diff --git a/src/main/java/gov/cms/madie/terminology/dto/ValueSetsSearchCriteria.java b/src/main/java/gov/cms/madie/terminology/dto/ValueSetsSearchCriteria.java
index 2bdc1c3..43e99bc 100644
--- a/src/main/java/gov/cms/madie/terminology/dto/ValueSetsSearchCriteria.java
+++ b/src/main/java/gov/cms/madie/terminology/dto/ValueSetsSearchCriteria.java
@@ -12,6 +12,7 @@ public class ValueSetsSearchCriteria {
 
   private String profile;
   private String includeDraft;
+  private String activeOnly;
   private ManifestExpansion manifestExpansion;
   private List<ValueSetParams> valueSetParams;
 
diff --git a/src/main/java/gov/cms/madie/terminology/service/FhirTerminologyService.java b/src/main/java/gov/cms/madie/terminology/service/FhirTerminologyService.java
index 213253d..cc560d7 100644
--- a/src/main/java/gov/cms/madie/terminology/service/FhirTerminologyService.java
+++ b/src/main/java/gov/cms/madie/terminology/service/FhirTerminologyService.java
@@ -64,6 +64,7 @@ public List<QdmValueSet> recursivelyRequestAllValueSetsExpansionsForQDM(
             vsParam,
             valueSetsSearchCriteria.getProfile(),
             valueSetsSearchCriteria.getIncludeDraft(),
+            valueSetsSearchCriteria.getActiveOnly(),
             valueSetsSearchCriteria.getManifestExpansion());
 
     ValueSet valueSetResource = parser.parseResource(ValueSet.class, resource);
diff --git a/src/main/java/gov/cms/madie/terminology/util/TerminologyServiceUtil.java b/src/main/java/gov/cms/madie/terminology/util/TerminologyServiceUtil.java
index 35f17e2..5ae3bb9 100644
--- a/src/main/java/gov/cms/madie/terminology/util/TerminologyServiceUtil.java
+++ b/src/main/java/gov/cms/madie/terminology/util/TerminologyServiceUtil.java
@@ -116,6 +116,7 @@ public static URI buildValueSetResourceUri(
       ValueSetsSearchCriteria.ValueSetParams valueSetParams,
       String profile,
       String includeDraft,
+      String activeOnly,
       ManifestExpansion manifestExpansion) {
     MultiValueMap<String, String> params = new LinkedMultiValueMap<>();
     String expandValueSetUri = "/ValueSet/" + valueSetParams.getOid() + "/$expand";
@@ -134,8 +135,12 @@ public static URI buildValueSetResourceUri(
     } else if (manifestExpansion != null
         && StringUtils.isNotBlank(manifestExpansion.getFullUrl())) {
       params.put("manifest", List.of(manifestExpansion.getFullUrl()));
-    } else if (StringUtils.isNotBlank(includeDraft)) {
-      params.put("includeDraft", List.of("true"));
+    } else {
+      if (StringUtils.isNotBlank(includeDraft)) {
+        params.put("includeDraft", List.of("true"));
+      }
+
+      params.put("activeOnly", List.of(activeOnly));
     }
 
     return UriComponentsBuilder.fromPath(expandValueSetUri).queryParams(params).build().toUri();
diff --git a/src/main/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClient.java b/src/main/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClient.java
index 395054c..8ac2131 100644
--- a/src/main/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClient.java
+++ b/src/main/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClient.java
@@ -108,11 +108,12 @@ public String getValueSetResource(
       ValueSetsSearchCriteria.ValueSetParams valueSetParams,
       String profile,
       String includeDraft,
+      String activeOnly,
       ManifestExpansion manifestExpansion) {
     profile = StringUtils.isNotBlank(profile) ? defaultProfile : profile;
     URI uri =
         TerminologyServiceUtil.buildValueSetResourceUri(
-            valueSetParams, profile, includeDraft, manifestExpansion);
+            valueSetParams, profile, includeDraft, activeOnly, manifestExpansion);
 
     return fetchResourceFromVsac(uri.toString(), apiKey, "ValueSet");
   }
diff --git a/src/test/java/gov/cms/madie/terminology/service/FhirTerminologyServiceTest.java b/src/test/java/gov/cms/madie/terminology/service/FhirTerminologyServiceTest.java
index 78a012d..f3b6ca1 100644
--- a/src/test/java/gov/cms/madie/terminology/service/FhirTerminologyServiceTest.java
+++ b/src/test/java/gov/cms/madie/terminology/service/FhirTerminologyServiceTest.java
@@ -173,6 +173,7 @@ void getValueSetsExpansionsForQdm_When_ManifestExpansionIsProvided() {
                         .build()))
             .profile("test-profile")
             .includeDraft("false")
+            .activeOnly("true")
             .manifestExpansion(
                 ManifestExpansion.builder()
                     .fullUrl("https://cts.nlm.nih.gov/fhir/Library/ecqm-update-2022-05-05")
@@ -180,7 +181,7 @@ void getValueSetsExpansionsForQdm_When_ManifestExpansionIsProvided() {
                     .build())
             .build();
     when(fhirTerminologyServiceWebClient.getValueSetResource(
-            anyString(), any(), anyString(), anyString(), any()))
+            anyString(), any(), anyString(), anyString(), anyString(), any()))
         .thenReturn(mockValueSetResourceWithCodes);
     when(fhirContext.newJsonParser()).thenReturn(FhirContext.forR4().newJsonParser());
     when(mappingService.getCodeSystemEntries()).thenReturn(codeSystemEntries);
@@ -209,6 +210,7 @@ void getsValueSetsExpansionsForQdm_withNoCodes_When_ManifestExpansionIsProvided(
                         .build()))
             .profile("test-profile")
             .includeDraft("false")
+            .activeOnly("false")
             .manifestExpansion(
                 ManifestExpansion.builder()
                     .fullUrl("https://cts.nlm.nih.gov/fhir/Library/ecqm-update-2022-05-05")
@@ -217,11 +219,12 @@ void getsValueSetsExpansionsForQdm_withNoCodes_When_ManifestExpansionIsProvided(
             .build();
     when(fhirContext.newJsonParser()).thenReturn(FhirContext.forR4().newJsonParser());
     when(fhirTerminologyServiceWebClient.getValueSetResource(
-            anyString(),
-            any(ValueSetsSearchCriteria.ValueSetParams.class),
-            anyString(),
-            anyString(),
-            any(ManifestExpansion.class)))
+        anyString(),
+        any(ValueSetsSearchCriteria.ValueSetParams.class),
+        anyString(),
+        anyString(),
+        anyString(),
+        any(ManifestExpansion.class)))
         .thenReturn(mockValueSetResourceWithNoCodes);
     when(mappingService.getCodeSystemEntries()).thenReturn(codeSystemEntries);
     List<QdmValueSet> result =
diff --git a/src/test/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClientTest.java b/src/test/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClientTest.java
index 10c84f2..6e9bef5 100644
--- a/src/test/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClientTest.java
+++ b/src/test/java/gov/cms/madie/terminology/webclient/FhirTerminologyServiceWebClientTest.java
@@ -91,11 +91,11 @@ void getLatestValueSetResourceSuccessfully_when_noCustomSearchCriteriaIsProvided
             .addHeader("Content-Type", "application/fhir+json"));
     String actualResponse =
         fhirTerminologyServiceWebClient.getValueSetResource(
-            MOCK_API_KEY, testValueSetParams, null, null, new ManifestExpansion());
+            MOCK_API_KEY, testValueSetParams, null, null, "false", new ManifestExpansion());
     assertNotNull(actualResponse);
     assertEquals(MOCK_RESPONSE_STRING, actualResponse);
     RecordedRequest recordedRequest = mockBackEnd.takeRequest();
-    assertEquals("/ValueSet/test-vs-id/$expand", recordedRequest.getPath());
+    assertEquals("/ValueSet/test-vs-id/$expand?activeOnly=false", recordedRequest.getPath());
   }
 
   @Test
@@ -108,11 +108,11 @@ void getDraftValueSetResourceSuccessfully_when_noCustomSearchCriteriaIsProvided(
             .addHeader("Content-Type", "application/fhir+json"));
     String actualResponse =
         fhirTerminologyServiceWebClient.getValueSetResource(
-            MOCK_API_KEY, testValueSetParams, null, "yes", new ManifestExpansion());
+            MOCK_API_KEY, testValueSetParams, null, "yes", "false", new ManifestExpansion());
     assertNotNull(actualResponse);
     assertEquals(MOCK_RESPONSE_STRING, actualResponse);
     RecordedRequest recordedRequest = mockBackEnd.takeRequest();
-    assertEquals("/ValueSet/test-vs-id/$expand?includeDraft=true", recordedRequest.getPath());
+    assertEquals("/ValueSet/test-vs-id/$expand?includeDraft=true&activeOnly=false", recordedRequest.getPath());
   }
 
   @Test
@@ -129,6 +129,7 @@ void getValueSetResourceSuccessfully_when_manifestExpansionIsProvided()
             testValueSetParams,
             null,
             null,
+            "true",
             ManifestExpansion.builder()
                 .id("test-manifest-456")
                 .fullUrl("https://cts.nlm.nih.gov/fhir/Library/test-manifest-456")
@@ -152,7 +153,7 @@ void getValueSetResourceSuccessfully_when_ValueSetVersionIsProvided()
     testValueSetParams.setVersion("test-value-set-version-2024");
     String actualResponse =
         fhirTerminologyServiceWebClient.getValueSetResource(
-            MOCK_API_KEY, testValueSetParams, null, null, new ManifestExpansion());
+            MOCK_API_KEY, testValueSetParams, null, null, "false", new ManifestExpansion());
     assertNotNull(actualResponse);
     assertEquals(MOCK_RESPONSE_STRING, actualResponse);
     RecordedRequest recordedRequest = mockBackEnd.takeRequest();
@@ -169,9 +170,9 @@ void getValueSetResource_ReturnsException() throws InterruptedException {
         WebClientResponseException.class,
         () ->
             fhirTerminologyServiceWebClient.getValueSetResource(
-                MOCK_API_KEY, testValueSetParams, null, null, new ManifestExpansion()));
+                MOCK_API_KEY, testValueSetParams, null, null, "false", new ManifestExpansion()));
     RecordedRequest recordedRequest = mockBackEnd.takeRequest();
-    assertEquals("/ValueSet/test-vs-id/$expand", recordedRequest.getPath());
+    assertEquals("/ValueSet/test-vs-id/$expand?activeOnly=false", recordedRequest.getPath());
   }
 
   @Test