IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Hospital medicine (hospitalists) in New York

In 2025 Q1–Q4, the provider or facility offer prevailed in 80.7% of 1,582 determined Federal IDR dispute line items for hospital medicine (hospitalists) in New York. The median prevailing offer was 1.75x the QPA (25th–75th percentile 1.42x–2.47x; n = 1,579). The median time to a decision was 35 business days (n = 1,582).

Determined line items

1,582

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

80.7%

n = 1,582 · 2025 Q1–Q4

Median payment vs QPA

1.75x

middle half 1.42x–2.47x · n = 1,579 · 2025 Q1–Q4

Median days to decision

35

business days, from dispute initiation · n = 1,582 · 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–Q41,58280.7%1.75x1.42x–2.47x1,57935
2024 Q1–Q44591.1%2.45x1.65x–2.83x45391
2023 Q1–Q49062.2%1.45x1.00x–2.80x90155.5
2023 Q1–2025 Q41,71780.0%1.76x1.39x–2.48x1,714not 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
99233 Subsequent hospital care with moderate levelof medical decision making, if using68283.0%1.73x67930
99223 Initial hospital care with moderate level of medical decision making, if using t30587.2%1.90x30540
99232 Subsequent hospital care with moderate levelof medical decision making, if using24569.8%1.75x24546
99239 Hospital discharge day management, more than 30 minutes21979.5%1.73x21952
99291 Critical care, first 30-74 minutes7178.9%1.85x7128

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

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

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 80.7% of 1,582 determined dispute line items for hospital medicine (hospitalists) in New York. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 New York?

In 2025 Q1–Q4, the median prevailing offer was 1.75x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.42x to 2.47x (n = 1,579 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 New York?

In 2025 Q1–Q4, the median was 35 business days (n = 1,582 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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