iRhythm Technologies
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iRhythm Technologies (IRTC) investor relations material

iRhythm Technologies Q4 2025 earnings summary

Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.
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Q4 2025 earnings summary19 Feb, 2026

Executive summary

  • Achieved record 2025 revenue of $747.1M, up 26.2% year-over-year, with five consecutive quarters above 20% growth, driven by strong volume across all channels and record commercial adoption.

  • Delivered first-ever positive free cash flow and positive quarterly GAAP net income in Q4 2025, marking a key profitability milestone.

  • Expanded market presence in primary care, integrated delivery networks, and international markets, commercializing in six markets and advancing new product innovations.

  • Advanced EHR integration, with over half of volume through integrated accounts and 75 of top 100 customers fully integrated.

  • Strengthened predictive AI capabilities, piloting programs with >85% accuracy in pre-identifying arrhythmia risk and signing a partnership for AI-driven patient risk identification.

Financial highlights

  • Q4 2025 revenue: $208.9M, up 27.1% year-over-year; full year 2025 revenue: $747.1M, up 26.2%.

  • Q4 gross margin: 70.9% (+90 bps YoY); full year gross margin: 70.6% (+170 bps YoY); Q4 gross margin also reported at 71.2%.

  • Q4 net income: $5.6M ($0.17/share), first positive quarterly net income; full year net loss: $44.6M ($1.39/share).

  • Q4 adjusted EBITDA: $34.3M (16.4% margin); full year adjusted EBITDA: $68.9M (9.2% margin).

  • Free cash flow: $14.5M in Q4, $34.5M for 2025; year-end cash and equivalents: $583.8M.

Outlook and guidance

  • 2026 revenue guidance: $870M–$880M (16–18% YoY growth), driven by volume across core, AT, innovative, and international channels.

  • Q1 2026 revenue expected at $193M–$195M, reflecting typical seasonality.

  • 2026 adjusted EBITDA margin guidance: 11.5–12.5%; Q1 2026: 3–4%.

  • Gross margin expected to improve by 80–100 bps in 2026.

  • Free cash flow expected to grow in 2026, weighted to the second half.

How will operating leverage sustain profitability?
Detail growth from new channels and international markets.
What is the ROI on AI and next-gen product investments?
Detail next-gen MCT mobile gateway changes
Explain chart-derived diagnosis tailwind potential
Expand on predictive AI pilot results
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Frequently asked questions

iRhythm Technologies, Inc., a digital healthcare company, provides ambulatory electrocardiogram (ECG) monitoring products for patients at risk for arrhythmias in the United States. Its primary product includes Zio XT service, which offers a wire-free patch that is worn for up to 14 continuous days; and Zio AT service that provides ambulatory monitoring over one to thirty days through a wire-connected patch worn by the patient. The company was incorporated in 2006 and is headquartered in San Francisco, California.

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