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 FY2025 revenue up 33% to $3.6M, driven by increased unit sales and new product launches.

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

• Commercial strategy focused on expanding payer coverage, scaling commercial footprint, and hiring to support growth in both pediatric and adult markets.

• Significant progress in payer engagement, with over 100 million covered lives and a major national insurer policy win covering 45 million members.

• Early Q1 2026 results show revenue and operational performance exceeding expectations, driven by increased patient submissions and improved reimbursement access.

Financial highlights

• Q4 2025 revenue: $968,000, up 27% from $761,000 in Q4 2024; FY2025 revenue: $3.6 million, up 33% from $2.7 million in FY2024; unit deliveries up 35% in Q4 and 44% for FY2025.

• Q4 2025 gross margin: 85.4% (down 100 bps YoY); FY2025 gross margin: 84.2% (down 130 bps YoY), impacted by inventory reserves, discounting, and lower-margin RED device sales.

• Q4 2025 operating expenses: $2.5 million, up 20% YoY; FY2025 operating expenses: $10.8 million, up 14%, driven by commissions, stock compensation, and legal settlement.

• Q4 2025 net loss: $1.7 million (up 18% YoY); FY2025 net loss: $7.8 million (down 5% YoY due to higher sales and absence of one-time legal settlements).

• Cash on hand at year-end: $5 million; $2.6 million raised post-year-end via equity and warrant exercises.

Outlook and guidance

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

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

• No near-term need for additional financing; sufficient liquidity to execute growth plans.

• Large randomized controlled trial in adults underway at Cleveland Clinic; cyclic vomiting syndrome and post-op pain studies ongoing.

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