraced to the Federal Register
The calendar

Every compliance date, grouped and dated

Final dates and proposed dates are shown distinctly. Managed-care obligations key to the rating period on or after the date — that distinction is in every row. Filter to your entity type to see only what applies to you.

April 8, 2024
7 obligations · already in force
Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213)
April 8, 2024 (effective date of the final rule; already in force)
CHIP fee-for-service 89 FR 8758
Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213)
April 8, 2024 (effective date of the final rule; already in force)
CHIP managed care 89 FR 8758
Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213)
April 8, 2024 (effective date of the final rule; already in force)
Medicaid fee-for-service 89 FR 8758
Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213)
April 8, 2024 (effective date of the final rule; already in force)
Medicaid managed care 89 FR 8758
Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213)
April 8, 2024 (effective date of the final rule; already in force)
Medicare Advantage (MA) 89 FR 8758
Patient Access API — expanded data content (all USCDI data classes and elements per 45 CFR 170.213)
April 8, 2024 (effective date of the final rule; already in force)
QHP issuers on the FFEs 89 FR 8758
Rule effective 2024-04-08
All impacted payers 89 FR 8758
October 1, 2025
1 obligation · already in force
Rule effective 2025-10-01
All impacted payers 90 FR 36536
January 1, 2026
18 obligations · already in force
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
CHIP fee-for-service 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
CHIP managed care 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
Medicaid fee-for-service 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
Medicaid managed care 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
Medicare Advantage (MA) 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
QHP issuers on the FFEs 89 FR 8758
Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard)
On or after January 1, 2026
CHIP fee-for-service 89 FR 8758
Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard)
Rating periods that start on or after January 1, 2026
CHIP managed care 89 FR 8758
Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard)
Beginning January 1, 2026
Medicaid fee-for-service 89 FR 8758
Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard)
Rating periods that start on or after January 1, 2026
Medicaid managed care 89 FR 8758
Prior authorization decision timeframes (72 hours expedited / 7 calendar days standard)
Beginning on or after January 1, 2026
Medicare Advantage (MA) 89 FR 8758
Specific reason for prior authorization denial (any communication channel) CHIP fee-for-service 89 FR 8758
Specific reason for prior authorization denial (any communication channel)
Rating periods beginning on or after January 1, 2026
CHIP managed care 89 FR 8758
Specific reason for prior authorization denial (any communication channel) Medicaid fee-for-service 89 FR 8758
Specific reason for prior authorization denial (any communication channel)
Rating periods beginning on or after January 1, 2026
Medicaid managed care 89 FR 8758
Specific reason for prior authorization denial (any communication channel) Medicare Advantage (MA) 89 FR 8758
Specific reason for prior authorization denial (any communication channel)
Plan years beginning on or after January 1, 2026
QHP issuers on the FFEs 89 FR 8758
HL7 FHIR US Core IG 3.1.1 expires 2026-01-01
All impacted payers 89 FR 8758
March 31, 2026
14 obligations · already in force
Annual public reporting of prior authorization metrics on payer website
First report due 2026-03-31 (PAYER_WEBSITE)
All impacted payers 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
CHIP fee-for-service 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
CHIP managed care 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
Medicaid fee-for-service 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
Medicaid managed care 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
Medicare Advantage (MA) 89 FR 8758
Annual public reporting of prior authorization metrics on payer website
Beginning in 2026; first public posting due March 31, 2026, covering calendar year 2025 data; recurring annually each March 31 for the prior calendar year
QHP issuers on the FFEs 89 FR 8758
Patient Access API usage metrics — annual report to CMS
First report due 2026-03-31 (CMS)
All impacted payers 89 FR 8758
Patient Access API usage metrics — annual report to CMS
Beginning in 2026: due March 31 each year for the previous calendar year (first report due March 31, 2026, covering CY2025)
CHIP fee-for-service 89 FR 8758
Patient Access API usage metrics — annual report to CMS
Beginning in 2026: due March 31 each year for the previous calendar year (first report due March 31, 2026, covering CY2025)
CHIP managed care 89 FR 8758
Patient Access API usage metrics — annual report to CMS
Beginning in 2026: due March 31 each year for the previous calendar year (first report due March 31, 2026, covering CY2025)
Medicaid fee-for-service 89 FR 8758
Patient Access API usage metrics — annual report to CMS
Beginning in 2026: due March 31 each year for the previous calendar year (first report due March 31, 2026, covering CY2025)
Medicaid managed care 89 FR 8758
Patient Access API usage metrics — annual report to CMS
Beginning in 2026: due March 31 each year for the previous calendar year (first report due March 31, 2026, covering CY2025)
Medicare Advantage (MA) 89 FR 8758
Patient Access API usage metrics — annual report to CMS
Beginning in 2026: due March 31 each year for the previous calendar year (first report due March 31, 2026, covering CY2025)
QHP issuers on the FFEs 89 FR 8758
May 26, 2026
1 obligation · already in force
Rule effective 2026-05-26
All impacted payers 91 FR 14350
June 15, 2026
1 obligation · already in force
Comment period closes 2026-06-15
All impacted payers Proposed 91 FR 19890
January 1, 2027 Key deadline
26 obligations
Electronic Prior Authorization measure (MIPS Promoting Interoperability performance category and Medicare Promoting Interoperability Program)
Beginning with the CY 2027 EHR reporting period (Medicare Promoting Interoperability Program)
Hospitals & critical access hospitals 89 FR 8758
Electronic Prior Authorization measure (MIPS Promoting Interoperability performance category and Medicare Promoting Interoperability Program)
Beginning with the CY 2027 performance period (2029 MIPS payment year)
MIPS-eligible clinicians 89 FR 8758
Patient Access API — prior authorization information CHIP fee-for-service 89 FR 8758
Patient Access API — prior authorization information
Rating periods beginning on or after January 1, 2027
CHIP managed care 89 FR 8758
Patient Access API — prior authorization information Medicaid fee-for-service 89 FR 8758
Patient Access API — prior authorization information
Rating periods beginning on or after January 1, 2027
Medicaid managed care 89 FR 8758
Patient Access API — prior authorization information Medicare Advantage (MA) 89 FR 8758
Patient Access API — prior authorization information
Plan years beginning on or after January 1, 2027
QHP issuers on the FFEs 89 FR 8758
Payer-to-Payer API
January 1, 2027 (one-time 1-year extension available, i.e. to January 1, 2028; 90%-MCO-enrollment exemption available)
CHIP fee-for-service 89 FR 8758
Payer-to-Payer API
Rating periods beginning on or after January 1, 2027
CHIP managed care 89 FR 8758
Payer-to-Payer API
January 1, 2027 (one-time 1-year extension available, i.e. to January 1, 2028; 90%-MCO-enrollment exemption available)
Medicaid fee-for-service 89 FR 8758
Payer-to-Payer API
Rating periods beginning on or after January 1, 2027
Medicaid managed care 89 FR 8758
Payer-to-Payer API Medicare Advantage (MA) 89 FR 8758
Payer-to-Payer API
Plan years beginning on or after January 1, 2027 (annual narrative-justification exception available through QHP certification)
QHP issuers on the FFEs 89 FR 8758
Prior Authorization API (CRD+DTR+PAS capability)
By January 1, 2027 (one-time 1-year extension available, i.e. to January 1, 2028; 90%-MCO-enrollment exemption available)
CHIP fee-for-service 89 FR 8758
Prior Authorization API (CRD+DTR+PAS capability)
Rating periods beginning on or after January 1, 2027
CHIP managed care 89 FR 8758
Prior Authorization API (CRD+DTR+PAS capability)
By January 1, 2027 (one-time 1-year extension available, i.e. to January 1, 2028; 90%-MCO-enrollment exemption available)
Medicaid fee-for-service 89 FR 8758
Prior Authorization API (CRD+DTR+PAS capability)
Rating periods beginning on or after January 1, 2027
Medicaid managed care 89 FR 8758
Prior Authorization API (CRD+DTR+PAS capability)
By January 1, 2027
Medicare Advantage (MA) 89 FR 8758
Prior Authorization API (CRD+DTR+PAS capability)
Plan years beginning on or after January 1, 2027 (annual narrative-justification exception available through QHP certification)
QHP issuers on the FFEs 89 FR 8758
Provider Access API
January 1, 2027 (one-time 1-year extension available, i.e. to January 1, 2028; 90%-MCO-enrollment exemption available)
CHIP fee-for-service 89 FR 8758
Provider Access API
Rating periods beginning on or after January 1, 2027
CHIP managed care 89 FR 8758
Provider Access API
January 1, 2027 (one-time 1-year extension available, i.e. to January 1, 2028; 90%-MCO-enrollment exemption available)
Medicaid fee-for-service 89 FR 8758
Provider Access API
Rating periods beginning on or after January 1, 2027
Medicaid managed care 89 FR 8758
Provider Access API Medicare Advantage (MA) 89 FR 8758
Provider Access API
Plan years beginning on or after January 1, 2027 (annual narrative-justification exception available through QHP certification)
QHP issuers on the FFEs 89 FR 8758
March 31, 2027
2 obligations
Annual public reporting of prior authorization metrics on payer website
Next annual 3/31 recurrence (PAYER_WEBSITE)
All impacted payers 89 FR 8758
Patient Access API usage metrics — annual report to CMS
Next annual 3/31 recurrence (CMS)
All impacted payers 89 FR 8758
October 1, 2027
22 obligations
Include a specific reason for denial in prior authorization responses for all drugs
October 1, 2027 (proposed)
Medicaid fee-for-service Proposed 91 FR 19890
Include a specific reason for denial in prior authorization responses for all drugs
October 1, 2027 (proposed)
Medicaid managed care Proposed 91 FR 19890
Include a specific reason for denial in prior authorization responses for all drugs
October 1, 2027 (proposed)
QHP issuers on the FFEs Proposed 91 FR 19890
Incorporate drugs covered under a medical benefit into the Prior Authorization API
October 1, 2027 (proposed)
CHIP fee-for-service Proposed 91 FR 19890
Incorporate drugs covered under a medical benefit into the Prior Authorization API
October 1, 2027 (proposed)
CHIP managed care Proposed 91 FR 19890
Incorporate drugs covered under a medical benefit into the Prior Authorization API
October 1, 2027 (proposed)
Medicaid fee-for-service Proposed 91 FR 19890
Incorporate drugs covered under a medical benefit into the Prior Authorization API
October 1, 2027 (proposed)
Medicaid managed care Proposed 91 FR 19890
Incorporate drugs covered under a medical benefit into the Prior Authorization API
October 1, 2027 (proposed)
Medicare Advantage (MA) Proposed 91 FR 19890
Incorporate drugs covered under a medical benefit into the Prior Authorization API
October 1, 2027 (proposed)
QHP issuers on the FFEs Proposed 91 FR 19890
Prior authorization decision timeframes for drugs
October 1, 2027 (proposed)
CHIP fee-for-service Proposed 91 FR 19890
Prior authorization decision timeframes for drugs
October 1, 2027 (proposed)
CHIP managed care Proposed 91 FR 19890
Prior authorization decision timeframes for drugs
October 1, 2027 (proposed)
Medicaid fee-for-service Proposed 91 FR 19890
Prior authorization decision timeframes for drugs
October 1, 2027 (proposed)
Medicaid managed care Proposed 91 FR 19890
Prior authorization decision timeframes for drugs
October 1, 2027 (proposed)
QHP issuers on the FFEs Proposed 91 FR 19890
Publicly report prior authorization metrics for drugs
October 1, 2027 (proposed); drug PA metrics reported annually thereafter
Medicaid managed care Proposed 91 FR 19890
Publicly report prior authorization metrics for drugs
October 1, 2027 (proposed); drug PA metrics reported annually thereafter
Medicare Advantage (MA) Proposed 91 FR 19890
Publicly report prior authorization metrics for drugs
October 1, 2027 (proposed); drug PA metrics reported annually thereafter
QHP issuers on the FFEs Proposed 91 FR 19890
Report usage metrics for the Provider Access, Payer-to-Payer, and Prior Authorization APIs to CMS
October 1, 2027 (proposed); metrics reported to CMS annually
Medicare Advantage (MA) Proposed 91 FR 19890
Report usage metrics for the Provider Access, Payer-to-Payer, and Prior Authorization APIs to CMS
October 1, 2027 (proposed); metrics reported to CMS annually
QHP issuers on the FFEs Proposed 91 FR 19890
Support the NCPDP SCRIPT standard for electronic prior authorization of pharmacy-benefit drugs
October 1, 2027 (proposed)
Medicaid fee-for-service Proposed 91 FR 19890
Support the NCPDP SCRIPT standard for electronic prior authorization of pharmacy-benefit drugs
October 1, 2027 (proposed)
Medicaid managed care Proposed 91 FR 19890
Support the NCPDP SCRIPT standard for electronic prior authorization of pharmacy-benefit drugs
October 1, 2027 (proposed)
QHP issuers on the FFEs Proposed 91 FR 19890
January 1, 2028
2 obligations
Apply interoperability and prior authorization API requirements to small-group QHP issuers on the FF-SHOPs
Plan years beginning on or after January 1, 2028 (proposed)
QHP issuers on the FF-SHOPs Proposed 91 FR 19890
HL7 FHIR Da Vinci Prior Authorization Support (PAS) IG 2.0.1 expires 2028-01-01
All impacted payers 89 FR 8758
May 26, 2028
3 obligations
Adopt HL7 C-CDA and HL7 Attachments IGs for claims-attachment content
Compliance required by May 26, 2028
HIPAA-covered entities 91 FR 14350
Adopt HL7 electronic/digital signature standard for attachments
Compliance required by May 26, 2028 (signature use as specified)
HIPAA-covered entities 91 FR 14350
Adopt X12N 275 (006020X314) and X12N 277 (006020X313) as claims-attachment transaction standards
Compliance required by May 26, 2028
HIPAA-covered entities 91 FR 14350
Which obligations apply to you

Pick your payer type

See only the obligations that apply to your organization, with their compliance dates and any extension or exemption paths named in the rule.

Beyond the rulebook

Knowing the rules is the easy part. Who’s actually complying?

The deadlines above are public. What isn’t: which payers have already posted their prior-authorization metrics, and what they reported. Dataplex tracks that layer — human-reviewed and traced to each payer’s own published source.

475+payer organizations tracked
500+posted PA metrics, source-traced
  • See which of your competitors have posted — and their approval, denial, and appeal rates.
  • Every metric human-reviewed and linked to the payer’s own published page.
  • Benchmark your organization against the field, or embed the matrix in your own product.
Free download

The one-page milestone cheat sheet

Every key CMS-0057-F compliance date on a single printable page — what’s due, who it hits, traced to the Federal Register. We’ll email you the PDF and a note from our team.

No spam. One follow-up from a human, then only if you ask.
Dataplex maintains this tracker from the published Federal Register text of CMS-0057-F and adjacent rulemaking. It is a reference summary, not legal advice — verify against the citations shown. For payer benchmarking, the full provenance-traced matrix, or embedding it in your product, talk to our team. Teams who want to self-serve the queryable dataset can find it on the Snowflake Marketplace.