diff --git a/library/package-manager.js b/library/package-manager.js
index c0a5681..00693d1 100644
--- a/library/package-manager.js
+++ b/library/package-manager.js
@@ -587,6 +587,50 @@ class PackageManager {
         }
     }
 
+    /**
+     * Fetch a package directly from a URL (e.g., a CI build .tgz)
+     * @param {string} url - URL to a package.tgz file
+     * @returns {Promise<string>} Path to extracted package folder
+     */
+    async fetchUrl(url) {
+        console.log("Fetch Package from URL: " + url);
+        const client = new CIBuildClient();
+        const packageData = await client.fetchFromUrlSpecific(url);
+
+        // Extract to a temp location to read package.json for name and version
+        const tempKey = `_url_temp_${Date.now()}`;
+        const tempPath = await this.extractToCache(tempKey, 'url', packageData);
+        const tempFullPath = path.join(this.cacheFolder, tempPath);
+
+        // Read package name and version from the extracted package
+        const pkgJsonPath = path.join(tempFullPath, 'package', 'package.json');
+        const pkgJson = JSON.parse(await fs.readFile(pkgJsonPath, 'utf8'));
+        const packageId = pkgJson.name;
+        const version = pkgJson.version;
+
+        if (!packageId || !version) {
+            throw new Error(`Package at ${url} has no name or version in package.json`);
+        }
+
+        // Use the same cache key format as npm packages
+        const finalName = `${packageId}#${version}`;
+        const finalPath = path.join(this.cacheFolder, finalName);
+
+        // If it already exists, the same package is already loaded - that's a config error
+        try {
+            await fs.access(finalPath);
+            await fs.rm(tempFullPath, { recursive: true, force: true });
+            throw new Error(`Package ${finalName} already exists in cache. Check library config for duplicates (url: ${url})`);
+        } catch (e) {
+            if (e.message.includes('already exists')) throw e;
+            // Doesn't exist yet, rename temp to final
+            await fs.rename(tempFullPath, finalPath);
+        }
+
+        this.totalDownloaded = this.totalDownloaded + packageData.length;
+        return finalName;
+    }
+
     /**
      * Extract package to cache folder
      * @param {string} packageId - Package identifier
@@ -857,7 +901,9 @@ class PackageContentLoader {
     }
 
     fhirVersion() {
-        return this.package.fhirVersions[0];
+        // Handle both modern 'fhirVersions' and older 'fhir-version-list' formats
+        const versions = this.package.fhirVersions || this.package['fhir-version-list'];
+        return versions ? versions[0] : undefined;
     }
 
     id() {
diff --git a/tests/library/package-manager.test.js b/tests/library/package-manager.test.js
index e4574d7..47d0571 100644
--- a/tests/library/package-manager.test.js
+++ b/tests/library/package-manager.test.js
@@ -305,6 +305,37 @@ const runTests = shouldRunSlowTests();
                   .toThrow('At least one package server must be provided');
             });
         });
+
+        describe('fetchUrl', () => {
+            test('should fetch a package from a direct URL and use name#version cache key', async () => {
+                const packageManager = new PackageManager(SERVERS, CACHE_FOLDER);
+                const url = 'https://packages2.fhir.org/packages/hl7.fhir.uv.tools/0.2.0';
+                const result = await packageManager.fetchUrl(url);
+                expect(result).toBe('hl7.fhir.uv.tools#0.2.0');
+
+                // Verify the extracted package has content
+                const packageDir = path.join(CACHE_FOLDER, result);
+                const files = await fs.readdir(path.join(packageDir, 'package'));
+                expect(files).toContain('package.json');
+            }, 30000);
+
+            test('should throw on duplicate fetch of same package', async () => {
+                const packageManager = new PackageManager(SERVERS, CACHE_FOLDER);
+                const url = 'https://packages2.fhir.org/packages/hl7.fhir.uv.tools/0.2.0';
+                await packageManager.fetchUrl(url);
+                await expect(
+                    packageManager.fetchUrl(url)
+                ).rejects.toThrow(/already exists in cache/);
+            }, 30000);
+
+            test('should throw on invalid URL', async () => {
+                const packageManager = new PackageManager(SERVERS, CACHE_FOLDER);
+                await expect(
+                    packageManager.fetchUrl('https://invalid.example.com/nonexistent/package.tgz')
+                ).rejects.toThrow();
+            }, 30000);
+        });
+
     });
 
     describe('PackageContentLoader', () => {
diff --git a/tx/README.md b/tx/README.md
index aaf679a..c0f249e 100644
--- a/tx/README.md
+++ b/tx/README.md
@@ -298,6 +298,22 @@ You can specify a version using the `#` syntax:
 
 If no version is specified, the latest released version is fetched.
 
+#### `url` - FHIR Packages from Direct URLs
+
+Loads a FHIR package directly from a tarball URL instead of the FHIR package registry. Useful for packages hosted on CI build servers, branches, or other locations.
+
+Use `url/cs` to load only CodeSystem resources from the package (same as `npm/cs`).
+
+```yaml
+# Load a package from a CI build server
+- url:https://example.com/my-package/package.tgz
+
+# Load a code-systems-only package from a URL
+- url/cs:https://example.com/my-codesystems/package.tgz
+```
+
+The URL must point to a `.tgz` file in standard FHIR NPM package format. Downloaded packages are cached locally by URL.
+
 ### Default Marker (`!`)
 
 When multiple versions of the same code system are loaded, append `!` to mark one as the default:
diff --git a/tx/library.js b/tx/library.js
index c4cba4f..c1cada9 100644
--- a/tx/library.js
+++ b/tx/library.js
@@ -255,6 +255,14 @@ class Library {
         await this.loadNpm(packageManager, details, isDefault, mode, true);
         break;
 
+      case 'url':
+        await this.loadUrl(packageManager, details, isDefault, mode, false);
+        break;
+
+      case 'url/cs':
+        await this.loadUrl(packageManager, details, isDefault, mode, true);
+        break;
+        
       default:
         throw new Error(`Unknown source type: ${type}`);
     }
@@ -459,6 +467,41 @@ class Library {
     this.#logPackage(contentLoader.id(), contentLoader.version(), csc, vs ? vs.valueSetMap.size : 0);
   }
 
+  async loadUrl(packageManager, url, isDefault, mode, csOnly) {
+    const packagePath = await packageManager.fetchUrl(url);
+    if (mode === "fetch" || mode === "cs") {
+      return;
+    }
+    const fullPackagePath = path.join(this.cacheFolder, packagePath);
+    const contentLoader = new PackageContentLoader(fullPackagePath);
+    await contentLoader.initialize();
+
+    this.contentSources.push(contentLoader.id()+"#"+contentLoader.version());
+
+    let cp = new ListCodeSystemProvider();
+    const resources = await contentLoader.getResourcesByType("CodeSystem");
+    let csc = 0;
+    for (const resource of resources) {
+      const cs = new CodeSystem(await contentLoader.loadFile(resource, contentLoader.fhirVersion()));
+      cs.sourcePackage = contentLoader.pid();
+      cp.codeSystems.set(cs.url, cs);
+      cp.codeSystems.set(cs.vurl, cs);
+      csc++;
+    }
+    this.codeSystemProviders.push(cp);
+    let vs = null;
+    if (!csOnly) {
+      vs = new PackageValueSetProvider(contentLoader);
+      await vs.initialize();
+      this.valueSetProviders.push(vs);
+      const cm = new PackageConceptMapProvider(contentLoader);
+      await cm.initialize();
+      this.conceptMapProviders.push(cm);
+    }
+
+    this.#logPackage(contentLoader.id(), contentLoader.version(), csc, vs ? vs.valueSetMap.size : 0);
+  }
+
   /**
    * Gets a file from local folder or downloads it from URL
    * @param {string} fileName - Name of the file