Tactile Systems (TCMD) Q4 2025 earnings summary

Executive summary

• Achieved 12% year-over-year revenue growth in 2025 to $329.5 million, with Q4 revenue up 21% to $103.6 million.

• Gross margin expanded by 190 basis points to 75.9% for the year and reached 78% in Q4, reflecting operational improvements.

• Adjusted EBITDA increased 21% to $44.8 million for the year and 41% to $22.9 million in Q4.

• Net income rose to $10.6 million in Q4 and $19.1 million for the year.

• Strategic acquisition of LymphaTech enhanced digital measurement and monitoring capabilities for lymphedema.

Financial highlights

• Q4 2025 revenue: $103.6 million (+21% YoY); full year: $329.5 million (+12% YoY).

• Lymphedema revenue increased 16% YoY in Q4 to $89.5 million; airway clearance revenue rose 66% to $14.1 million.

• Q4 gross margin was 78.2%, up from 75.2% in Q4 2024.

• Q4 operating income increased to $18.8 million; net income was $10.6 million ($0.46 per diluted share).

• Q4 adjusted EBITDA: $22.9 million (+41% YoY); full year: $44.8 million (+21% YoY).

Outlook and guidance

• 2026 revenue expected between $357 million and $365 million, representing 8%-11% year-over-year growth.

• Adjusted EBITDA projected at $49 million-$51 million for 2026.

• Both lymphedema and airway clearance businesses expected to grow, with airway clearance growing modestly faster.

• Guidance incorporates a short-term impact from new Medicare prior authorization requirements for pneumatic compression devices, effective April 2026.

• GAAP gross margin for 2026 expected at approximately 76%; operating expenses to increase 8%-10% year-over-year.