Neuronetics (STIM) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue reached $34.5 million, up 8% year-over-year, driven by strong U.S. clinic growth, expanded SPRAVATO® offerings, and the Greenbrook acquisition.

• Net loss narrowed to $10.8 million from $12.7 million in Q1 2025, reflecting improved operating leverage and reduced expenses.

• The company is evaluating shareholder suggestions, including a potential business separation, and is focused on long-term value and operational excellence.

• Strategic initiatives include expanding patient access, operational rigor, and preparing for future psychedelic therapies.

• Optum/UHC/UBH expanded TMS policy, allowing nurse practitioners to administer NeuroStar, broadening access to 34.8 million covered lives.

Financial highlights

• U.S. clinic revenue grew 15% to $21.5 million, now representing 63% of U.S. revenues; NeuroStar system revenue rose 13% to $3.2 million.

• Gross margin declined to 46.9% from 49.2% due to revenue mix and increased SPRAVATO buy and bill.

• Operating expenses decreased 6% year-over-year to $25.1 million, mainly from SG&A savings.

• Adjusted EBITDA loss improved to $(6.6) million from $(8.6) million in Q1 2025.

• Cash and equivalents at quarter-end were $19 million, with $9.4 million used in operations, a $7.6 million improvement year-over-year.

Outlook and guidance

• 2026 revenue guidance remains $160–166 million, with gross margin expected between 47% and 49%.

• Operating expenses projected at $100–105 million, including $8.5 million in stock-based compensation.

• Operating cash flow guidance is -$13 million to -$17 million, with improvement expected sequentially and flat to positive in the second half.

• Q2 2026 revenue expected to grow in the mid-single digits.

• Management anticipates continued operating losses in the near term as investments in sales, marketing, and product development persist.