Cardiovascular imaging payment and reimbursement systems: understanding the past and present in order to guide the future.

Uncertainty regarding the future of cardiovascular (CV) services and reimbursement systems in this era of rapid change in health care delivery may lead to further confusion among imagers. This article provides a brief history of national payment and reimbursement systems, and discusses potential changes that will impact CV imaging in the coming years. Data over the last decade are presented on payment and utilization of services to demonstrate the impact of reimbursement reforms and education on imaging use.