Content created by Office of Medicare Hearings and Appeals (OMHA)
| Appeals | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| Favorable | 25.6% | 17.2% | 17.3% | 17.7% | 16.6% | 19.9% | 27.9% | 29.2% | 27.5% | 21.3% |
| Partially Favorable | 2.0% | 1.0% | 1.1% | 1.9% | 2.0% | 2.2% | 3.0% | 2.6% | 2.5% | 1.5% |
| Unfavorable | 44.5% | 24.8% | 20.9% | 26.1% | 31.0% | 31.0% | 42.6% | 50.2% | 47.6% | 61.1% |
| Dismissed | 27.9% | 57.0% | 60.7% | 54.3% | 50.5% | 46.9% | 26.5% | 18.0% | 22.4% | 16.2% |
| Claims | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|---|---|---|---|
| Favorable | 7.6% | 11.2% | 10.3% | 9.7% | 7.0% | 9.5% | 9.0% | 10.2% | 16.7% | 16.1% |
| Partially Favorable | 4.1% | 4.1% | 10.8% | 10.6% | 25.0% | 10.1% | 14.1% | 12.1% | 21.6% | 14.0% |
| Unfavorable | 13.2% | 18.2% | 10.9% | 14.1% | 13.8% | 20.8% | 51.0% | 57.9% | 42.6% | 50.0% |
| Dismissed | 75.1% | 66.5% | 68.0% | 65.6% | 54.2% | 59.6% | 25.9% | 19.8% | 19.1% | 19.9% |
**FY25 YTD as of September 30, 2025
***Run date: October 6, 2025