The 2027 Annual Update draft measure specifications are now available. Question and comment on Eligible Clinician eCQMs, Hospital - Inpatient eCQMs, and Hospital - Outpatient eCQM until December 19, 2025.
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Now Available: 2026 CMS QRDA I Implementation Guide (IG), Schematron, and Sample Files for Hospital Quality Reporting (HQR)
The Centers for Medicare & Medicaid Services (CMS) has published the 2026 CMS Quality Reporting Document Architecture (QRDA) Category I Implementation Guide (IG), Schematron, and Sample Files for Hospital Quality Reporting (HQR). The 2026 CMS QRDA I IG outlines requirements for hospitals to report electronic clinical quality measures (eCQMs) for the calendar year 2026 reporting period for the Hospital Inpatient Quality Reporting (IQR) Program, the Medicare Promoting Interoperability Program, and the Outpatient Quality Reporting (OQR) Program.
The 2026 CMS QRDA I IG contains these high-level changes compared with the 2025 CMS QRDA I IG, Version 1.1:
- Updated the QRDA Category I Report – CMS template to Version 9 with an updated templateId extension
- Updated the conformance statements to use the Federal Administrative Sex value set for patient sex
- Updated HQR validation rule CMS_0073 to validate with the updated QRDA Category I Report – CMS (V9) templateId extension
- Updated HQR validation rule CMS_0082 for CMS EHR Certification ID format starts with “2026C”
- Updated eCQM information to align with the updated version for the 2026 reporting period
The 2026 CMS QRDA I Schematron File contains these high-level changes:
- Updated to support the QRDA Category I Report – CMS (V9) template version updates
- Updated to support the changes to the conformance statements for using the Federal Administrative Sex value set
The 2026 CMS QRDA I Sample Files updates include:
- Updated to submit patient sex using code from the Federal Administrative Sex value set
- Updated eCQM information to align with the updated versions for the 2026 reporting period
Additional QRDA-Related Resources:
- To learn more, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center QRDA and Getting Started with eCQMs pages.
- For questions related to the QRDA IGs and/or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.
- See the QRDA Known Issues Dashboard for solutions under development for both QRDA I and III known technical issues. These known issues supplement the information in QRDA IGs and other supporting documents.
Last Updated: Dec 04, 2025