Federal IDR outcomes: Pain medicine in Arizona
In 2025 Q1–Q4, the provider or facility offer prevailed in 80.1% of 437 determined Federal IDR dispute line items for pain medicine in Arizona. The median prevailing offer was 50.11x the QPA (25th–75th percentile 22.11x–72.50x; n = 437). The median time to a decision was 21 business days (n = 437).
Determined line items
437
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
80.1%
n = 437 · 2025 Q1–Q4
Median days to decision
21
business days, from dispute initiation · n = 437 · 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 | 437 | 80.1% | 50.11x † | 22.11x–72.50x | 437 | 21 |
| 2024 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 437 | 80.1% | 50.11x † | 22.11x–72.50x | 437 | 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.
Most disputed CPT codes
| CPT code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 00812 Anesthesia for exam of colon using an endoscope | 213 | 78.4% | 47.71x † | 213 | 21 |
| 00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using | 65 | 76.9% | 58.46x † | 65 | 23 |
| 01992 Anesthesia for nerve block and injection procedure, prone position | 40 | 87.5% | 48.56x † | 40 | 21 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Arizona · Pain medicine in all states
FAQ
What is the Federal IDR provider win rate for pain medicine in Arizona?
In 2025 Q1–Q4, the provider or facility offer was selected in 80.1% of 437 determined dispute line items for pain medicine in Arizona. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 pain medicine in Arizona?
In 2025 Q1–Q4, the median prevailing offer was 50.11x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 22.11x to 72.50x (n = 437 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 pain medicine in Arizona?
In 2025 Q1–Q4, the median was 21 business days (n = 437 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).