Improved Access to Personalized Prostate
Cancer Care with CMS and AMA Support for Unfold AI
CULVER
CITY, Calif., July 25,
2024 /PRNewswire/ -- Avenda Health, an AI healthcare
company creating the future of personalized prostate cancer care,
today announces the Centers for Medicare & Medicaid Services
(CMS) has assigned a national payment rate for the company's
innovative prostate cancer mapping technology, Unfold AI.
Additionally, effective July 1, 2024,
the American Medical Association (AMA) implemented a new Category
III code for reimbursement on services related to the use of Unfold
AI, marking a major step forward in making this technology more
widely available to patients.
Category III codes allow data collection for new
or emerging healthcare approaches and establish the foundation that
facilitates reimbursement pathways for healthcare providers. The
code for Unfold AI, 0898T, enables healthcare providers to bill for
these non-invasive prostate cancer estimation maps, which are
derived from advanced analysis of image-guided fusion biopsy and
pathology. This includes visualization of tumor margins, margin
determination and physician interpretation and reporting.
Medicare reimbursement is determined by the Hospital Outpatient
Prospective Payment System (OPPS), assigning the procedure to the
appropriate Ambulatory Payment Classification (APC) for diagnostic
tests and related services. This is a standardized approach for
outpatient settings, while reimbursement for physician services and
commercial payers will depend on individual contractual agreements
and geographic variations. These designations underscore the
growing recognition of AI technology in enhancing prostate cancer
care.
"Receiving the new CPT code and national payment
rate for Unfold AI is an important development in making advanced
personalized prostate cancer care accessible to more patients,"
said Avenda Health COO Brit
Berry-Pusey, PhD. "This recognition by the AMA and CMS
validates the transformative potential of our technology in
improving diagnostic accuracy and patient outcomes."
Last month, a study conducted at UCLA was published in The Journal of Urology,
demonstrating Unfold AI's ability to identify the extent of
prostate cancer with 84% accuracy. The study showed that
AI-assisted diagnosis improves the ability of physicians by 45
times compared to standard human-driven identification methods.
This means more accurate diagnoses and targeted treatments,
potentially reducing the need for full-gland removal and its
associated side effects.
For more information, visit avendahealth.com.
About Avenda Health
Avenda Health is
creating a more personalized future of prostate cancer
care. Using deep learning, Avenda Health software maps a
patient's cancer in 3D, giving physicians precise information and
the confidence to make care decisions. Dedicated to bringing
this cutting-edge technology to all practices and physicians
treating prostate cancer patients, Avenda Health aims to improve
outcomes, preserve quality of life, and create a new standard of
cancer care.
For more information, visit avendahealth.com and
follow the company on LinkedIn and X.
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SOURCE Avenda Health