diff --git a/src/extractor/OnlyRuleExtractor.ts b/src/extractor/OnlyRuleExtractor.ts
index 878f7143..8b2450ed 100644
--- a/src/extractor/OnlyRuleExtractor.ts
+++ b/src/extractor/OnlyRuleExtractor.ts
@@ -1,3 +1,4 @@
+import { fshrules } from 'fsh-sushi';
 import { ProcessableElementDefinition } from '../processor';
 import { ExportableOnlyRule } from '../exportable';
 import { getPath } from '../utils';
@@ -9,9 +10,17 @@ export class OnlyRuleExtractor {
     }
     const onlyRule = new ExportableOnlyRule(getPath(input));
     input.type.forEach((t, i) => {
-      if (['Reference', 'CodeableReference'].includes(t.code) && t.targetProfile) {
+      if (['Reference', 'CodeableReference', 'canonical'].includes(t.code) && t.targetProfile) {
+        const targeting: Partial<fshrules.OnlyRuleType> = {};
+        if (t.code === 'Reference') {
+          targeting.isReference = true;
+        } else if (t.code === 'CodeableReference') {
+          targeting.isCodeableReference = true;
+        } else {
+          targeting.isCanonical = true;
+        }
         t.targetProfile.forEach((tp, tpi) => {
-          onlyRule.types.push({ type: tp, isReference: true });
+          onlyRule.types.push(Object.assign({ type: tp }, targeting));
           input.processedPaths.push(`type[${i}].targetProfile[${tpi}]`);
         });
       } else if (t.profile) {
diff --git a/test/extractor/OnlyRuleExtractor.test.ts b/test/extractor/OnlyRuleExtractor.test.ts
index 1cf50385..0978482b 100644
--- a/test/extractor/OnlyRuleExtractor.test.ts
+++ b/test/extractor/OnlyRuleExtractor.test.ts
@@ -82,8 +82,11 @@ describe('OnlyRuleExtractor', () => {
     const onlyRule = OnlyRuleExtractor.process(element);
     const expectedRule = new ExportableOnlyRule('activity.performedActivity');
     expectedRule.types = [
-      { type: 'http://hl7.org/fhir/StructureDefinition/Observation', isReference: true },
-      { type: 'http://hl7.org/fhir/StructureDefinition/MolecularSequence', isReference: true }
+      { type: 'http://hl7.org/fhir/StructureDefinition/Observation', isCodeableReference: true },
+      {
+        type: 'http://hl7.org/fhir/StructureDefinition/MolecularSequence',
+        isCodeableReference: true
+      }
     ];
     expect(onlyRule).toEqual<ExportableOnlyRule>(expectedRule);
     expect(element.processedPaths).toEqual([
@@ -107,6 +110,99 @@ describe('OnlyRuleExtractor', () => {
     expect(element.processedPaths).toEqual(['type[0].code', 'type[1].profile[0]', 'type[1].code']);
   });
 
+  it('should extract an only rule with a subset of a canonical type', () => {
+    const element = ProcessableElementDefinition.fromJSON(
+      sdWithCodeableReference.differential.element[4]
+    );
+    const onlyRule = OnlyRuleExtractor.process(element);
+    const expectedRule = new ExportableOnlyRule('extension[toast].value[x]');
+    expectedRule.types = [
+      { type: 'http://hl7.org/fhir/StructureDefinition/Observation', isCanonical: true },
+      {
+        type: 'http://hl7.org/fhir/StructureDefinition/Patient',
+        isCanonical: true
+      }
+    ];
+    expect(onlyRule).toEqual<ExportableOnlyRule>(expectedRule);
+    expect(element.processedPaths).toEqual([
+      'type[0].targetProfile[0]',
+      'type[0].targetProfile[1]',
+      'type[0].code'
+    ]);
+  });
+
+  it('should extract an only rule on an element with both Reference and CodeableReference types', () => {
+    const element = ProcessableElementDefinition.fromJSON(
+      sdWithCodeableReference.differential.element[2]
+    );
+    const onlyRule = OnlyRuleExtractor.process(element);
+    const expectedRule = new ExportableOnlyRule('extension[bar].value[x]');
+    expectedRule.types = [
+      { type: 'http://hl7.org/fhir/StructureDefinition/Practitioner', isReference: true },
+      { type: 'http://hl7.org/fhir/StructureDefinition/Patient', isReference: true },
+      { type: 'http://hl7.org/fhir/StructureDefinition/Observation', isCodeableReference: true },
+      {
+        type: 'http://hl7.org/fhir/StructureDefinition/DiagnosticReport',
+        isCodeableReference: true
+      }
+    ];
+    expect(onlyRule).toEqual<ExportableOnlyRule>(expectedRule);
+    expect(element.processedPaths).toEqual([
+      'type[0].targetProfile[0]',
+      'type[0].targetProfile[1]',
+      'type[0].code',
+      'type[1].targetProfile[0]',
+      'type[1].targetProfile[1]',
+      'type[1].code'
+    ]);
+  });
+
+  it('should extract an only rule on an element with CodeableReference and non-Reference types', () => {
+    const element = ProcessableElementDefinition.fromJSON(
+      sdWithCodeableReference.differential.element[3]
+    );
+    const onlyRule = OnlyRuleExtractor.process(element);
+    const expectedRule = new ExportableOnlyRule('extension[cookie].value[x]');
+    expectedRule.types = [
+      { type: 'string' },
+      { type: 'http://hl7.org/fhir/StructureDefinition/Observation', isCodeableReference: true },
+      {
+        type: 'http://hl7.org/fhir/StructureDefinition/DiagnosticReport',
+        isCodeableReference: true
+      }
+    ];
+    expect(onlyRule).toEqual<ExportableOnlyRule>(expectedRule);
+    expect(element.processedPaths).toEqual([
+      'type[0].code',
+      'type[1].targetProfile[0]',
+      'type[1].targetProfile[1]',
+      'type[1].code'
+    ]);
+  });
+
+  it('should extract an only rule with canonical and non-canonical types', () => {
+    const element = ProcessableElementDefinition.fromJSON(
+      sdWithCodeableReference.differential.element[5]
+    );
+    const onlyRule = OnlyRuleExtractor.process(element);
+    const expectedRule = new ExportableOnlyRule('extension[blank].value[x]');
+    expectedRule.types = [
+      { type: 'http://hl7.org/fhir/StructureDefinition/Patient', isCanonical: true },
+      {
+        type: 'http://hl7.org/fhir/StructureDefinition/Observation',
+        isCanonical: true
+      },
+      { type: 'Annotation' }
+    ];
+    expect(onlyRule).toEqual<ExportableOnlyRule>(expectedRule);
+    expect(element.processedPaths).toEqual([
+      'type[0].targetProfile[0]',
+      'type[0].targetProfile[1]',
+      'type[0].code',
+      'type[1].code'
+    ]);
+  });
+
   it('should return null when the element has no type info', () => {
     const element = ProcessableElementDefinition.fromJSON(looseSD.differential.element[4]);
     const onlyRule = OnlyRuleExtractor.process(element);
diff --git a/test/extractor/fixtures/only-profile-with-codeablereference.json b/test/extractor/fixtures/only-profile-with-codeablereference.json
index a086e774..3d9a88bf 100644
--- a/test/extractor/fixtures/only-profile-with-codeablereference.json
+++ b/test/extractor/fixtures/only-profile-with-codeablereference.json
@@ -34,6 +34,71 @@
             "versioning": "either"
           }
         ]
+      },
+      {
+        "id": "CarePlan.extension:bar.value[x]",
+        "path": "CarePlan.extension:bar.value[x]",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": [
+              "http://hl7.org/fhir/StructureDefinition/Practitioner",
+              "http://hl7.org/fhir/StructureDefinition/Patient"
+            ]
+          },
+          {
+            "code": "CodeableReference",
+            "targetProfile": [
+              "http://hl7.org/fhir/StructureDefinition/Observation",
+              "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
+            ]
+          }
+        ]
+      },
+      {
+        "id": "CarePlan.extension:cookie.value[x]",
+        "path": "CarePlan.extension:cookie.value[x]",
+        "type": [
+          {
+            "code": "string"
+          },
+          {
+            "code": "CodeableReference",
+            "targetProfile": [
+              "http://hl7.org/fhir/StructureDefinition/Observation",
+              "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
+            ]
+          }
+        ]
+      },
+      {
+        "id": "CarePlan.extension:toast.value[x]",
+        "path": "CarePlan.extension:toast.value[x]",
+        "type": [
+          {
+            "code": "canonical",
+            "targetProfile": [
+              "http://hl7.org/fhir/StructureDefinition/Observation",
+              "http://hl7.org/fhir/StructureDefinition/Patient"
+            ]
+          }
+        ]
+      },
+      {
+        "id": "CarePlan.extension:blank.value[x]",
+        "path": "CarePlan.extension:blank.value[x]",
+        "type": [
+          {
+            "code": "canonical",
+            "targetProfile": [
+              "http://hl7.org/fhir/StructureDefinition/Patient",
+              "http://hl7.org/fhir/StructureDefinition/Observation"
+            ]
+          },
+          {
+            "code": "Annotation"
+          }
+        ]
       }
     ]
   }