Neuronetics, Inc. (NASDAQ: STIM) reported fourth‑quarter 2025 revenue of $41.8 million, an 86% year‑over‑year increase and a 23% rise on an adjusted pro‑forma basis. The company beat consensus revenue estimates of $41.48 million and posted earnings per share of $‑0.10 versus the consensus estimate of $‑0.12, a beat of $0.02 per share. Gross margin for the quarter fell to 52% from 66% in the same period last year, a decline driven by the lower‑margin clinic business acquired in December 2024.
The Greenbrook TMS acquisition, completed in December 2024, contributed $19.0 million of clinic revenue to the quarter’s top line and shifted the company’s mix toward a lower‑margin service model. CFO Steve Pfanstiel noted that “Gross margin was 52% in the fourth quarter of 2025 compared to 66% in the prior‑year quarter. The decrease was due to the inclusion of Greenbrook’s clinic business, which operates at a lower margin.” The acquisition also added $87.0 million of clinic revenue to the full‑year total, accounting for a significant portion of the 99% revenue growth to $149.2 million.
Operating cash flow turned positive for the first time in the quarter, with $0.9 million generated from operations. Net loss narrowed to $7.2 million, or $‑0.10 per share, from $12.7 million, or $‑0.34 per share, a $5.5 million improvement. The company’s cost‑control efforts and the efficiency gains in the newly acquired clinics helped offset the margin compression and contributed to the cash‑flow milestone.
Full‑year 2025 revenue reached $149.2 million, up 99% from $74.9 million in 2024. Gross margin fell to 48.5% from 72.3% in 2024, reflecting the lower‑margin clinic mix. Operating expenses rose 16.9% to $103.7 million from $88.7 million, largely due to the integration of Greenbrook’s general and administrative costs.
Management highlighted the strong commercial execution across both segments. CEO Keith Sullivan said, “We wrapped up 2025 with strong commercial execution during the fourth quarter across both segments of the business.” He added, “Our integration with Greenbrook has significantly bolstered our revenue growth, but we remain focused on improving our profitability and operational efficiencies.” The company reiterated its 2026 revenue guidance but did not provide a specific Q1 forecast. Dan Reuvers will assume the CEO role on March 23, 2026, following Keith Sullivan’s departure.
Investor reaction was muted, with the stock trading down in pre‑market sessions. Analysts cited the gross‑margin compression, ongoing net losses, and the cautious outlook for 2026 as key concerns, despite the revenue beat and the first positive operating cash flow. The market’s focus on profitability challenges underscores the importance of margin improvement in the company’s future outlook.
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