Pediatrix Medical Group (MD) Q4 2025 earnings summary

Executive summary

• Q4 2025 adjusted EBITDA reached $66 million, aligning with upwardly revised guidance, and net income was $34 million with Adjusted EPS of $0.50, capping a strong year with full-year adjusted EBITDA of $276 million and net income of $165.4 million, marking a turnaround from a net loss in 2024.

• Strong volume, acuity, and payer mix, along with financial discipline, drove results; new leadership and physician alignment initiatives were introduced.

• Q4 results reflected solid same-unit revenue growth, offset by higher variable practice incentive compensation and practice dispositions.

Financial highlights

• Full-year adjusted EBITDA for 2025 was $276 million; Q4 adjusted EBITDA was $66 million.

• Q4 operating cash flow was $115 million, down from $135 million year-over-year, mainly due to changes in payables and liabilities.

• Ended Q4 with $375 million in cash and net debt just over $220 million, net leverage under 1x.

• Same-unit revenue grew 4% year-over-year, with same-unit pricing up just under 7% and patient service volumes down just under 3%.

• Practice-level salary, wages, and benefits expenses declined slightly year-over-year, offset by same-unit increases.

Outlook and guidance

• 2026 adjusted EBITDA expected in the range of $280 million–$300 million, a 5% increase at the midpoint over 2025.

• 2026 revenue projected at approximately $1.9 billion, flat with 2025; G&A expense expected to decline to $230–$240 million from $241 million.

• Q1 2026 adjusted EBITDA anticipated to be 17–19% of full-year guidance, reflecting normal seasonality.

• Guidance assumes steady volume, acuity, and payer mix; no M&A contributions included.