Cardiac computed tomography (CCT) is often used synonymously with coronary CT angiography (CCTA) and coronary artery calcium scoring (CACS), but also encompasses the use of CT for the assessment of structural, valvular, and congenital heart disease, and other cardiovascular pathology. This paper looks at the role of cardiac CT in the context of value-based care and predominantly focuses on the role of cardiac CT in the assessment of coronary artery disease (CAD), as this is where most of the clinical use and evidence of value can be found. Critical questions as to the defining of quality health care using cardiac CT are highllighted and the wider use of CT for the assessment of non-coronary disease is commented on towards the end of the manuscript but does not yet have the same level of health economic and value-based evidence.