Federal IDR outcomes: Pain medicine in Pennsylvania
In 2025 Q1–Q4, the provider or facility offer prevailed in 76.5% of 34 determined Federal IDR dispute line items for pain medicine in Pennsylvania. The median time to a decision was 33 business days (n = 34).
Determined line items
34
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
76.5%
n = 34 · 2025 Q1–Q4
Median payment vs QPA
–
n = 17, below 30 · 2025 Q1–Q4
Median days to decision
33
business days, from dispute initiation · n = 34 · 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
| Period | Line items | Win % | Median ×QPA | 25th–75th | Ratio n | Median days |
|---|---|---|---|---|---|---|
| 2025 Q1–Q4 | 34 | 76.5% | – | – | 17 | 33 |
| 2024 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 36 | 77.8% | – | – | 17 | not 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 Pennsylvania · Pain medicine in all states
FAQ
What is the Federal IDR provider win rate for pain medicine in Pennsylvania?
In 2025 Q1–Q4, the provider or facility offer was selected in 76.5% of 34 determined dispute line items for pain medicine in Pennsylvania. Split decisions are excluded from the denominator and default decisions are included. Withdrawn, settled and ineligible disputes are not in the CMS data.
How long do Federal IDR decisions take for pain medicine in Pennsylvania?
In 2025 Q1–Q4, the median was 33 business days (n = 34 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).