Federal IDR outcomes: Neurology

In 2025 Q1–Q4, the provider or facility offer prevailed in 86.0% of 13,565 determined Federal IDR dispute line items for neurology. The median prevailing offer was 45.68x the QPA (25th–75th percentile 10.78x–98.84x; n = 12,957). The median time to a decision was 35 business days (n = 13,565).

Specialty group built from the CMS free-text specialty field; see the grouping rules.

Determined line items

13,565

2025 Q1–Q4 · 14 split decisions excluded

Provider win rate

86.0%

n = 13,565 · 2025 Q1–Q4

Median payment vs QPA

45.68x †

middle half 10.78x–98.84x · n = 12,957 · 2025 Q1–Q4

Median days to decision

business days, from dispute initiation · n = 13,565 · 2025 Q1–Q4

Dollar amounts are not shown for specialty groups: the CMS QPA and Offers file, the only source of dollar figures, has no specialty field. See methodology.

By period

Period	Line items	Win %	Median ×QPA	25th–75th	Ratio n	Median days
2025 Q1–Q4	13,565	86.0%	45.68x †	10.78x–98.84x	12,957	35
2024 Q1–Q4	17,497	85.1%	13.51x	2.19x–57.06x	16,455	57
2023 Q1–Q4	1,247	76.9%	4.85x	1.05x–35.73x	1,200	73
2023 Q1–2025 Q4	32,309	85.2%	27.82x †	3.29x–75.15x	30,612	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

State (place of service)	Line items	Win %	Median ×QPA	Ratio n	Median days
New Jersey	3,406	84.5%	43.92x †	3,244	36
Texas	3,184	90.8%	65.87x †	3,022	32
New York	2,504	84.9%	27.10x †	2,276	37
Ohio	1,064	83.3%	65.82x †	1,063	35
Oklahoma	483	90.3%	91.58x †	464	31
California	481	85.2%	48.39x †	481	30
Tennessee	380	78.4%	37.54x †	368	40.5
Arizona	377	82.0%	44.63x †	374	29
Florida	285	87.7%	81.84x †	279	53
Colorado	277	85.2%	32.98x †	277	32
Connecticut	160	86.2%	25.97x †	155	50.5
Kentucky	160	85.0%	105.95x †	160	44
Georgia	145	83.4%	27.06x †	145	32
Wisconsin	108	82.4%	24.38x †	107	31
Pennsylvania	95	88.4%	62.12x †	94	27
Virginia	95	82.1%	22.98x †	94	42
North Carolina	57	98.2%	31.34x †	56	30
South Carolina	51	90.2%	45.91x †	51	30
Massachusetts	45	80.0%	5.24x	44	30
Louisiana	42	71.4%	14.20x	42	27
Missouri	36	88.9%	50.16x †	36	34.5
Alaska	32	90.6%	8.90x	31	141

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

Most disputed CPT codes

CPT code	Line items	Win %	Median ×QPA	Ratio n	Median days
95938 Placement of skin electrodes and measurement of stimulated sites on arms and leg	1,898	85.6%	118.37x †	1,856	37
95941 Continuous remote monitoring of nervous system during operation, each hour	1,394	85.4%	23.78x †	1,344	41
95937 Testing of nerve-muscle junction	1,197	86.8%	68.29x †	1,166	35
95939 Placement of skin electrodes and measurement of central motor stimulation in arm	1,089	83.6%	51.19x †	1,059	35
95861 Needle measurement of electrical activity in arm or leg muscles, 2 extremities	942	84.4%	44.55x †	905	37
95955 Measurement of brain wave activity (EEG) outside the brain during surgery	732	90.3%	128.85x †	712	34
95720 Measurement of brain wave activity with video (VEEG), 12-26 hours with review an	698	92.6%	45.46x †	594	35.5
99233 Subsequent hospital care with moderate levelof medical decision making, if using	277	92.8%	37.02x †	268	32
95870 Needle measurement of electrical activity in arm, leg, trunk or head muscles, li	275	86.2%	117.99x †	271	38
95886 Needle measurement of electrical activity in arm or leg muscles, complete study	254	81.9%	44.79x †	247	33
95718 Measurement of brain wave activity with video (VEEG), 2-12 hours with review and	251	93.6%	59.19x †	245	34
99232 Subsequent hospital care with moderate levelof medical decision making, if using	241	88.4%	51.72x †	239	27
95957 Measurement of brain wave activity (EEG), digital analysis	185	82.7%	18.97x	185	29
95868 Needle measurement of electrical activity in muscles on both sides of body	184	84.8%	72.17x †	180	33
95940 Continuous monitoring of nervous system during operation, each 15 minutes	179	79.9%	21.32x †	159	64
95907 Nerve conduction, 1-2 studies	166	89.2%	29.90x †	164	35
95908 Nerve conduction, 3-4 studies	165	89.1%	29.31x †	164	33
99223 Initial hospital care with moderate level of medical decision making, if using t	153	90.2%	14.54x	149	30
36226 Insertion of tube into brain artery for diagnosis or treatment with review by ra	144	86.8%	32.92x †	135	31
95865 Needle measurement of electrical activity in voice box muscles	140	89.3%	47.16x †	135	35.5
99291 Critical care, first 30-74 minutes	140	87.1%	31.50x †	121	27
36223 Insertion of tube into intracranial artery for diagnosis or treatment with revie	115	86.1%	39.08x †	114	30
95885 Needle measurement of electrical activity in arm or leg muscles, limited study	107	90.7%	90.91x †	107	38
99222 Initial hospital care with straightforward or low-level medical decision making,	106	91.5%	26.73x †	106	29
36222 Insertion of tube into extracranial artery for diagnosis or treatment with revie	102	88.2%	45.02x †	82	29.5

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

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FAQ

What is the Federal IDR provider win rate for neurology?

In 2025 Q1–Q4, the provider or facility offer was selected in 86.0% of 13,565 determined dispute line items for neurology. 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 neurology?

In 2025 Q1–Q4, the median prevailing offer was 45.68x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 10.78x to 98.84x (n = 12,957 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.

How long do Federal IDR decisions take for neurology?

In 2025 Q1–Q4, the median was 35 business days (n = 13,565 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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