Answers / The hospitalist record
The hospital medicine IDR record
In the 2025 public use files, 60,968 federal IDR disputes carried hospitalist line items, and quarterly volume grew more than sixfold year over year, the fastest of any specialty. Providers won 85.2 percent of decisions under the No Surprises Act at a median of 8.13 times the QPA. Observation lines (G0378) paid a median of $14,400; high-level admissions (99223) paid $1,000.
The sixfold year
Hospital medicine barely registered in the early federal IDR files. Then it did: 3,012 disputes in the third quarter of 2024 became 18,980 in the third quarter of 2025, growth of more than six times, faster than any other specialty bucket in the record. The full 2025 files hold 60,968 disputes with hospitalist line items. Providers won 85.2 percent of decisions, the median decided line paid 8.13 times the QPA, and the median payer offer never moved off 1.0 times the benchmark. Across the bucket, a median QPA of $128.12 became a median decided award of $616.
The E/M ladder in the files
The disputed codes map the hospitalist workday. Level-three initial hospital care, 99223, appeared in 11,595 disputes at an 85.67 percent win rate, with a median decided award of $1,000 against a $238.20 QPA. The subsequent-care pair 99232 and 99233 ran 9,794 and 8,973 disputes, winning 85.96 and 84.08 percent. Extended discharge management, 99239, added 6,386. Above all of them sits observation: G0378 appeared in 14,331 disputes, won 79.82 percent, and paid a median decided award of $14,400 against a $1,055.40 median QPA, the largest line in the bucket by a wide margin.
The UnitedHealthcare outlier
Payer results split sharply. Blue Cross Blue Shield of Texas, the volume leader at 12,976 disputes, decided at a 10.33 median multiple. Anthem's 6,861 decided at 10.67, and Aetna's 6,550 at an 89.69 percent provider win rate. UnitedHealthcare is the exception: 11,260 disputes decided at just 3.85 times the QPA, less than half the bucket median. The spread is a reminder that the record prices payers individually, and an offer calibrated to the wrong payer's numbers leaves money on the table in both directions.
States and filers
Texas carries 22,090 of the 2025 hospitalist disputes and California 5,979. New Jersey's 3,874 decided at a 29.77 median multiple, the highest of the large states. The published filers include the national groups: Sound Physicians entities appear in 2,158 disputes at a 75.49 percent win rate, and Vituity in 1,556. Most hospitalist groups in the country have never filed at all, which is what sixfold growth from a near-zero base looks like. The full record is explorable at idrexplorer.com, and Lido IDR uses it to price each offer, then files for a flat fee per arbitration.
Price your census against the record
Lido IDR prices hospitalist offers payer by payer from the published decisions, then files for a flat fee per arbitration. Talk to an IDR specialist.