Federal IDR outcomes: Emergency medicine and emergency departments in Tennessee
In 2025 Q1–Q4, the provider or facility offer prevailed in 82.9% of 87,652 determined Federal IDR dispute line items for emergency medicine and emergency departments in Tennessee. The median prevailing offer was 3.16x the QPA (25th–75th percentile 1.89x–4.52x; n = 83,719). The median time to a decision was 45 business days (n = 87,652).
Determined line items
87,652
2025 Q1–Q4 · 74 split decisions excluded
Provider win rate
82.9%
n = 87,652 · 2025 Q1–Q4
Median payment vs QPA
3.16x
middle half 1.89x–4.52x · n = 83,719 · 2025 Q1–Q4
Median days to decision
45
business days, from dispute initiation · n = 87,652 · 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 | 87,652 | 82.9% | 3.16x | 1.89x–4.52x | 83,719 | 45 |
| 2024 Q1–Q4 | 47,933 | 83.3% | 3.16x | 2.00x–5.29x | 44,492 | 185 |
| 2023 Q1–Q4 | 19,155 | 90.2% | 2.89x | 2.00x–3.24x | 17,885 | 72 |
| 2023 Q1–2025 Q4 | 154,740 | 83.9% | 3.09x | 1.95x–4.41x | 146,096 | 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
| CPT code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 99284 Emergency department visit with moderate level of medical decision making | 39,533 | 85.0% | 2.87x | 38,630 | 45 |
| 99285 Emergency department visit with high level of medical decision making | 25,906 | 79.9% | 3.52x | 24,768 | 49 |
| 99283 Emergency department visit with low level of medical decision making | 7,184 | 91.2% | 3.31x | 7,017 | 49 |
| 99291 Critical care, first 30-74 minutes | 3,081 | 89.1% | 3.45x | 2,970 | 42 |
| 74177 CT scan of abdomen and pelvis with contrast | 787 | 75.7% | 1.86x | 752 | 36 |
| 93010 Routine electrocardiogram (ECG) using at least 12 leads with interpretation and | 673 | 79.3% | 5.83x | 325 | 30 |
| 70450 CT scan head or brain without contrast | 533 | 79.2% | 3.36x | 514 | 34 |
| 85025 Complete blood cell count (red cells, white blood cell, platelets), automated te | 416 | 73.3% | 3.29x | 364 | 42 |
| 36415 Insertion of needle into vein for collection of blood sample | 391 | 72.9% | 2.84x | 327 | 43 |
| 84484 Troponin (protein) analysis, quantitative | 354 | 72.6% | 2.95x | 318 | 41 |
| 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | 329 | 75.1% | 2.82x | 288 | 42 |
| 80053 Blood test, comprehensive group of blood chemicals | 312 | 70.5% | 4.94x | 284 | 36.5 |
| 74176 CT scan of abdomen and pelvis without contrast | 261 | 72.8% | 2.43x | 253 | 32 |
| 71045 X-ray of chest, 1 view | 235 | 70.6% | 2.36x | 207 | 43 |
| 96374 Injection of drug or substance into vein | 233 | 69.5% | 2.62x | 193 | 44 |
| 71275 CT scan of blood vessels of chest with contrast | 219 | 74.4% | 2.46x | 210 | 30 |
| 81001 Manual urinalysis test with examination using microscope, automated | 210 | 76.7% | 0.93x | 184 | 40.5 |
| 83735 Magnesium level | 194 | 71.6% | 1.00x | 169 | 45 |
| 96375 Injection of additional new drug or substance into vein | 192 | 72.4% | 2.21x | 164 | 41 |
| 72125 CT scan of upper spine without contrast | 176 | 77.3% | 2.91x | 163 | 29 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Tennessee · Emergency medicine and emergency departments in all states
FAQ
What is the Federal IDR provider win rate for emergency medicine and emergency departments in Tennessee?
In 2025 Q1–Q4, the provider or facility offer was selected in 82.9% of 87,652 determined dispute line items for emergency medicine and emergency departments in Tennessee. 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 emergency medicine and emergency departments in Tennessee?
In 2025 Q1–Q4, the median prevailing offer was 3.16x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.89x to 4.52x (n = 83,719 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 emergency medicine and emergency departments in Tennessee?
In 2025 Q1–Q4, the median was 45 business days (n = 87,652 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).