IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Internal and family medicine in Washington

In 2025 Q1–Q4, the provider or facility offer prevailed in 92.4% of 105 determined Federal IDR dispute line items for internal and family medicine in Washington. The median prevailing offer was 3.61x the QPA (25th–75th percentile 3.43x–4.88x; n = 105). The median time to a decision was 36 business days (n = 105).

Determined line items

105

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

92.4%

n = 105 · 2025 Q1–Q4

Median payment vs QPA

3.61x

middle half 3.43x–4.88x · n = 105 · 2025 Q1–Q4

Median days to decision

36

business days, from dispute initiation · n = 105 · 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–Q410592.4%3.61x3.43x–4.88x10536
2024 Q1–Q43093.3%5.19x4.13x–7.56x3027
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q413592.6%3.98x3.50x–5.26x135not 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 Washington · Internal and family medicine in all states

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 92.4% of 105 determined dispute line items for internal and family medicine in Washington. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 Washington?

In 2025 Q1–Q4, the median prevailing offer was 3.61x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 3.43x to 4.88x (n = 105 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 Washington?

In 2025 Q1–Q4, the median was 36 business days (n = 105 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

How to Utilize IDR