NeurAxis (NRXS) Q4 2025 earnings summary

Executive summary

• Achieved sixth consecutive quarter of double-digit revenue growth, with Q4 2025 revenue up 27% to $968,000 and FY 2025 revenue up 33% to $3.6 million, driven by increased unit sales and new product launches.

• Major milestones included FDA indication and label expansion for IB-Stim, securing a Category I CPT code effective January 2026, and academic society guideline recommendation for pediatric IBS.

• Commercial scaling advanced with 45 million additional covered lives, a federal FSS contract for VA access, and over 100 million total covered lives.

• Focus shifted from access creation to execution, with a clear roadmap for 2026 growth and commercial strategy deployment.

• Operating loss increased 17% in Q4 and 9% for FY2025, mainly due to higher selling expenses and a one-time legal settlement.

Financial highlights

• Q4 2025 revenue: $968,000, up 27% YoY; FY 2025 revenue: $3.6 million, up 33% from $2.7 million in 2024; unit deliveries up 44%.

• Q4 2025 gross margin: 85.4% (down 100 bps YoY); FY 2025 gross margin: 84.2% (down 130–230 bps YoY) due to mix shift, discounting, and inventory reserves.

• Q4 2025 operating loss: $1.7 million (up 17% YoY); FY 2025 operating loss: $7.8 million (up 9% YoY).

• Q4 2025 net loss: $1.7 million (up 18% YoY); FY 2025 net loss: $7.8 million (improved 5% YoY from $8.2 million in 2024) due to higher sales and absence of one-time settlements.

• Cash on hand at year-end: $5 million; raised $2.6 million in Q1 2026, current cash over $6 million.

Outlook and guidance

• Management expects a multi-year growth cycle, focusing on expanding insurance coverage and scaling utilization nationwide.

• Expect continued revenue growth and gross margin improvement in 2026 as more sales transition to full reimbursement.

• Operating expense leverage anticipated, with SG&A and R&D investments increasing at a slower pace than revenue.

• No formal 2026 guidance provided, but management reports Q1 revenue is better than expected and will provide detailed KPIs in the next call.

• Commercial strategy deployment and reimbursement framework are expected to drive adoption in 2026.