Avenda expands Medicare reimbursement for Unfold AI

Avenda Health’s Unfold AI prostate cancer mapping platform is now included in Medicare physician fee schedules across parts of the western U.S., the company said.

The coverage applies in California, Arizona, Utah, Nevada, Oregon, Washington, and Idaho. Avenda said the update makes Unfold AI reimbursable by Medicare in physician office settings in those states.

The company said the regional expansion gives urologists and care teams clearer payment pathways for the platform. Avenda added that office-based settings have historically lagged behind hospital outpatient settings for emerging technologies.

Physicians using Unfold AI began receiving Medicare reimbursement in 2025, according to Avenda. The company said the new fee schedule inclusion builds on earlier reimbursement and regulatory milestones.

Unfold AI is an FDA-cleared AI-based decision support platform for prostate cancer care. The FDA database lists the device as Avenda Health AI Prostate Cancer Planning Software under 510(k) K221624.

The software is indicated as an adjunct to the review of prostate MR images and biopsy findings in the prostate oncological workflow, according to the FDA.

Avenda said Unfold AI combines patient-specific data, including bloodwork, imaging, and biopsy results, to create a personalized 3D cancer map. The map is intended to help physicians assess cancer extent and inform treatment decisions.

In 2024, Unfold AI received a Category III CPT code from the American Medical Association and a national Medicare payment rate for outpatient hospital settings, Avenda said.