Texas appears in 869,943 published IDR disputes.

In 2025, Texas appears in 869,943 published Federal IDR disputes.

Arizona is next at 160,511. Florida follows at 143,284.

Texas is 5.4 times the next state.

If your team handles Federal IDR as one national queue, this map says the work is not national in practice. It has a clear center of gravity.

That changes the operating question. Texas needs its own lane for payer names, provider mix, service mix and response discipline. A single national average can hide the place where the queue is actually formed.

This is not a count of every case filed. These are distinct disputes represented in CMS detailed determination records, grouped by service location. A batched dispute can include more than one state, so these state counts should not be added into a national total.

Federal IDR has one federal rulebook. The public record shows a very uneven operating map.