Neuronetics (STIM) Q4 2025 earnings summary

Executive summary

• Achieved 23% adjusted pro forma revenue growth in Q4 2025, driven by strong capital shipments and Greenbrook clinic momentum; completed Greenbrook acquisition, creating a vertically integrated mental health platform with national reach.

• Positive operating cash flow reached in Q4 2025, reflecting revenue growth and operational discipline.

• Leadership transition announced: Dan Reuvers appointed as next President and CEO, effective March 23, 2026.

• Operational focus on cost savings, cash flow improvement, and preparation for new treatment paradigms, including psychedelics.

Financial highlights

• Q4 2025 total revenue was $41.8 million, up 86% year-over-year as reported and 23% on an adjusted pro forma basis.

• FY 2025 total revenue was $149.2 million, a 99% increase year-over-year.

• Gross margin for Q4 2025 was 52%, down from 66% prior year due to Greenbrook's lower-margin clinic business.

• Net loss for Q4 2025 was $(7.2) million ($0.10/share), improved from $(12.7) million ($0.34/share) year-over-year.

• Cash and equivalents at year-end 2025 totaled $34.1 million, up from $19.5 million at year-end 2024.

Outlook and guidance

• FY 2026 revenue guidance: $160–$166 million, representing 7%–11% year-over-year growth.

• Full-year gross margin expected between 47% and 49%.

• Operating expenses for 2026 forecasted at $100–$105 million, including $8.5 million stock-based compensation.

• Operating cash flow for 2026 expected between -$13 million and -$17 million, with positive cash flow in H2.

• Q1 2026 revenue projected at $33–$35 million.