IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Laboratory and pathology in Tennessee

In 2023 Q1–2025 Q4, the provider or facility offer prevailed in 90.6% of 320 determined Federal IDR dispute line items for laboratory and pathology in Tennessee. The median prevailing offer was 2.47x the QPA (25th–75th percentile 2.38x–2.47x; n = 318).

Determined line items

320

2023 Q1–2025 Q4 · 0 split decisions excluded

Provider win rate

90.6%

n = 320 · 2023 Q1–2025 Q4

Median payment vs QPA

2.47x

middle half 2.38x–2.47x · n = 318 · 2023 Q1–2025 Q4

Median days to decision

–

not pooled across years (CMS changed the definition in 2025)

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–Q4Fewer than 30 determined line items; not shown.
2024 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–Q428198.6%2.47x2.38x–2.47x28157
2023 Q1–2025 Q432090.6%2.47x2.38x–2.47x318not 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 Tennessee · Laboratory and pathology in all states

FAQ

What is the Federal IDR provider win rate for laboratory and pathology in Tennessee?

In 2023 Q1–2025 Q4, the provider or facility offer was selected in 90.6% of 320 determined dispute line items for laboratory and pathology 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 laboratory and pathology in Tennessee?

In 2023 Q1–2025 Q4, the median prevailing offer was 2.47x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.38x to 2.47x (n = 318 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.

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