Natera (NTRA) Q4 2025 earnings summary

Executive summary

• Processed 924,000 tests in Q4 2025, with MRD clinical units up 56% year-over-year to 225,000 units.

• Achieved Q4 2025 revenue of $666 million, up 40% year-over-year, and positive cash inflow of $107.6 million for 2025.

• Expanded MRD portfolio with launches of Signatera Genome and Latitude MRD, and acquired Foresight Diagnostics.

• Strong clinical adoption, with over 50% of US oncologists ordering Signatera in Q4.

• Women's health advanced with Fetal Focus NIPT launch and strong clinical trial validation.

Financial highlights

• Q4 gross margin reached 66.9%, up from 62.9% year-over-year; organic gross margin at 63.7% excluding true-ups.

• Product revenues were $661.2M in Q4 2025, with licensing and other revenues at $4.3M.

• Operating losses narrowed in Q4 despite increased OpEx; net income aided by a one-time deferred tax item.

• Cash and investments stood at $1,076.1 million at year-end 2025.

• Revenue true-ups contributed about $60 million in Q4, with DSOs improving to 47 days from 68 days year-over-year.

Outlook and guidance

• 2026 revenue guidance: $2.62–$2.7 billion, with gross margins between 63% and 65%.

• SG&A projected at $1,125M–$1,225M and R&D at $750M–$850M for 2026.

• Guidance assumes no significant revenue true-ups; expects further ASP and COGS improvements.

• Revenue growth for 2026 guided at ~25–26% over 2025 (excluding true-ups), with positive cash flow expected.

• OpEx to grow ~9.5%, well below revenue growth rate.