Federal IDR outcomes: Critical care in Florida
In 2025 Q1–Q4, the provider or facility offer prevailed in 94.3% of 176 determined Federal IDR dispute line items for critical care in Florida. The median prevailing offer was 4.28x the QPA (25th–75th percentile 2.50x–5.00x; n = 153). The median time to a decision was 24 business days (n = 176).
Determined line items
176
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
94.3%
n = 176 · 2025 Q1–Q4
Median payment vs QPA
4.28x
middle half 2.50x–5.00x · n = 153 · 2025 Q1–Q4
Median days to decision
24
business days, from dispute initiation · n = 176 · 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 | 176 | 94.3% | 4.28x | 2.50x–5.00x | 153 | 24 |
| 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 | 177 | 94.4% | 4.28x | 2.50x–5.00x | 154 | 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 |
|---|---|---|---|---|---|
| 99190 Assembly and operation of heart-lung machine, each hour | 47 | 95.7% | 4.08x | 41 | 26 |
| 99191 Assembly and operation of heart-lung machine, 45 minutes | 31 | 93.5% | 4.32x | 30 | 26 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Florida · Critical care in all states
FAQ
What is the Federal IDR provider win rate for critical care in Florida?
In 2025 Q1–Q4, the provider or facility offer was selected in 94.3% of 176 determined dispute line items for critical care in Florida. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 critical care in Florida?
In 2025 Q1–Q4, the median prevailing offer was 4.28x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.50x to 5.00x (n = 153 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 critical care in Florida?
In 2025 Q1–Q4, the median was 24 business days (n = 176 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).