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Emergency Medicine IDR: win rates and median awards
What Emergency Medicine providers win in No Surprises Act arbitration, from 1,130,093 published disputes.
What do Emergency Medicine providers win at federal IDR? In the CMS federal IDR public use files, providers in Emergency Medicine won 84.6 percent of decided federal IDR disputes under the No Surprises Act, across 1,130,093 published disputes. The median award was 3.9x the qualifying payment amount across decided line items in the specialty, and the median time from filing to decision was 29 days. Estimate your own case with the free IDR calculator.
Emergency Medicine line items in the CMS federal IDR public use files, 2023 through 2025. Method on the methodology page.
A worked example
Take the most disputed Emergency Medicine billing code, 99284, with a median qualifying payment amount of $216 in the files. A Emergency Medicine dispute with a qualifying payment amount of $216 resolves at the specialty median of 3.9x, an estimated award of $842. A median is not a floor or a ceiling: half of decided line items in the specialty resolve higher and half lower.
Top Emergency Medicine billing codes at federal IDR
The most disputed Emergency Medicine codes in the public use files, at the line-item grain. Median award is the median decided award in dollars for that code. Win rates are within decided line items for the code.
| Code | Line items | Win rate | Median QPA | Median award |
|---|---|---|---|---|
| 99284 | 603,194 | 85.0% | $216 | $720 |
| 99285 | 303,070 | 86.7% | $292 | $914 |
| 99283 | 215,893 | 81.1% | $187 | $1,750 |
| 99282 | 7,636 | 78.5% | $285 | $1,581 |
| 99281 | 928 | 68.0% | $209 | $3,218 |
Source: CMS federal IDR public use files, 2023 through 2025. "n/a" means CMS did not publish a usable dollar figure for that code.
Common questions
What percentage of Emergency Medicine federal IDR disputes do providers win?
Providers won 84.6 percent of decided federal IDR disputes in Emergency Medicine, across 1,130,093 disputes in the CMS federal IDR public use files. Decided disputes exclude default decisions, where one side never submitted an offer.
What is the median IDR award for code 99284?
Code 99284, the most disputed Emergency Medicine code in the files, shows a median decided award of $720 against a median qualifying payment amount of $216, with an 85.0 percent provider win rate across 603,194 line items.
How long does a Emergency Medicine IDR case take?
The median Emergency Medicine dispute took 29 days from filing to decision. The No Surprises Act process is written only: after the payer's initial payment there are 30 business days to start open negotiation, 30 to negotiate, then 4 to initiate arbitration. There is no hearing.
Related pages
Critical Care IDR, Radiology & Imaging IDR, and Hospital Medicine IDR have their own pages, and the IDR calculator covers all 22 specialties. For filing help, Lido IDR files federal IDR for a flat fee per arbitration. To browse every published dispute, see idrexplorer.com.