IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Hospitals and facilities in Kansas

In 2025 Q1–Q4, the provider or facility offer prevailed in 88.5% of 6,615 determined Federal IDR dispute line items for hospitals and facilities in Kansas. The median prevailing offer was 2.56x the QPA (25th–75th percentile 1.25x–4.59x; n = 4,560). The median time to a decision was 42 business days (n = 6,615).

Determined line items

6,615

2025 Q1–Q4 · 4 split decisions excluded

Provider win rate

88.5%

n = 6,615 · 2025 Q1–Q4

Median payment vs QPA

2.56x

middle half 1.25x–4.59x · n = 4,560 · 2025 Q1–Q4

Median days to decision

42

business days, from dispute initiation · n = 6,615 · 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–Q46,61588.5%2.56x1.25x–4.59x4,56042
2024 Q1–Q41,76892.1%2.67x1.26x–5.44x1,11025
2023 Q1–Q44468.2%2.38x1.81x–4.36x4098.5
2023 Q1–2025 Q48,42789.2%2.58x1.25x–4.63x5,710not 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 making41283.3%3.50x39234
99285 Emergency department visit with high level of medical decision making29787.9%2.76x27242
85025 Complete blood cell count (red cells, white blood cell, platelets), automated te29287.3%2.00x22545
99283 Emergency department visit with low level of medical decision making27878.4%3.64x27330
36415 Insertion of needle into vein for collection of blood sample24890.7%–2938.5
80053 Blood test, comprehensive group of blood chemicals19886.4%2.72x14245
84484 Troponin (protein) analysis, quantitative18287.9%1.67x14542.5
93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing17991.1%2.13x14048
96374 Injection of drug or substance into vein14588.3%7.68x8145
71045 X-ray of chest, 1 view14390.9%2.79x12441
83690 Lipase (fat enzyme) level12387.0%3.11x9242
80048 Blood test, basic group of blood chemicals (Calcium, total)11788.0%2.36x9942
96375 Injection of additional new drug or substance into vein11387.6%2.67x6242
96361 Infusion into a vein for hydration, each additional hour11191.0%2.65x6041
81001 Manual urinalysis test with examination using microscope, automated9689.6%2.03x7345
81025 Urine pregnancy test8490.5%2.33x5237.5
74177 CT scan of abdomen and pelvis with contrast7387.7%1.60x5050
96372 Injection of drug or substance under skin or into muscle7395.9%3.72x4836
70450 CT scan head or brain without contrast6388.9%2.68x4750
81003 Automated urinalysis test6392.1%1.15x4536

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

Related: all specialties in Kansas · Hospitals and facilities in all states

FAQ

What is the Federal IDR provider win rate for hospitals and facilities in Kansas?

In 2025 Q1–Q4, the provider or facility offer was selected in 88.5% of 6,615 determined dispute line items for hospitals and facilities in Kansas. 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 hospitals and facilities in Kansas?

In 2025 Q1–Q4, the median prevailing offer was 2.56x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.25x to 4.59x (n = 4,560 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 hospitals and facilities in Kansas?

In 2025 Q1–Q4, the median was 42 business days (n = 6,615 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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