German Practice Management FHIR Profiles (R4)
0.90.0 - STU1
Germany
German Practice Management FHIR Profiles (R4) - Local Development build (v0.90.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Official URL: https://fhir.cognovis.de/praxis/ImplementationGuide/de.cognovis.fhir.praxis | Version: 0.90.0 | |||
| Active as of 2026-07-29 | Computable Name: GermanPracticeManagementProfiles | |||
| Other Identifiers: OID:2.16.840.1.113883.3.7985 | ||||
FHIR R4 profiles and extensions for German ambulatory practice management (Vertragsarzt/MVZ). This Implementation Guide defines a comprehensive, PVS-agnostic extension layer for the day-to-day data needs of German medical practices — from billing and budget management to AI provenance tracking under the EU AI Act.
Any German practice management system can map its internal data model to these profiles. The IG deliberately avoids vendor-specific structures and instead models the shared regulatory and clinical domain.
| Domain | Description |
|---|---|
| Billing (EBM/GOÄ/BGT) | EBM-Ziffern, GOÄ-Faktoren inkl. Sachkosten/Analogziffern, BGT2001, Scheinarten, Abrechnungsquartal |
| Selektivverträge (HZV) | Generisches Katalogmodell für HZV/Facharztverträge aller KV-Regionen über ChargeItemDefinition |
| Budget Management (RLV/QZV) | Regelleistungsvolumen, qualifikationsgebundene Zusatzvolumina, Entbudgetierung |
| Remittance (Honorarbescheid) | KV-Honorarbescheide, Richtigstellungen, Auszahlungsbeträge |
| Private Billing Workflow | Freigabe-/Review-Status für Privatrechnungen |
| Queue Management (Warteraum) | Ankunftszeiten, Aufrufzeiten, R5-Encounter.subjectStatus-Backport |
| AI Provenance | Bounded compatibility profile for accepted-resource lineage with the official HL7 AI Device constraint |
| Administrative Workflows | Aufgaben, Genehmigungen, Überweisungen, Einweisungen, Einwilligungen, AU-Bescheinigungen |
HZV-Verträge werden nicht in dieser IG enumeriert — die konkreten Vertragsausprägungen (AOK Bayern, TK, etc.) werden durch den jeweiligen PVS-Adapter als Contract-Ressourcen erzeugt und via Account.coverage -> Coverage(HZV) referenziert (die EXT_HZV.rechnungsschema Extension wurde in Version 0.69.0 retired; der Vertragskontext liegt jetzt auf dem AccountPraxisSchein). Die IG definiert nur die Struktur, nicht den Inhalt der Verträge.
Bei Leistungen im Rahmen eines Hausarztvertrags (73b SGB V) oder Facharztvertrags (73b SGB V) oder Facharztvertrags (
https://fhir.cognovis.de/praxis/CodeSystem/hzv-bayern-ek), nicht EBM.
EBM bleibt nur korrekt, wenn die Leistung tatsächlich im EBM-Kontext abgerechnet wird.Coverage.class (Vertragsreferenz)
und Contract (Vertragsdetails mit Contract.identifier / hvg-Extensions) abgebildet.Siehe Beispiel: HZV-Szenario (Coverage mit HZV class, Contract mit hvg-kennung, ChargeItem mit HZV-Katalog-CodeSystem).
This IG builds on the German and international FHIR packages declared in
sushi-config.yaml, including:
The following standards are used as semantic references or mapping targets, but are not necessarily direct package dependencies:
cognovis GmbH — cognovis.de
This Implementation Guide is published under CC-BY-4.0.
Draft / CI-Build — This IG is under active development. Breaking changes may occur between versions.
These profiles are designed with international FHIR concepts in mind. Where possible, they use standard R4 resources and documented mappings to international equivalents. See the International Interoperability page for detailed mapping tables.
Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00) |
Package hl7.fhir.uv.extensions.r4#5.3.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, May 16, 2026 18:32+1000+10:00) |
Package de.basisprofil.r4#1.5.4 Projekt Basisprofilierung R4 (HL7 Deutschland e.V.) |
Package de.cognovis.terminology.imaging#1.1.0 FHIR terminology resources for radiation billing triggers, contrast agents, justifying indications, imaging procedure codes, and radiation protection qualifications. Covers EBM chapter 34, GOÄ 5000-5855, BEMA dental radiology Ä-codes, DICOM CID 12, and ICD-10-GM. |
Package de.cognovis.terminology.esco#1.0.0 FHIR terminology package containing a curated ESCO occupation fragment and ValueSet for German practice-function modelling. ESCO source version: v1.2.0. |
Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00) |
Package ihe.rad.imr#1.1.0 Support encoding and presentation of an interactive multimedia report (built Thu, Jun 20, 2024 08:48-0500-05:00) |
Package dvmd.kdl.r4#2025.0.1 Publikation der Terminologie-Ressourcen für die Nutzung der Klinische Dokumentenklassen-Liste (KDL) des DVMD Version 2025 |
Package hl7.fhir.uv.ips#1.1.0 International Patient Summary (IPS) FHIR Implementation Guide (built Tue, Nov 22, 2022 03:24+0000+00:00) |
Package de.cognovis.terminology.kbv#1.0.0 KBV Schluesseltabellen and Basis-Terminologie from MII SU-TermServ. |
Package de.cognovis.terminology.heilmittel#1.0.1 FHIR terminology mirror of the gevko eHeilmittelverordnung (Muster 13) CodeSystems and ValueSets. Source: de.gevko.evo.hlm@1.3.0 (https://fhir.gevko.de/). Mirror: keeps original gevko canonical URLs unchanged. Consumers: fhir-praxis-de IG, polaris codegen. |
Package hl7.fhir.uv.xver-r5.r4#0.1.0 Extensions for Using Data Elements from FHIR R5 in FHIR R4 (built Fri, Mar 20, 2026 15:40+1100+11:00) |
Package hl7.fhir.eu.extensions.r4#1.3.0 This guide lists the extensions specified for the European REALM. (built Fri, Mar 27, 2026 19:47+0100+01:00) |
Package ihe.pharm.mpd.r4#1.0.0-comment-2 ImplementationGuide for IHE Pharmacy Medication Prescription and Dispense (MPD) profile (built Tue, May 27, 2025 16:32+0200+02:00) |
Package hl7.fhir.eu.base#2.0.0 This guide collects base and core profiles to be used in the European context. It also includes common artifacts, such as the profiles describing the European Health Insurance Card. (built Mon, Apr 27, 2026 22:40+0300+03:00) |
Package kbv.basis#1.9.0 KBV-Basis-Profile V 1.9.0 Package beinhaltet nur die Resources, Terminologie-Dateien und Example-Dateien. |
Package de.basisprofil.r4#1.5.2 Projekt Basisprofilierung R4 (HL7 Deutschland e.V.) |
Package hl7.fhir.uv.subscriptions-backport.r4#1.1.0 The Subscription R5 Backport Implementation Guide enables servers running versions of FHIR earlier than R5 to implement a subset of R5 Subscriptions in a standardized way. (built Wed, Jan 11, 2023 15:34+1100+11:00) |
Package de.gematik.isik-basismodul#4.0.3 Put a description here |
Package de.ihe-d.terminology#3.0.1 de.ihe-d.terminology |
Package de.gematik.dipag#1.0.8 Der 'Digitale Patientenrechnung'-Fachdienst ermöglicht es Versicherten (allgemein Rechnungsempfängern) Rechnungen von Leistungserbringern zu erhalten und bei Kostenträgern einzureichen. |
Package hl7.fhir.uv.sdc#3.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. |
Package hl7.fhir.uv.security-label-ds4p#1.0.0 FHIR data segmentation for privacy security label implementation guide (built Mon, Apr 17, 2023 19:19+0000+00:00) |
Package hl7.fhir.uv.aitransparency#1.0.0-ballot Provides guidance for representing the usage of AI in influencing FHIR resources. Starting with how to tag FHIR resources, and expanding into how to use Provenance, Device, and other data elements, this FHIR IG provides standards that enable downstream use cases to identify such resources. This allows the informed usage of AI-inferred health data. (built Tue, Dec 9, 2025 18:35+0000+00:00) |
Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00) |
This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (de.cognovis.fhir.praxis.r4) and R4B (de.cognovis.fhir.praxis.r4b) are available.
There are no Global profiles defined
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