Computed tomographic colonography (CTC) was first introduced in the mid-1990s as a minimally invasive technology for colorectal cancer screening. Given its potential to significantly change colorectal cancer screening practices in the United States, it has attracted widespread multidisciplinary interest among radiologists, gastroenterologists, colorectal surgeons, and primary care physicians. Because of its potential for widespread utilization and the potential associated costs, it has also attracted much scrutiny from payers. The authors discuss the coding and reimbursement history of CTC, outline strategies for obtaining local coverage for CTC, and attempt to outline some of the possible future influences on CTC reimbursement.