Hi Riki,
Some of the details may vary depending on what domain you are working in, but I can provide one data point from the Radiology perspective.
Due to evolution over the years from the late 90s into the 2000s, several IHE RAD transactions were updated to specify two sets of message semantics, one for 2.3.1 and one for 2.5.1. As an example, look at section 4.1.4.1.2 and the following subsections. Then the Profile says which semantics to implement. The new SWF.b requires implementation of the v2.5.1 semantics. The older (and now retired) SWF profile required implementation of v2.3.1 semantics and had a named option to additionally declare support for v2.5.1 semantics.
https://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_TF_Vol2.pdf
A Volume 4 National Extension could do something similar.
Cheers,
Kevin
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