IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Hospital medicine (hospitalists) in Kentucky

In 2025 Q1–Q4, the provider or facility offer prevailed in 89.9% of 494 determined Federal IDR dispute line items for hospital medicine (hospitalists) in Kentucky. The median prevailing offer was 3.61x the QPA (25th–75th percentile 3.16x–3.61x; n = 490). The median time to a decision was 38 business days (n = 494).

Determined line items

494

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

89.9%

n = 494 · 2025 Q1–Q4

Median payment vs QPA

3.61x

middle half 3.16x–3.61x · n = 490 · 2025 Q1–Q4

Median days to decision

38

business days, from dispute initiation · n = 494 · 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–Q449489.9%3.61x3.16x–3.61x49038
2024 Q1–Q413591.1%3.45x3.37x–3.63x135133
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q462990.1%3.61x3.16x–3.61x625not 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
99232 Subsequent hospital care with moderate levelof medical decision making, if using30291.7%3.61x29942
99233 Subsequent hospital care with moderate levelof medical decision making, if using13889.9%3.16x13838
99239 Hospital discharge day management, more than 30 minutes3083.3%3.27x3024

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

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

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 89.9% of 494 determined dispute line items for hospital medicine (hospitalists) in Kentucky. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 Kentucky?

In 2025 Q1–Q4, the median prevailing offer was 3.61x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 3.16x to 3.61x (n = 490 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 Kentucky?

In 2025 Q1–Q4, the median was 38 business days (n = 494 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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