Medicare reimbursement for echocardiographic procedures is clouded by the fact that Medicare defines ultrasound services to be "radiologic." As such, a 40% limitation has been imposed in some states. In addition, as a result of the Omnibus Budget Reconciliation Act of 1987, a new radiology fee structure was negotiated with Medicare, without the input of internists and cardiologists, that may significantly affect reimbursement patterns for echocardiographic services. Those who perform and interpret cardiac ultrasound studies are again urged to use the medicine codes (90,000 series) rather than radiology codes (70,000 series).