How often do providers win No Surprises Act IDR disputes?

Providers prevail in about 86% of resolved federal No Surprises Act IDR disputes, across 2.25 million decisions in the CMS public-use data. Informational, not legal advice; outcomes vary by case.

How much do providers win in IDR, relative to the QPA?

When a party prevails, the winning amount is a median of 391% of the qualifying payment amount (QPA), with a 25th-to-75th percentile range of 217% to 758% of QPA. The QPA is roughly the insurer’s median in-network rate for the item or service.

What is IDR under the No Surprises Act?

Independent dispute resolution (IDR) is the federal arbitration process under the No Surprises Act (45 CFR 149.510) for out-of-network payment disputes. Each side submits an offer and a certified IDR entity picks one. A federal arbitrator may weigh up to four plan years of contracted-rate history and local market share.

Which payers lose the most in IDR?

In this data, the highest-volume payers in IDR include UnitedHealthcare (84.6% provider win rate), Aetna (92.5% provider win rate), Blue Cross Blue Shield of Texas (HCSC) (89.2% provider win rate). See the full table above.

Reddenda · No Surprises Act · IDR outcomes

No Surprises Act arbitration: who wins, and by how much

Name: US No Surprises Act IDR outcomes
Creator: Reddenda

Providers win about 86% of IDR disputes. In federal No Surprises Act payment disputes (independent dispute resolution, or IDR), providers prevail in about 86% of decisions, and the prevailing amount is a median of 391% of the qualifying payment amount (QPA), across 2.25 million resolved disputes. The pattern holds across payers, specialties, and states. From the federal CMS IDR public-use data; informational, not legal advice, and past outcomes do not guarantee future results.

86%of resolved IDR disputes are decided in the provider’s favor

391%median prevailing award, as a share of the qualifying payment amount (QPA)

2.25 millionresolved federal IDR disputes in the data

57median days to a decision

Provider win rate by payer

The qualifying payment amount (QPA) is roughly the insurer’s own median in-network rate. A median prevailing award well above 100% of QPA means arbitrators are landing far above what the payer initially offered.

Payer	Disputes	Provider win rate	Median award (% of QPA)
UnitedHealthcare	644,814	84.6%	330%
Aetna	353,895	92.5%	472%
Blue Cross Blue Shield of Texas (HCSC)	258,714	89.2%	721%
MultiPlan (repricer)	242,897	80%	473%
Anthem	191,370	85.6%	341%
Clear Health	165,065	84.6%	279%
Cigna	78,045	83.8%	277%
Florida Blue (Blue Cross Blue Shield of Florida)	60,881	93.1%	309%
Other / Unmapped	58,192	85%	438%
Blue Cross Blue Shield of Illinois (HCSC)	37,844	83.2%	140%

By specialty

Specialty	Disputes	Provider win rate	Median award (% of QPA)
Emergency Medicine	1,087,940	87%	323%
Radiology	393,183	93%	532%
Anesthesiology	223,092	86.8%	315%
Other Specialty	172,474	78.6%	296%
Neuromonitoring	168,066	86.9%	1675%
Surgery	100,791	89.2%	1861%
Hospital/Facility	66,669	73.3%	258%
Not Reported	46,014	28%	100%

By state

State	Disputes	Provider win rate	Median award (% of QPA)
TX	793,570	86.1%	518%
FL	213,996	89.2%	260%
AZ	168,112	84.5%	381%
NJ	111,693	85%	751%
TN	105,338	82.3%	291%
GA	96,797	83.7%	287%
NY	86,880	85.7%	462%
IN	66,178	86.3%	369%
VA	63,070	84.5%	304%
MO	55,937	85.7%	435%

Building an IDR case?

Reddenda documents your own contracted-rate history and local market for a No Surprises Act dispute, from public rate data. See where your rates land first with a free RateScore, then talk to us about an IDR evidence exhibit. No PHI.

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About this data

Figures are aggregated from the federal CMS Independent Dispute Resolution (IDR) public-use files, which report outcomes of No Surprises Act out-of-network payment disputes (45 CFR 149.510). "Provider win rate" is the share of resolved disputes decided for the provider or facility; "median award, % of QPA" is the median prevailing offer as a share of the qualifying payment amount. These are aggregate outcomes, not any individual provider’s record, and no protected health information is used. This is informational and not legal advice; outcomes vary by case and past outcomes do not guarantee future results. Source: CMS No Surprises Act reports and 45 CFR 149.510. As of 2026-07-23.