IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Hospital medicine (hospitalists) in Indiana

In 2025 Q1–Q4, the provider or facility offer prevailed in 80.9% of 298 determined Federal IDR dispute line items for hospital medicine (hospitalists) in Indiana. The median prevailing offer was 1.68x the QPA (25th–75th percentile 1.29x–3.33x; n = 298). The median time to a decision was 32 business days (n = 298).

Determined line items

298

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

80.9%

n = 298 · 2025 Q1–Q4

Median payment vs QPA

1.68x

middle half 1.29x–3.33x · n = 298 · 2025 Q1–Q4

Median days to decision

32

business days, from dispute initiation · n = 298 · 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–Q429880.9%1.68x1.29x–3.33x29832
2024 Q1–Q412390.2%1.96x1.96x–3.33x12332
2023 Q1–Q47973.4%2.00x1.02x–2.22x79175
2023 Q1–2025 Q450082.0%1.91x1.32x–2.77x500not 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
99233 Subsequent hospital care with moderate levelof medical decision making, if using6975.4%2.27x6931
99239 Hospital discharge day management, more than 30 minutes6478.1%1.68x6432
99223 Initial hospital care with moderate level of medical decision making, if using t5381.1%1.68x5335
99291 Critical care, first 30-74 minutes5194.1%1.68x5133
99232 Subsequent hospital care with moderate levelof medical decision making, if using4778.7%1.48x4730

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

Related: all specialties in Indiana · Hospital medicine (hospitalists) in all states

FAQ

What is the Federal IDR provider win rate for hospital medicine (hospitalists) in Indiana?

In 2025 Q1–Q4, the provider or facility offer was selected in 80.9% of 298 determined dispute line items for hospital medicine (hospitalists) in Indiana. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 hospital medicine (hospitalists) in Indiana?

In 2025 Q1–Q4, the median prevailing offer was 1.68x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.29x to 3.33x (n = 298 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 hospital medicine (hospitalists) in Indiana?

In 2025 Q1–Q4, the median was 32 business days (n = 298 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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