Federal IDR outcomes: Laboratory and pathology in Texas
In 2023 Q1–2025 Q4, the provider or facility offer prevailed in 100.0% of 67 determined Federal IDR dispute line items for laboratory and pathology in Texas. The median prevailing offer was 6.99x the QPA (25th–75th percentile 2.07x–7.83x; n = 57).
Determined line items
67
2023 Q1–2025 Q4 · 0 split decisions excluded
Provider win rate
100.0%
n = 67 · 2023 Q1–2025 Q4
Median payment vs QPA
6.99x
middle half 2.07x–7.83x · n = 57 · 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
| Period | Line items | Win % | Median ×QPA | 25th–75th | Ratio n | Median days |
|---|---|---|---|---|---|---|
| 2025 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2024 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–Q4 | 41 | 100.0% | 2.23x | 2.07x–7.82x | 41 | 72 |
| 2023 Q1–2025 Q4 | 67 | 100.0% | 6.99x | 2.07x–7.83x | 57 | 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 Texas · Laboratory and pathology in all states
FAQ
What is the Federal IDR provider win rate for laboratory and pathology in Texas?
In 2023 Q1–2025 Q4, the provider or facility offer was selected in 100.0% of 67 determined dispute line items for laboratory and pathology in Texas. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 Texas?
In 2023 Q1–2025 Q4, the median prevailing offer was 6.99x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.07x to 7.83x (n = 57 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.