IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Cardiology in New Jersey

In 2025 Q1–Q4, the provider or facility offer prevailed in 91.1% of 756 determined Federal IDR dispute line items for cardiology in New Jersey. The median prevailing offer was 44.76x the QPA (25th–75th percentile 19.56x–108.33x; n = 745). The median time to a decision was 33 business days (n = 756).

Determined line items

756

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

91.1%

n = 756 · 2025 Q1–Q4

Median payment vs QPA

44.76x †

middle half 19.56x–108.33x · n = 745 · 2025 Q1–Q4

Median days to decision

33

business days, from dispute initiation · n = 756 · 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–Q475691.1%44.76x †19.56x–108.33x74533
2024 Q1–Q431691.8%27.99x †15.77x–56.24x31430
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q41,07491.3%38.24x †19.14x–89.31x1,061not 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
99291 Critical care, first 30-74 minutes30092.0%29.12x †29535
99232 Subsequent hospital care with moderate levelof medical decision making, if using5791.2%55.14x †5633
99152 Use of a drug to induce depression of consciousness by physician performing a pr3488.2%337.21x †3434.5

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

Related: all specialties in New Jersey · Cardiology in all states

FAQ

What is the Federal IDR provider win rate for cardiology in New Jersey?

In 2025 Q1–Q4, the provider or facility offer was selected in 91.1% of 756 determined dispute line items for cardiology in New Jersey. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 cardiology in New Jersey?

In 2025 Q1–Q4, the median prevailing offer was 44.76x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 19.56x to 108.33x (n = 745 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 cardiology in New Jersey?

In 2025 Q1–Q4, the median was 33 business days (n = 756 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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