NeoGenomics (NEO) Q4 2025 earnings summary

Executive summary

• Achieved record Q4 revenue of $190M, up 11% year-over-year, and full-year revenue of $727M, up 10%, driven by strong clinical and NGS growth, and ten consecutive quarters of positive adjusted EBITDA.

• Clinical revenue grew 16% year-over-year in Q4, with NGS revenue up 23%; five NGS products launched since 2023 contributed up to 25% of clinical revenue.

• Expanded product portfolio with launches such as RaDaR ST MRD assay and PanTracer Pro, targeting high-growth oncology markets.

• Sales force expansion and commercial execution increased penetration among community oncologists, with 75% of new oncologists ordering 5+ tests in 2025.

• Net loss for Q4 decreased 36% to $10M, but full-year net loss increased 37% to $108M.

Financial highlights

• Q4 adjusted gross profit increased by $5.8M (7–8%) to $83M, with adjusted EBITDA reaching $13.4M, up 10–13% year-over-year.

• Full-year adjusted gross profit rose $23M (8%) to $335M, with an adjusted gross margin of 46%.

• Adjusted EBITDA for 2025 was $43–43.4M, up 9% from prior year.

• Free cash flow improved by $12M or 35–36% year-over-year; cash and equivalents at year-end totaled $160M.

• Q4 average revenue per clinical test increased 5% to $488; 7% growth excluding Pathline.

Outlook and guidance

• 2026 revenue guidance: $793M–$801M, representing 9–10% growth; adjusted EBITDA expected between $55M–$57M, up 27–31% year-over-year.

• Modest revenue contribution expected from RaDaR ST MRD assay and PanTracer LBx in 2026, with substantial long-term opportunity.

• Quarterly revenue growth expected to be 10% in Q1, 8–9% in Q2, 9–10% in Q3, and slightly above 10% in Q4.

• Gross margin expected to expand by 100–120 basis points in 2026, driving most of the adjusted EBITDA margin improvement.

• 2026 GAAP net loss projected at $63–$50M; adjusted net income $39–$36M.