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CARIN IG
For Blue Button®

The CARIN Implementation Guide (IG) for Blue Button® is an HL7® FHIR® IG developed through the CARIN Alliance and HL7 to support consumer-directed access to claims and health plan information. It reflects the work of a diverse community of health plans, providers, health IT developers, consumer-facing applications, standards organizations, consumers, caregivers, and government partners advancing consumer-directed exchange across the United States.

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Implementation Guide
Explore
CARIN IG for Blue Button

Vision For
Consumer Access

The CARIN Alliance is working toward a future in which consumers and their authorized caregivers can securely get, use, and share their digital health information when, where, and how they want to achieve their goals.

CARIN IG for Blue Button® advances that vision by providing a common implementation approach for access to claims and health plan information. Standardized APIs can make this information more portable and usable across health plans, applications, and other parts of the health care ecosystem.

We envision a future where consumers can securely access their health plan information from participating payers through applications they choose.

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From Call to Action to Federal Policy Alignment

One of the largest responsibilities for Health Systems is Revenue Cycle Management:

The CARIN IG for Blue Button® began as an industry response to a national call to action. In March 2018, CMS Administrator Seema Verma announced Blue Button® 2.0 at HIMSS and called on insurers to give patients electronic access to their claims data. CARIN members recognized that health plans would need a common, standards-based way to meet that call across the payer ecosystem.
CARIN responded by convening health plans and other stakeholders through the CARIN Health Plan Workgroup to define the Common Payer Consumer Data Set and map payer-held claims and encounter information into profiled HL7® FHIR® resources. That work became the CARIN IG for Blue Button®, giving payers, application developers, and regulators an implementation-ready approach for consumer access to payer data before the federal Patient Access API requirements were finalized.
In that sense, CARIN Blue Button® did not simply respond to federal policy; it helped make federal policy possible to implement. When CMS finalized the Interoperability and Patient Access Final Rule, CMS-9115-F, the agency was able to point to a practical standards-based pathway for making claims and encounter information available through Patient Access APIs. The guide gave the market a shared technical foundation for turning a consumer-access vision into operational FHIR APIs.
Subsequent CMS rulemaking and guidance have continued to align with and reference the CARIN IG for Blue Button®. In 2024, the CMS Interoperability and Prior Authorization Final Rule, CMS-0057-F, made extensive reference to the CARIN IG for Blue Button® and updated CMS’s recommendation to CARIN Blue Button® STU 2.0.0 for the Patient Access API. CARIN Blue Button® has continued to evolve alongside these policies, including support for oral and vision claims in STU 2.0.0, non-financial ExplanationOfBenefit profiles and US Core 6.1 alignment in STU 2.1.0, and continued technical refinement in STU 2.2.0.
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Test and Validate the Standard

CARIN works with government and industry partners to make conformance testing resources available to implementers. These resources allow health plans, application developers, and technology vendors to evaluate client and server implementations against CARIN Blue Button® requirements and identify issues before broader deployment.

ONC Inferno Test Kit
As of May 31, 2026, the public CARIN IG for Blue Button Test Kit on Inferno is version 0.16.2. It supports server testing for CARIN Blue Button® v1.1.0, server and client testing for v2.0.0, and server testing for the non-financial proposal. The server suites test SMART on FHIR discovery, the standalone SMART App Launch sequence, CapabilityStatement support, Must Support elements, profile validation, reference validation, and searches on ExplanationOfBenefit. The client suite tests whether applications can retrieve conformant profile instances, perform required searches, and process examples populated with Must Support elements.
‍Explore the CARIN Blue Button® Inferno Test Kit

AEGIS Touchstone Test Scripts
‍AEGIS Touchstone also provides CARIN Blue Button® test scripts for implementers. Available scripts include capability testing and read tests for Coverage, Patient, Practitioner, Organization, and multiple ExplanationOfBenefit profiles. CMS directs implementers to Touchstone for testing questions and support, and CARIN Connectathon materials identify Touchstone scripts as a free testing resource for STU1 and STU2.
‍Explore AEGIS Touchstone CARIN test scripts

Implementation Support
‍CMS points implementers to the CARIN IG for Blue Button® Zulip stream for technical questions. CARIN testing events and Connectathon tracks also provide opportunities to test synthetic data exchange, exercise required interactions, compare approaches, and bring implementation feedback directly to the workgroup.
‍Join the CARIN Blue Button® Zulip discussion
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Resource & IG
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Get Involved

The CARIN Blue Button® Workgroup brings together health plans, application developers, standards experts, providers, policymakers, consumers, and other interested stakeholders to maintain and mature the implementation guide. Participants can bring implementation questions, contribute feedback, take part in testing, and help shape future releases.

IMPLEMENT: View the IG

TEST: Use Inferno

COLLABORATE: Join Zulip

Get Involved!
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