Federal IDR benchmarks, 2025
Built from the CMS supplemental tables for the first four quarters of 2025. We refresh them each quarter when CMS posts new data.
Outcomes by quarter
| Quarter | Disputes initiated | Determinations | Provider side prevailed | Plan prevailed | Only one party submitted an offer |
|---|---|---|---|---|---|
| 2025-Q1 | 545,422 | 466,227 | 87.4% | 12.5% | 23.0% |
| 2025-Q2 | 641,390 | 616,020 | 88.2% | 11.7% | 22.1% |
| 2025-Q3 | 653,445 | 602,901 | 86.8% | 13.1% | 19.6% |
| 2025-Q4 | 719,118 | 542,138 | 83.8% | 16.1% | 13.2% |
Source: CMS Federal IDR Supplemental Tables, reporting year 2025 (CMS reports page). Quarterly medians cannot be combined into a yearly median, so each quarter is shown separately.
By specialty
Median prevailing offer as a percentage of the QPA, 2025-Q4.
| Specialty | Median % of QPA | Determinations |
|---|---|---|
| Emergency Department Services | 334% | 277,058 |
| Radiology | 398% | 79,253 |
| Pathology and Laboratory | 440% | 31,977 |
| Anesthesia | 361% | 58,016 |
| Surgery | 1503% | 55,885 |
| Neurology and Neuromuscular Procedures | 2585% | 32,145 |
| Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions and Chemotherapy and Other Highly Complex Biologic Agent Administration | 424% | 20,079 |
| Hospital Inpatient and Observation Care Services | 370% | 14,340 |
| Critical Care Services | 347% | 11,730 |
| Cardiovascular | 474% | 13,009 |
| Air Ambulance | 237% | 9,513 |
More
By QPA band
Lower QPAs see much higher multiples.
Initiations by state
Where disputes are filed, 2025-Q4.
Who files
Top initiating parties and practice-size mix.
Get the next quarterly update
We are building a flat-fee tracker for eligibility, deadlines, batches and payment follow-up. Join the list and we will email you when it opens. No patient information needed.