IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Internal and family medicine in North Carolina

In 2025 Q1–Q4, the provider or facility offer prevailed in 88.2% of 51 determined Federal IDR dispute line items for internal and family medicine in North Carolina. The median prevailing offer was 4.66x the QPA (25th–75th percentile 2.50x–6.88x; n = 51). The median time to a decision was 37 business days (n = 51).

Determined line items

51

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

88.2%

n = 51 · 2025 Q1–Q4

Median payment vs QPA

4.66x

middle half 2.50x–6.88x · n = 51 · 2025 Q1–Q4

Median days to decision

37

business days, from dispute initiation · n = 51 · 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–Q45188.2%4.66x2.50x–6.88x5137
2024 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q46687.9%4.88x3.01x–8.78x66not 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

No row has 30 or more determined line items in 2025 Q1–Q4.

Related: all specialties in North Carolina · Internal and family medicine in all states

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 88.2% of 51 determined dispute line items for internal and family medicine in North Carolina. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 North Carolina?

In 2025 Q1–Q4, the median prevailing offer was 4.66x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.50x to 6.88x (n = 51 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 North Carolina?

In 2025 Q1–Q4, the median was 37 business days (n = 51 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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