Neuronetics, Inc. (NASDAQ: STIM) posted preliminary Q4 2025 results that marked a historic milestone for the company, reporting revenue of $41.8 million—an 86% increase on an as‑reported basis and 23% on an adjusted pro‑forma basis versus the fourth quarter of 2024. The jump was driven by $18.3 million in NeuroStar system sales and $23.5 million in clinic revenue, reflecting strong demand for the company’s flagship TMS device and the rapid expansion of its newly acquired Greenbrook TMS network.
In the fourth quarter, NeuroStar system sales grew 30% from $14.2 million in Q4 2024, while clinic revenue rose 37% from $16.8 million. The clinic segment’s growth was largely attributable to the integration of Greenbrook’s 120‑site network, which added 15 new clinics and increased same‑store sales by 12%. The company’s full‑year 2025 revenue reached $149.2 million, up 99% on an as‑reported basis and 15% on an adjusted pro‑forma basis versus $74.9 million in 2024. NeuroStar contributed $62.2 million to the full‑year total, a 20% increase from $51.8 million in 2024, while clinic revenue climbed to $87.0 million from $70.5 million.
Operating cash flow for Q4 2025 was $0.9 million, the first positive figure in Neuronetics’ history. The improvement was largely a result of tighter working‑capital management and the elimination of a one‑time restructuring charge that had weighed on cash flow in prior periods. CEO Keith Sullivan emphasized that the milestone “demonstrates the effectiveness of our cost‑control initiatives and the scalability of our clinic model.” The company’s cash balance stood at $34.1 million at year‑end, providing a cushion for continued investment.
The company’s full‑year guidance remains unchanged, with management reaffirming a revenue outlook of $149–$152 million and a net income target of $5.5–$6.0 million. Sullivan noted that the guidance reflects confidence in sustained demand for NeuroStar systems and the continued growth of the clinic network, while acknowledging that margin compression from the clinic acquisition will persist in the short term.
Investors responded positively to the results, citing the company’s first positive operating cash flow and the robust growth in both core segments. Analysts highlighted the strategic value of the Greenbrook acquisition and the company’s ability to convert that value into cash flow.
The results underscore Neuronetics’ progress toward long‑term profitability, but the company remains mindful of headwinds such as margin pressure from the clinic business and the need to maintain pricing power in a competitive TMS market. The company’s focus on operational efficiency and strategic expansion positions it well for continued growth in 2026.
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