CPT 97112: Federal IDR outcomes
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes
In 2023 Q1–2025 Q4, the provider or facility offer prevailed in 90.9% of 77 determined Federal IDR dispute line items for CPT 97112. The median prevailing offer was 2.80x the QPA (25th–75th percentile 2.78x–2.80x; n = 62).
Determined line items
77
2023 Q1–2025 Q4 · 0 split decisions excluded
Provider win rate
90.9%
n = 77 · 2023 Q1–2025 Q4
Median payment vs QPA
2.80x
middle half 2.78x–2.80x · n = 62 · 2023 Q1–2025 Q4
Median days to decision
–
not pooled across years (CMS changed the definition in 2025)
Dollar amounts
Total awarded
$13,682
sum of prevailing offers · n = 46 · 2024 Q3–2025 Q4
Total QPA
$4,951
sum of QPAs, same line items · n = 46 · 2024 Q3–2025 Q4
Awarded above QPA
$8,731
total awarded minus total QPA · n = 46 · 2024 Q3–2025 Q4
Median award per line item
$250
mean $297 · n = 46 · 2024 Q3–2025 Q4
Median QPA
$90
per line item · n = 46 · 2024 Q3–2025 Q4
Award vs QPA, dollar-weighted
2.76x
total awarded ÷ total QPA · n = 46 · 2024 Q3–2025 Q4
Dollar amounts come from the separate CMS “QPA and Offers” file: line items decided for the provider or the plan with a non-suppressed QPA and prevailing offer. That file cannot be joined to the line items above, so its n differs. Awarded = the prevailing (selected) offer; it is not a record of what was paid. State comes from the file’s geographic region; a metro area that spans states counts in each. How the dollar figures work
Dollar amounts by period
| Period | Line items with $ | Total awarded | Total QPA | Above QPA | Median award | Median QPA | Award ×QPA ($-weighted) |
|---|---|---|---|---|---|---|---|
| 2025 Q1–Q4 | Fewer than 30 line items with dollar amounts; not shown. | ||||||
| 2024 Q3–Q4 | 46 | $13,682 | $4,951 | $8,731 | $250 | $90 | 2.76x |
| 2024 Q3–2025 Q4 | 46 | $13,682 | $4,951 | $8,731 | $250 | $90 | 2.76x |
| 2023 Q1–2024 Q2 | Not available (see methodology). | ||||||
From the CMS QPA and Offers file (see above). Award ×QPA here is total awarded ÷ total QPA, so large claims weigh more than in the per-line median ratio.
By period
| Period | Line items | Win % | Median ×QPA | 25th–75th | Ratio n | Median days |
|---|---|---|---|---|---|---|
| 2025 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2024 Q1–Q4 | 50 | 92.0% | 2.80x | 2.78x–2.80x | 50 | 31 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 77 | 90.9% | 2.80x | 2.78x–2.80x | 62 | not pooled |
Line items = determined dispute line items (n). Win rate excludes split decisions and includes default decisions. Ratio n = line items reporting a payment-to-QPA ratio. Days are business days as reported by CMS (2023–2024: from IDR entity assignment; 2025: from initiation) and are never pooled.
By state
No row has 30 or more determined line items in 2025 Q1–Q4.
By specialty
No row has 30 or more determined line items in 2025 Q1–Q4.
Section: Medicine (90281–99607, excluding E/M)
FAQ
What is the Federal IDR provider win rate for CPT 97112?
In 2023 Q1–2025 Q4, the provider or facility offer was selected in 90.9% of 77 determined dispute line items for CPT 97112. Split decisions are excluded from the denominator and default decisions are included. Withdrawn, settled and ineligible disputes are not in the CMS data.
How do Federal IDR payments compare with the QPA for CPT 97112?
In 2023 Q1–2025 Q4, the median prevailing offer was 2.80x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.78x to 2.80x (n = 62 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.