IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Neonatology in Louisiana

In 2025 Q1–Q4, the provider or facility offer prevailed in 88.4% of 311 determined Federal IDR dispute line items for neonatology in Louisiana. The median prevailing offer was 2.01x the QPA (25th–75th percentile 1.90x–2.36x; n = 311). The median time to a decision was 128 business days (n = 311).

Determined line items

311

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

88.4%

n = 311 · 2025 Q1–Q4

Median payment vs QPA

2.01x

middle half 1.90x–2.36x · n = 311 · 2025 Q1–Q4

Median days to decision

128

business days, from dispute initiation · n = 311 · 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–Q431188.4%2.01x1.90x–2.36x311128
2024 Q1–Q455281.9%4.68x2.03x–5.91x552218
2023 Q1–Q47671.1%3.58x1.00x–4.77x7634
2023 Q1–2025 Q493983.2%2.58x1.90x–5.60x939not 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 day10194.1%1.90x101229
99469 Follow-up inpatient hospital critical care of newborn per day (28 days or younge6280.6%2.10x62172.5
99472 Follow-up inpatient hospital critical care of infant or young child per day (29 5284.6%2.01x5274
99480 Follow-up intensive care of recovering medium birth weight infant per day4190.2%1.99x41199

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

Related: all specialties in Louisiana · Neonatology in all states

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 88.4% of 311 determined dispute line items for neonatology 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 neonatology in Louisiana?

In 2025 Q1–Q4, the median prevailing offer was 2.01x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.90x to 2.36x (n = 311 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 Louisiana?

In 2025 Q1–Q4, the median was 128 business days (n = 311 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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