Natera (NTRA) 47th Annual Raymond James Institutional Investor Conference summary

Financial performance and outlook

• Achieved strong Q4 revenue growth, with record volumes and gross margins climbing to 67%, up 240 basis points sequentially from Q3.

• Generated net income for the quarter, aided by a deferred tax benefit from an acquisition, and narrowed operating losses.

• Delivered over $100 million in free cash flow for the year and set a strong, achievable financial guide for 2026.

• Guidance implies continued robust growth across Women's Health, Organ Health, and especially Signatera, with ongoing pricing improvements and broader coverage efforts.

• Operating expenses will remain focused on aggressive R&D investment, while SG&A is expected to be stable year-on-year, reflecting operational leverage.

Market expansion and product adoption

• Signatera has reached 50% oncologist penetration, with significant opportunity remaining in both new physician adoption and deeper usage within existing practices.

• Adoption is accelerating due to strong clinical trial data and broader acceptance of MRD and recurrence monitoring in cancer care.

• 30%-35% of current Signatera volume is in non-covered areas, representing a $200 million potential if coverage expands.

• Ongoing efforts with MolDX and Medicare aim to secure additional coverage for more cancer indications, with expectations for incremental announcements over the next 12-18 months.

Pricing, reimbursement, and guidelines

• 2026 guidance includes an additional $30 of ASP, primarily from improved Medicare Advantage reimbursement rather than new indications.

• Medicare fee-for-service reimbursement is near 99% for covered services, while Medicare Advantage is at 80%, with ongoing efforts to close the gap.

• Guideline inclusion remains important for long-term adoption, with upcoming data readouts in CRC and muscle-invasive bladder cancer expected to support further inclusion.