MDxHealth (MDXH) Q4 2025 earnings summary

Executive summary

• Achieved strong performance in Q4 and full year 2025, with revenue up 20% to $107.9 million and Q4 revenue up 19% to $29.5 million, driven by focus, execution, and growth strategy.

• Integration of ExoDx business completed, transitioning all Select mdx customers, expanding the diagnostic menu, and contributing to increased operating expenses and test volume growth.

• Maintained disciplined capital allocation, including a favorable amendment to the Exact Sciences earn-out, reducing near-term payment by ~$20 million and deferring the remainder by a year.

• Organizational improvements led to best-in-class turnaround times, enhanced customer experience, and operational leverage reflected in improved adjusted EBITDA.

• Net loss for 2025 decreased 12% to $33.5 million, driven by higher gross profit, partially offset by increased financial expenses.

Financial highlights

• Q4 revenue increased 19% year-over-year to $29.5 million; full-year revenue reached $107.9 million, up 20%.

• Q4 gross profit rose 20% to $18.7 million; full-year gross profit was $69.6 million, up 26% year-over-year.

• Q4 operating loss increased 14% to $5.3 million; Q4 net loss rose 31% to $8.9 million, while full-year net loss decreased 12% to $33.5 million.

• Q4 adjusted EBITDA was -$2.1 million (53% improvement); full-year adjusted EBITDA loss narrowed to -$1.1 million (92% improvement).

• Year-end cash and cash equivalents totaled $29.0 million.

Outlook and guidance

• 2026 revenue guidance set at $137–$140 million, representing 27–30% projected growth.

• Expects to exit 2026 with a 10% adjusted EBITDA margin run rate, reflecting significant operating leverage.

• Growth to be balanced across tissue and liquid biopsy segments, with continued integration of ExoDx and cross-selling opportunities.