QRDA - Quality Reporting Document Architecture
Overview
The Quality Reporting Document Architecture (QRDA) is the data submission standard used for a variety of quality measurement and reporting initiatives. It is based on the Health Level Seven International® (HL7®) Clinical Document Architecture (CDA). QRDA creates a standard method to report quality measure results in a structured, consistent format and can be used to exchange eCQM data between systems.
QRDA is a CDA-based standard. It further constrains CDA Release 2 for exchange of eCQM data. QRDA was adopted by the Office of the National Coordinator for Health Information Technology (ONC) as the standard to support both QRDA I (individual patient) and QRDA III (measured entity’s aggregate) data submission approaches for quality reporting.
- QRDA I is an individual patient-level report. It contains quality data for one patient for one or more eCQMs. It is implemented by eligible hospitals (EHs) and critical access hospitals (CAHs) to submit QRDA I data to CMS.
- QRDA III is an aggregate quality report. A QRDA III report contains quality data for a set of patients for one or more eCQMs, It is implemented by eligible clinicians to submit QRDA III data to CMS.
The HL7 Clinical Quality Information Workgroup maintains and updates both HL7 QRDA I and III standards to ensure alignment with other quality-related standards.
CMS publishes QRDA implementation guides (IGs), schematrons, and sample files annually to provide technical guidance for implementing the HL7 QRDA I and III standards for reporting to CMS quality reporting programs. The CMS IGs further constrain the HL7 QRDA standards to support CMS specific requirements, such as requiring CMS program names. The CMS IGs also provide submission guidance for a specific performance/reporting period. Schematron files contain a list of assertion rules used to validate that the generated QRDA reports conform to the requirements specified in the IGs.
Note: IGs, schematrons, and sample files may be updated after initial publication to address stakeholder or policy requirements. Revisit this page for updated resources prior to use.
Current QRDA Reference and Implementation Guides:
Find QRDA Known Issues in the ONC QRDA Known Issues Project.
Connections between Standards
The graphic depicts the flow of quality reporting data between CMS and health care organizations. Health care organizations receive the measure specifications, expressed in HQMF using QDM and CQL and then report results to CMS using QRDA.
2025 Reporting and Performance Period
The 2025 CMS QRDA I Implementation Guide for Hospital Quality Reporting for 2025 eCQM reporting is based on the HL7 CDA Release 2: QRDA Category I, Release 1, Standard for Trial Use Release 5.3 with errata (published December 2022).
- 2025 CMS QRDA I Implementation Guide for Hospital Quality Reporting (published May 2024)
- 2025 CMS QRDA I Schematron and Sample Files for Hospital Quality Reporting (published May 2024)
The 2025 CMS QRDA III IG, Schematron, and Sample Files for Eligible Clinicians for 2025 eCQM reporting is based on the HL7 Implementation Guide for CDA Release 2: QRDA Category III, Release 1 (published September 2021).
- 2025 CMS QRDA III Implementation Guide for Eligible Clinicians (published July 2024)
- 2025 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians (published July 2024)
2024 Reporting and Performance Period
The 2024 CMS QRDA I Implementation Guide for Hospital Quality Reporting for 2024 eCQM reporting is based on the HL7 CDA Release 2: QRDA Category I, Release 1, Standard for Trial Use Release 5.3 with errata (published December 2022).
- 2024 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated August 2023)
- 2024 CMS QRDA I Schematron and Sample Files for Hospital Quality Reporting (Updated August 2023)
The 2024 CMS QRDA III IG, Schematron, and Sample Files for Eligible Clinicians for 2024 eCQM reporting is based on the HL7 Implementation Guide for CDA Release 2: QRDA Category III, Release 1 (published September 2021).
- 2024 CMS QRDA III Implementation Guide for Eligible Clinicians (Updated November 2023)
- 2024 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians (Updated February 2024)
Previous Versions
- Please note - Previous versions are for reference only. Do not use these versions for submissions to CMS.
2023 CMS QRDA I
- 2023 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated August 2023)
- 2023 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated August 2023)
2023 CMS QRDA III
- 2023 CMS QRDA III Implementation Guide for Eligible Clinicians (Updated December 2022)
- 2023 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians (Updated February 2024)
2022 CMS QRDA I
- 2022 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated November 2021)
- 2022 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated November 2021)
2022 CMS QRDA III
- 2022 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated December 2021)
- 2022 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated December 2021)
2021 CMS QRDA I
- 2021 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Published May 2020)
- 2021 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated December 2020)
2021 CMS QRDA III
- 2021 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated May 2021)
- 2021 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated May 2021)
2020 CMS QRDA I
- 2020 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2020 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- 2020 QRDA Category I Conformance Statement Resource
2020 CMS QRDA III
- 2020 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
- 2020 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals
2019 CMS QRDA I
- 2019 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2019 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- 2019 CMS QRDA I Conformance Statement Resource
2019 CMS QRDA III
- 2019 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
- 2019 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals
- Addendum to 2019 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
2018 CMS QRDA I
- 2018 CMS QRDA I Conformance Statement Resource
- 2018 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2018 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- Addendum to 2018 CMS QRDA Category I Implementation Guide for Hospital Quality Reporting
- Sample Hybrid Hospital-Wide Readmission Measure QRDA I file
- Guidance for reporting diagnostic test data in the Diagnostic Study Performed (V3) template of QRDA Category I files
2018 CMS QRDA III
- 2018 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
- 2018 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals
2017 CMS QRDA I
- 2017 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2017 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- 2017 CMS QRDA I Conformance Statement Resource
- Technical Guidance for Valid Reporting of Custodian ID using CMS Certification Numbers in QRDA I Files for Hospital Quality Reporting
- Technical Instructions for QRDA I Submissions for CY 2017 eCQM Reporting
2017 CMS QRDA III
Resources for use when implementing QRDA
CMS QRDA Pre-Submission Validation Tools - The intent of the Validation Tools Resource is to give users a single point of reference for these tools and assist them in selecting the most appropriate tool to meet their individual needs.
QRDA III Conversion Tool – An open source tool for converting QRDA III files to the Quality Payment Program (QPP) JavaScript Object Notation (JSON) format for data submission to the QPP. Using this tool measure developers can test their ability to create a QRDA III file for successful conversion to the QPP JSON format.
Find QRDA Known Issues in the ONC QRDA Known Issues Project.
Visit the eCQI Tools & Key Resources Library for a complete list of tools and resources used with eCQMs and eCQI.
CMS QRDA I (for patient-level data)
- 2024 CMS QRDA I Implementation Guide (IG), Schematron, and Samples File - CMS Quality Bi-Monthly Forum Slides / YouTube - June 20, 2023
- Updated 2023 CMS QRDA I IG and Schematron for Hospital Quality Reporting - CMS Quality Bi-Monthly Forum Slides / YouTube - March 28, 2023
- Updated 2022 CMS QRDA I IG and Hybrid Measure Sample File for Hospital Quality Reporting Slides / YouTube - December 14, 2021
- CMS QRDA Category I IG Changes for CY 2021 Hospital Quality Reporting Slides / YouTube - April 27, 2021
CMS QRDA III (for aggregate data)
- 2023 QRDA III Updates for the CY 2023 Physician Fee Final Rule - CMS Quality Bi-Monthly Forum Slides / YouTube - January 17, 2023
- 2023 QRDA III Updates - CMS Quality Bi-Monthly Forum Slides / YouTube - March 1, 2022
- Final 2022 CMS QRDA III IG Publication - CMS Quality Bi-Monthly Forum Slides / YouTube - July 27, 2021
CMS QRDA I and III
- 2023 CMS QRDA I and III Updates - CMS Quality Bi-Monthly Forum Slides / YouTube - August 11, 2022
- Public Comments on the Draft 2023 CMS QRDA I IG and Updates to the 2023 CMS QRDA III IG and Sample Files - CMS Quality Bi-Monthly Forum Slides / YouTube - May 10, 2022
- 2022 CMS QRDA I and III Updates - CMS Quality Bi-Monthly Forum Slides / YouTube - May 20, 2021
Get Involved
Participate in an upcoming Health Level Seven International® (HL7®) Clinical Quality Information Workgroup call. This Workgroup creates and maintains HL7 standards supporting quality measurement, evaluation, and reporting.
Seek Help and Provide Feedback
Post questions and comments related to the development and implementation of QRDA to the ONC Jira QRDA Issue Tracker. You must have an account to enter a question or comment.
Find QRDA Known Issues in the ONC QRDA Known Issues Project.