IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Neonatology in Iowa

In 2025 Q1–Q4, the provider or facility offer prevailed in 78.5% of 1,051 determined Federal IDR dispute line items for neonatology in Iowa. The median prevailing offer was 2.41x the QPA (25th–75th percentile 2.00x–2.50x; n = 1,051). The median time to a decision was 41 business days (n = 1,051).

Determined line items

1,051

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

78.5%

n = 1,051 · 2025 Q1–Q4

Median payment vs QPA

2.41x

middle half 2.00x–2.50x · n = 1,051 · 2025 Q1–Q4

Median days to decision

41

business days, from dispute initiation · n = 1,051 · 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–Q41,05178.5%2.41x2.00x–2.50x1,05141
2024 Q1–Q477178.6%3.32x2.34x–4.23x771233
2023 Q1–Q422364.6%2.18x1.00x–2.86x22339
2023 Q1–2025 Q42,04577.0%2.46x1.96x–3.36x2,045not 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
99479 Follow-up intensive care of recovering low birth weight infant per day40772.0%2.47x40746
99480 Follow-up intensive care of recovering medium birth weight infant per day21287.3%2.41x21231
99469 Follow-up inpatient hospital critical care of newborn per day (28 days or younge18788.2%2.27x18760
99472 Follow-up inpatient hospital critical care of infant or young child per day (29 8155.6%2.39x8130
99238 Hospital discharge day management, 30 minutes or less4682.6%3.28x4636

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

Related: all specialties in Iowa · Neonatology in all states

FAQ

What is the Federal IDR provider win rate for neonatology in Iowa?

In 2025 Q1–Q4, the provider or facility offer was selected in 78.5% of 1,051 determined dispute line items for neonatology in Iowa. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 Iowa?

In 2025 Q1–Q4, the median prevailing offer was 2.41x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.00x to 2.50x (n = 1,051 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 Iowa?

In 2025 Q1–Q4, the median was 41 business days (n = 1,051 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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