BillionToOne (BLLN) Q4 2025 earnings summary

Executive summary

• Achieved 100% year-over-year revenue growth in 2025, reaching $305.1M, with Q4 revenue at $96.1M and annualized run-rate of $384M, driven by strong prenatal and oncology test growth.

• Delivered over 610,000 tests in FY 2025, up 51% from the prior year, with significant expansion in both prenatal and oncology segments.

• Achieved GAAP profitability and positive cash flow for both Q4 and FY 2025, with net income of $7.4M for the year and $4.4M in Q4.

• Launched multiple innovative products in prenatal and oncology, including expanded UNITY NIPT, Northstar Select add-ons, and first-in-class Red Blood Cell and Platelet Fetal Antigen NIPT.

• Ended 2025 with $496M in cash and ~$50M in term debt, maintaining a strong balance sheet.

Financial highlights

• FY 2025 revenue doubled to $305.1M from $152.6M in FY 2024; Q4 revenue was $96.1M, up 113% year-over-year.

• Q4 prenatal revenue was $86.9M (up 98–99%); oncology revenue was $9.1M (up 736–8.5x); full-year prenatal revenue was $277.1–$280.2M (up 87–90%), oncology $25M (up 748%).

• Gross margin in Q4 was 71–71.4%, up from 57% a year ago; full-year gross margin was 68%.

• Operating margin was 11% in Q4 and 5% for the year; Q4 operating income was $10.3M, full-year $16M.

• Net income in Q4 was $4.4M ($0.11 per diluted share); full-year net income was $2.9–$7.4M.

Outlook and guidance

• Raised 2026 revenue guidance to $430–$445M, representing 41–46% growth over 2025.

• Guidance excludes upside from new health system adoptions and UnitedHealthcare contract.

• Expects to maintain positive GAAP operating income and gross margins in the low 70% range.

• Key 2026 growth drivers include expanded sales teams, new product launches, further Medicaid coverage, and significant COGS reductions.

• In-network agreement with UnitedHealthcare effective April 2026 expected to drive further adoption.