IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Hospital medicine (hospitalists) in Wisconsin

In 2025 Q1–Q4, the provider or facility offer prevailed in 84.7% of 150 determined Federal IDR dispute line items for hospital medicine (hospitalists) in Wisconsin. The median prevailing offer was 1.29x the QPA (25th–75th percentile 1.18x–1.82x; n = 150). The median time to a decision was 43 business days (n = 150).

Determined line items

150

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

84.7%

n = 150 · 2025 Q1–Q4

Median payment vs QPA

1.29x

middle half 1.18x–1.82x · n = 150 · 2025 Q1–Q4

Median days to decision

43

business days, from dispute initiation · n = 150 · 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–Q415084.7%1.29x1.18x–1.82x15043
2024 Q1–Q45265.4%1.21x1.00x–1.43x5244
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q420279.7%1.23x1.17x–1.65x202not 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 codeLine itemsWin %Median ×QPARatio nMedian days
99233 Subsequent hospital care with moderate levelof medical decision making, if using7781.8%1.21x7736
99239 Hospital discharge day management, more than 30 minutes4092.5%1.17x4048

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

Related: all specialties in Wisconsin · Hospital medicine (hospitalists) in all states

FAQ

What is the Federal IDR provider win rate for hospital medicine (hospitalists) in Wisconsin?

In 2025 Q1–Q4, the provider or facility offer was selected in 84.7% of 150 determined dispute line items for hospital medicine (hospitalists) in Wisconsin. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 hospital medicine (hospitalists) in Wisconsin?

In 2025 Q1–Q4, the median prevailing offer was 1.29x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.18x to 1.82x (n = 150 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 hospital medicine (hospitalists) in Wisconsin?

In 2025 Q1–Q4, the median was 43 business days (n = 150 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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