[Reimbursement of cardiac CT: A practical guide for general practitioners].

Technical developments in recent decades have made it possible to visualize the coronary arteries non-invasively in much detail using computed tomography (CT). In addition to imaging the coronary anatomy, coronary CT angiography (CCTA) enables the detection of atherosclerotic plaques, their characterization and the estimation of the resulting stenosis. According to guidelines, the main clinical indication for CCTA is the work-up of patients with suspected coronary artery disease (CAD). CT is indicated in patients with a clinical risk-factor-based pre-test probability for CAD of > 5%-50%. A significant proportion of patients with first-time symptoms fall into this category. The new, important role of the CCTA is based on good evidence from multicenter, randomized trials in recent years. With the integration of CCTA into the reimbursement catalogue of the health insurances in Germany since January 1, 2025, after the G-BA decision in January 2024, the use of this method will probably become more widespread, even if the amount of remuneration for this service certainly poses some challenges. To ensure a high level of quality, structured training programs to evaluate the risk-factor-based pre-test probability and the integration of cardiology expertise into the entire process are important. This starts with the indication and preparation of the patients, through the CT examination and analysis, to the classification of the findings in the clinical context. This article provides a practical overview of the topic with a focus on general practitioner aspects, presents the essential evidence and conveys the challenges of optimal quality for the CCTA.