IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Laboratory and pathology in Louisiana

In 2025 Q1–Q4, the provider or facility offer prevailed in 64.9% of 74 determined Federal IDR dispute line items for laboratory and pathology in Louisiana. The median prevailing offer was 1.00x the QPA (25th–75th percentile 0.22x–1.00x; n = 73). The median time to a decision was 183 business days (n = 74).

Determined line items

74

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

64.9%

n = 74 · 2025 Q1–Q4

Median payment vs QPA

1.00x

middle half 0.22x–1.00x · n = 73 · 2025 Q1–Q4

Median days to decision

183

business days, from dispute initiation · n = 74 · 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–Q47464.9%1.00x0.22x–1.00x73183
2024 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q47865.4%1.00x0.22x–1.00x77not 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
0340U DNA assays for detection of minimal residual disease in cancer6465.6%1.00x63183

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

Related: all specialties in Louisiana · Laboratory and pathology in all states

FAQ

What is the Federal IDR provider win rate for laboratory and pathology in Louisiana?

In 2025 Q1–Q4, the provider or facility offer was selected in 64.9% of 74 determined dispute line items for laboratory and pathology 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 laboratory and pathology in Louisiana?

In 2025 Q1–Q4, the median prevailing offer was 1.00x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 0.22x to 1.00x (n = 73 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 laboratory and pathology in Louisiana?

In 2025 Q1–Q4, the median was 183 business days (n = 74 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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