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 integration of Greenbrook, creating a vertically integrated mental health platform.

• Q4 2025 revenue reached $41.8M, up 86% as reported year-over-year; full year 2025 revenue was $149.2M, up 99% as reported.

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

• Announced leadership transition with Dan Reuvers appointed as next 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; adjusted pro forma revenue up 23%.

• Full year 2025 revenue was $149.2M, a 99% increase year-over-year.

• Gross margin for Q4 2025 was 52%, down from 66% due to Greenbrook's lower-margin clinic business; full year 2025 gross margin was 48.5%.

• Net loss for Q4 2025 was $(7.2)M ($0.10/share), improved from $(12.7)M ($0.34/share) prior year; full year net loss was $(39.1)M, improved from $(43.7)M.

• Cash and equivalents at year-end 2025 totaled $34.1M, including $6M restricted; positive operating cash flow of $0.9M in Q4.

Outlook and guidance

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

• Clinic business expected to grow double digits to mid-teens; NeuroStar business to grow low to mid-single digits.

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

• 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.