Federal IDR outcomes: Neonatology in Indiana
In 2025 Q1–Q4, the provider or facility offer prevailed in 88.2% of 1,317 determined Federal IDR dispute line items for neonatology in Indiana. The median prevailing offer was 3.46x the QPA (25th–75th percentile 2.96x–3.96x; n = 1,317). The median time to a decision was 47 business days (n = 1,317).
Determined line items
1,317
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
88.2%
n = 1,317 · 2025 Q1–Q4
Median payment vs QPA
3.46x
middle half 2.96x–3.96x · n = 1,317 · 2025 Q1–Q4
Median days to decision
47
business days, from dispute initiation · n = 1,317 · 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 | 1,317 | 88.2% | 3.46x | 2.96x–3.96x | 1,317 | 47 |
| 2024 Q1–Q4 | 762 | 83.9% | 3.71x | 2.26x–5.94x | 761 | 59 |
| 2023 Q1–Q4 | 119 | 34.5% | 1.00x | 1.00x–3.77x | 119 | 33 |
| 2023 Q1–2025 Q4 | 2,198 | 83.8% | 3.58x | 2.40x–4.52x | 2,197 | 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 |
|---|---|---|---|---|---|
| 99479 Follow-up intensive care of recovering low birth weight infant per day | 470 | 89.1% | 3.31x | 470 | 38 |
| 99469 Follow-up inpatient hospital critical care of newborn per day (28 days or younge | 241 | 94.6% | 3.58x | 241 | 38 |
| 99480 Follow-up intensive care of recovering medium birth weight infant per day | 197 | 95.9% | 4.14x | 197 | 34 |
| 99472 Follow-up inpatient hospital critical care of infant or young child per day (29 | 182 | 76.9% | 3.12x | 182 | 100 |
| 99478 Follow-up intensive care of recovering very low birth weight infant per day | 69 | 71.0% | 2.40x | 69 | 73 |
| 99468 Initial inpatient hospital critical care of newborn per day (28 days or younger) | 65 | 84.6% | 2.79x | 65 | 36 |
| 99477 Initial intensive care of newborn per day (28 days or younger) | 37 | 81.1% | 3.18x | 37 | 36 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Indiana · Neonatology in all states
FAQ
What is the Federal IDR provider win rate for neonatology in Indiana?
In 2025 Q1–Q4, the provider or facility offer was selected in 88.2% of 1,317 determined dispute line items for neonatology 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 neonatology in Indiana?
In 2025 Q1–Q4, the median prevailing offer was 3.46x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.96x to 3.96x (n = 1,317 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 neonatology in Indiana?
In 2025 Q1–Q4, the median was 47 business days (n = 1,317 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).