Federal IDR outcomes: Neurology in California
In 2025 Q1–Q4, the provider or facility offer prevailed in 85.2% of 481 determined Federal IDR dispute line items for neurology in California. The median prevailing offer was 48.39x the QPA (25th–75th percentile 13.64x–94.80x; n = 481). The median time to a decision was 30 business days (n = 481).
Determined line items
481
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
85.2%
n = 481 · 2025 Q1–Q4
Median days to decision
30
business days, from dispute initiation · n = 481 · 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 | 481 | 85.2% | 48.39x † | 13.64x–94.80x | 481 | 30 |
| 2024 Q1–Q4 | 515 | 84.7% | 5.18x | 1.88x–33.63x | 512 | 65 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 1,010 | 85.0% | 21.38x † | 2.70x–67.17x | 1,007 | 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 |
|---|---|---|---|---|---|
| 99233 Subsequent hospital care with moderate levelof medical decision making, if using | 74 | 93.2% | 83.50x † | 74 | 25.5 |
| 95938 Placement of skin electrodes and measurement of stimulated sites on arms and leg | 57 | 89.5% | 139.23x † | 57 | 38 |
| 95941 Continuous remote monitoring of nervous system during operation, each hour | 54 | 85.2% | 22.62x † | 54 | 37 |
| 99223 Initial hospital care with moderate level of medical decision making, if using t | 50 | 84.0% | 37.75x † | 50 | 27 |
| 95861 Needle measurement of electrical activity in arm or leg muscles, 2 extremities | 34 | 94.1% | 64.31x † | 34 | 29 |
| 99291 Critical care, first 30-74 minutes | 34 | 88.2% | 51.55x † | 34 | 22 |
| 95939 Placement of skin electrodes and measurement of central motor stimulation in arm | 30 | 83.3% | 16.36x | 30 | 37.5 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in California · Neurology in all states
FAQ
What is the Federal IDR provider win rate for neurology in California?
In 2025 Q1–Q4, the provider or facility offer was selected in 85.2% of 481 determined dispute line items for neurology in California. 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 California?
In 2025 Q1–Q4, the median prevailing offer was 48.39x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 13.64x to 94.80x (n = 481 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 California?
In 2025 Q1–Q4, the median was 30 business days (n = 481 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).