IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Emergency medicine and emergency departments in Delaware

In 2025 Q1–Q4, the provider or facility offer prevailed in 72.6% of 1,880 determined Federal IDR dispute line items for emergency medicine and emergency departments in Delaware. The median prevailing offer was 2.06x the QPA (25th–75th percentile 1.54x–3.63x; n = 1,843). The median time to a decision was 185 business days (n = 1,880).

Determined line items

1,880

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

72.6%

n = 1,880 · 2025 Q1–Q4

Median payment vs QPA

2.06x

middle half 1.54x–3.63x · n = 1,843 · 2025 Q1–Q4

Median days to decision

185

business days, from dispute initiation · n = 1,880 · 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

PeriodLine itemsWin %Median ×QPA25th–75thRatio nMedian days
2025 Q1–Q41,88072.6%2.06x1.54x–3.63x1,843185
2024 Q1–Q464557.7%2.64x1.25x–3.63x645319
2023 Q1–Q425140.2%1.00x0.96x–3.51x25189
2023 Q1–2025 Q42,77666.2%2.06x1.25x–3.58x2,739not 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 codeLine itemsWin %Median ×QPARatio nMedian days
99284 Emergency department visit with moderate level of medical decision making93374.1%1.96x925155
99285 Emergency department visit with high level of medical decision making82170.8%2.23x799187
99283 Emergency department visit with low level of medical decision making6254.8%2.85x61482

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

Related: all specialties in Delaware · Emergency medicine and emergency departments in all states

FAQ

What is the Federal IDR provider win rate for emergency medicine and emergency departments in Delaware?

In 2025 Q1–Q4, the provider or facility offer was selected in 72.6% of 1,880 determined dispute line items for emergency medicine and emergency departments in Delaware. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 emergency medicine and emergency departments in Delaware?

In 2025 Q1–Q4, the median prevailing offer was 2.06x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.54x to 3.63x (n = 1,843 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 emergency medicine and emergency departments in Delaware?

In 2025 Q1–Q4, the median was 185 business days (n = 1,880 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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