Biodesix (BDSX) Q4 2025 earnings summary

Executive summary

• Achieved 41% year-over-year revenue growth in Q4 2025 and 24% for the full year, driven by strong performance in lung diagnostics and expanded commercial reach.

• Reached adjusted EBITDA positivity for the first time in Q4, reflecting operational leverage and improved gross margins.

• Q4 gross margin reached 83%, surpassing guidance, with FY2025 gross margin at 81%.

• Expanded sales force and commercial strategy, with primary care volumes rising and new partnerships announced.

• Continued to generate and publish real-world clinical and health economics data to support adoption and reimbursement.

Financial highlights

• Q4 revenue: $28.8M (+41% YoY); FY2025 revenue: $88.5M (+24% YoY).

• Lung diagnostics/diagnostic tests revenue: $25.1M in Q4 (+46% YoY); $79.2M for FY2025 (+22% YoY).

• Test volumes: 18,000 in Q4 (+23% YoY); 62,600 for FY2025 (+15% YoY).

• Gross margin: 83% in Q4 (+400 bps YoY); 81% for FY2025 (+300 bps YoY).

• Net loss: $4M in Q4 (improved 52% YoY); $35.3M for FY2025 (improved 18% YoY).

• Adjusted EBITDA: +$0.53M in Q4 (first positive quarter); -$17.5M for FY2025 (improved 21% YoY).

• Cash and cash equivalents at year-end: $19M; pro forma $33.7M after subsequent ATM proceeds.

Outlook and guidance

• FY2026 revenue guidance: $106M–$112M, midpoint implies 23% growth over 2025.

• Expect continued improvement toward sustained adjusted EBITDA positivity.

• Revenue growth to be driven by expanded and maturing sales force, higher average revenue per test, new clinical data, and increased development services pipeline.

• Guidance incorporates expected Q1 seasonality and weather-related impacts.