Lifestance Health Group (LFST) Q4 2025 earnings summary

Executive summary

• Achieved robust organic revenue and visit growth in 2025, with Q4 revenue of $382.2 million (up 17% year-over-year) and full year revenue of $1.424 billion (up 14%), driven by clinician expansion and productivity improvements.

• Delivered care to over 1 million patients with nearly 9 million visits, maintaining high patient satisfaction (NPS 84, Google rating 4.7).

• Clinician base grew 9% to 8,040, with 657 net clinician additions in 2025 and visit volumes up 18% in Q4 and 14% for the year.

• Adjusted EBITDA for Q4 was $48.8 million (12.8% margin), up 49% year-over-year; full year Adjusted EBITDA $157.7 million (11.1% margin), up 32%.

• Announced a $100 million share repurchase program, reflecting strong cash generation and balance sheet health.

Financial highlights

• Q4 Center Margin was $126.3 million (33% of revenue), up 15% year-over-year; full year Center Margin $461.1 million (32.4% of revenue), up 15%.

• Net income for Q4 was $11.7 million, compared to a net loss of $7.1 million in Q4 2024; full year net income was $9.7 million, reversing prior year losses.

• Free cash flow reached $46.6 million in Q4 and $110 million for the year; operating cash flow for FY 2025 was $146.2 million.

• Ended Q4 with $248.6 million in cash and net long-term debt of $265.9 million.

• Achieved positive net income and EPS for the full year, a year ahead of expectations.

Outlook and guidance

• 2026 revenue guidance: $1.615–$1.655 billion; Center Margin: $526–$550 million; Adjusted EBITDA: $185–$205 million (midpoint margin 11.9%).

• Q1 2026 revenue expected at $380–$400 million; Center Margin $118–$132 million; Adjusted EBITDA $39–$45 million.

• Expect to open 20–30 new centers in 2026; EHR implementation to use $20–$30 million cash over 2026–2027.

• Long-term: mid-teens revenue growth and Adjusted EBITDA margins by 2028.