CMS-0057-F

A practical roadmap to real-time, automated prior authorization

  • Understand CMS-0057-F requirements and deadlines (2026–2027)
  • Build an architecture that supports real-time prior auth workflows
  • Reduce administrative burden and accelerate ROI through automation

What’s inside

This practical guide breaks down what payers must deliver to support FHIR-based prior authorization—without rebuilding core systems.

Inside, you’ll find:

  • CMS-0057-F requirements and reporting obligations, at a glance
  • Key deadlines for decision timeframes, denial reasons, and API go-live
  • What CRD, DTR, and PAS mean in practice, and how they work together
  • The ROI case for modernizing prior authorization workflows
  • Recommended modular architecture for a CMS-ready FHIR layer
  • A phased roadmap to implementation, testing, and rollout

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