IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Internal and family medicine in Louisiana

In 2025 Q1–Q4, the provider or facility offer prevailed in 73.9% of 268 determined Federal IDR dispute line items for internal and family medicine in Louisiana. The median prevailing offer was 9.14x the QPA (25th–75th percentile 2.02x–10.80x; n = 267). The median time to a decision was 37 business days (n = 268).

Determined line items

268

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

73.9%

n = 268 · 2025 Q1–Q4

Median payment vs QPA

9.14x

middle half 2.02x–10.80x · n = 267 · 2025 Q1–Q4

Median days to decision

37

business days, from dispute initiation · n = 268 · 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–Q426873.9%9.14x2.02x–10.80x26737
2024 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q427474.5%9.14x2.35x–10.92x273not 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
99223 Initial hospital care with moderate level of medical decision making, if using t7265.3%9.09x7244
99291 Critical care, first 30-74 minutes4278.6%6.70x4237

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

Related: all specialties in Louisiana · Internal and family medicine in all states

FAQ

What is the Federal IDR provider win rate for internal and family medicine in Louisiana?

In 2025 Q1–Q4, the provider or facility offer was selected in 73.9% of 268 determined dispute line items for internal and family medicine in Louisiana. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 internal and family medicine in Louisiana?

In 2025 Q1–Q4, the median prevailing offer was 9.14x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.02x to 10.80x (n = 267 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 internal and family medicine in Louisiana?

In 2025 Q1–Q4, the median was 37 business days (n = 268 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

How to Utilize IDR