How many air ambulance disputes reach federal IDR?

The 2025 files hold 44,087, up from 31,944 in 2024 and 11,467 in 2023. Three operators filed 84.45 percent of the 2025 total.

What do helicopter and fixed-wing claims pay?

Helicopter base lines (A0431) had a median decided award of $36,484 against a $14,917.16 median QPA, and helicopter mileage lines (A0436) $19,000 against $6,024.94. Fixed-wing base lines (A0430) paid $31,620 and fixed-wing mileage lines (A0435) $46,228.16.

Which payers lose air ambulance disputes most often?

Providers won 98.2 percent of 8,209 disputes against Centene plans and 97.6 percent of 5,485 against Blue Cross Blue Shield of Texas. Kaiser Permanente is the low outlier, at 54.5 percent.

Answers / The air ambulance record

The air ambulance IDR record

In the 2025 public use files, 44,087 air ambulance disputes ended in a decision under the No Surprises Act, and providers won 91.81 percent at a median of 2.45 times the QPA. Volume rose 38 percent in a year and the median decision took 33 days, down from 65 in 2023. Helicopter transports account for 86.12 percent of disputes.

Volume, speed, and defaults

Each year of the files is larger than the last: 11,467 air ambulance disputes in 2023, 31,944 in 2024, and 44,087 in 2025, up 38 percent on the year before. Quarterly volume peaked at 12,113 in the second quarter of 2025 and eased to 9,549 in the fourth. Speed improved faster than volume. The median dispute took 65 days to decide in 2023, 50 in 2024, and 33 in 2025. Default decisions, where one side never submits an offer, fell from 24.2 percent of disputes to 15.84 percent, and the provider win rate climbed from 85.39 to 91.81 percent.

What each code pays

Air ambulance lines are priced in the tens of thousands of dollars, so a single line carries real money. In 2025, helicopter base lines (A0431) numbered 17,478, with a median QPA of $14,917.16, a median plan offer of $21,623.72, and a median decided award of $36,484. Helicopter mileage lines (A0436) numbered 17,283: QPA $6,024.94, plan offer $7,790, award $19,000. Fixed-wing base lines (A0430) ran 2,118 with a $31,620 award against an $11,797.33 QPA, and fixed-wing mileage lines (A0435) ran 2,162 at $46,228.16 against $10,265.39. Counting only lines that report a QPA and offers, provider wins on the four codes total $1,136.2 million in prevailing offers for 2025, against $650.8 million in 2024 and $133.6 million in 2023.

Three operators and everyone else

Three operators account for 84.45 percent of the 2025 disputes. The largest filed 25,099, the second 7,831, and the third 4,301, winning 91.9, 94.4, and 94.9 percent. The third stands apart on price: its decided awards sat at a median of 5.44 times the QPA, against 2.33 for the largest and 2.21 for the second. The other 52 filer domains brought 6,856 disputes, won 86.61 percent of them, and waited a median of 39 days for a decision, against 32 for the large three.

Payers, plan types, and states

Centene plans were the other side in 8,209 disputes, and providers won 98.2 percent of them. Blue Cross Blue Shield of Texas followed with 5,485 disputes at 97.6 percent and a 3.41 median multiple, MultiPlan with 3,928 at 90.0 percent, and Aetna with 3,644 at 96.7 percent, 36.0 percent of them default decisions. Kaiser Permanente is the low outlier at 54.5 percent. By plan type, self-insured employer plans produced 17,698 disputes and individual-market plans 12,588. Texas leads the states with 8,773 disputes, and Florida and New Mexico decided at 6.83 and 5.81 times the QPA. Anyone can pull these cuts at idrexplorer.com, and Lido IDR weighs each offer against them before it files for a flat fee per arbitration.

Price your transports against the record

Lido IDR sets each air ambulance offer from the decided results for that operator and payer, and files for a flat fee per arbitration. Talk to an IDR specialist.