Paysign (PAYS) Q4 2025 earnings summary

Executive summary

• Full year 2025 revenue grew 40.5% to $82 million, with net income up 98% to $7.6 million and adjusted EBITDA up 107% to $19.94 million, driven by patient affordability and plasma businesses.

• Operating margins expanded by 723 basis points to 9%, signaling a key inflection point for future profitability and scalability.

• Patient Affordability business annual revenue surged 168% year-over-year to $33.9 million, processing nearly $1 billion in financial assistance for over 840,000 patients.

• Plasma donor compensation revenue increased 4% to $45.62 million, with 595 centers at year-end, up 115 from the prior year.

• Strong balance sheet with $21.07 million in unrestricted cash and zero debt at year-end.

Financial highlights

• Gross profit margin improved to 59.4% from 55.1% year-over-year.

• Operating margin rose to 9% from 1.7% the previous year.

• Fourth quarter earnings before taxes reached $2.5 million, up from $1.2 million year-over-year.

• Effective tax rate for 2025 was 24.7%, up from 7.8% in 2024.

• Restricted cash balances rose 29% to $143.92 million.

Outlook and guidance

• 2026 revenue expected at $106.5–$110.5 million, up 30–35% year-over-year, with plasma and pharma contributing equally.

• Gross profit margin projected at 60–62%, operating expenses to rise 20%, and net income to nearly double to $13–$16 million.

• Adjusted EBITDA forecasted at $30–$33 million; Q1 2026 revenue expected at $27–$27.5 million, up 45–48% year-over-year.

• Margins expected to expand further, with Q1 operating margin at 20–22% and net margin at 17–19%.

• Net income forecasted at $0.21–$0.26 per diluted share for 2026.