NeoGenomics, Inc.NEONASDAQ
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Operator: Good morning, and welcome to the NeoGenomics, Inc. Fourth Quarter and Full Year 2025 Financial Results Call. Please be advised that today's conference is being recorded. I will now turn the call over to Kendra Webster with NeoGenomics, Inc. The floor is yours. Thank you, Kelly, and good morning, everyone. Welcome to the NeoGenomics, Inc. Fourth Quarter and Full Year 2025 Financial Results Call. With me today to discuss the results are Anthony P. Zook, Chief Executive Officer, Jeffrey S. Sherman, Chief Financial Officer, and Abhishek Jain, EVP of Finance. Additional members of the management team will be available for the Q&A portion of our call. This call is being simultaneously webcast. For reference, concurrent with today's call, we posted a short slide presentation to the Investors tab on our website at ir.neogenomics.com. During this call, we will make forward-looking statements regarding our future financial and business performance, business strategy, the timing and outcome of reimbursement decisions, and financial guidance. We caution you that the actual events or results could differ materially from those expressed or implied by the forward-looking statements. These forward-looking statements made during the call speak only as of the original date of the call, and we undertake no obligation to update or revise any of these statements. Please refer to the information disclosed on the Safe Harbor Statement slide in the deck posted on our website as well as the information under the heading Risk Factors in our most recent Forms 10-Ks, 10-Q, and 8-K that we filed with the SEC to identify important risks and other factors that may cause our actual results to differ materially from the forward-looking statements. These documents can be found in the Investors section of our website or on the SEC's website. During this call, we also refer to certain non-GAAP financial measures that include adjustments to GAAP results. The non-GAAP financial measures presented should not be considered an alternative to the financial measures required by GAAP, should not be considered measures of liquidity, and are unlikely to be comparable to non-GAAP financial measures provided by other companies. Any non-GAAP financial measures referenced on this call are reconciled to the most directly comparable GAAP financial measures in a table available in the press release we issued this morning and in the slide deck available in the Investors section of our website. I will now turn the call over to Tony.
Anthony P. Zook: Thanks, Kendra. Well, good morning, everyone. Thank you for joining us today. As been our practice, I will begin with a discussion of Q4 highlights and key business growth drivers before turning the call over to Jeff for a deep dive into our 2025 financial results. Our new EVP and incoming CFO, Abhishek Jain, will then introduce our 2026 guidance. Afterwards, we will open up the call for your questions. Our mission and vision guided us through 2025 to deliver improving results throughout the year. Let us get into the recent highlights. As we covered in our preannouncement, during 2025, we delivered record revenues while making meaningful progress advancing our NGS and MRD long-term growth initiatives, including preparing for a full clinical launch of our RADAR ST MRD this month. I will cover these initiatives in more detail shortly. Total revenue for Q4 was $190 million, representing double-digit growth of 11% year over year. Representing double-digit growth of 11% year over year. Our clinical business continued its robust growth with revenue increasing 16% year over year. The clinical performance was driven by effective execution of our key commercial strategy, enabling volume and share gains in key segments. In the fourth quarter, we again saw a sequential improvement in AUP, continued growth in test volumes, and NGS revenue growth of 23%, well ahead of NGS market growth rate. The five NGS products launched in 2023 contributed 23 of clinical revenue in the quarter. We continue to see demand for our non-NGS modalities as well, with all modalities continuing to grow at above market. Our full full year total revenue was $727 million, which represents 10% growth over full year 2024. We ended the year with significant momentum, and I attribute this to several factors. One, a pure play oncology solutions provider driving rapid dissemination and adoption of innovation through our best-in-class commercial organization in the community setting. Studies have shown that as much as 80% of all cancer care is now delivered in the community setting, which has historically lagged NCI-designated cancer when it comes to introducing the latest in cancer testing innovation. How are we winning in the community? We believe community oncologists are guideline driven and focused on certainty not possibility, and they choose partners that remove friction and enable confident treatment decisions under operational, economic, and time pressures. Reimbursement coverage also is critical. The results of several meetings of our scientific advisory board as well as independent market research that we commissioned reveal several reasons why community oncologists look to us. NeoGenomics, Inc. offers ease of ordering, simple-to-interpret test reports, fast and consistent test turnaround times, access to medical expertise, and most importantly, our comprehensive test menu spanning diagnosis, therapy selection, FRD. Our net promoter score of 79 reflects strong physician satisfaction among our current customer base with our NPS score continuing to improve in 2025, even with record test volumes. Two, we enjoy a leadership position in the hematology testing market, with greater than 25% share across diagnostics and therapy selection. And as pathologists and oncologists consolidate the number of vendors they use, we are successfully leveraging this team leadership position to create enhanced test demand, particularly in high-value areas such as therapy selection, MRD. In fact, in 2025, we saw 14% growth in the total number of pathologists and oncologists ordering five or more tests from NEO. On top of that, we estimate that approximately 40% of all active pathologists and oncologists have ordered five or more tests of ours during the year. While we are proud of that reach, it also means that over half the practice providers are still available to us to bring over to Neo. Three, we built a geographically balanced lab network that allows us to be responsive to customer needs, including offering some of the fastest test turnaround times in the industry, when faster, more accurate treatment decisions can have a material impact on patient outcomes. This network was further strengthened by our acquisition of New Jersey-based Pathline last year, which gives us a meaningful presence in the number three cancer market in the country. We are on track to capture operational efficiencies and synergies from the Pathline acquisition that we anticipate will be accretive to profitability beginning this year. And four, we have one of the broadest cancer test menus in the industry, spanning diagnosis to therapy selection to MRD, for both heme and solid tumor cancers, including over 300 commercial payer contracts, which enables us to be the partner of choice among community hospitals and community oncologists. We are highly differentiated from both large reference labs as well as specialty oncology labs, and this optimally positions us to address underpenetrated markets in therapy selection and MRD in excess of $30 billion while potentially improving outcomes for patients as they advance along the cancer care journey. We are enabling precision oncology in the community setting. Turning now to RADAR ST. November, we presented new research for the RADAR ST assay for circulating tumor DNA detection across solid tumor types. The data from this bridging study showed that RADAR ST demonstrated 97% concordance, maintained equivalent sensitivity with RADAR 1.0. This bridging study was used to secure MolDX reimbursement in the two previously approved indications, HPV-negative head and neck cancer, and a subset of breast cancers. This decision paves the way for us to broadly commercialize RADAR ST, formerly 1.1. To that end, we are on track to execute a full clinical launch of RADAR ST by the end of this month. As part of our go-to-market strategy, we are expanding our sales force to help us penetrate the head and neck market. We believe adding feet on the ground will help us penetrate this market with the only MolDX-approved HPV-negative test currently available to patients. To ensure that we are well positioned to capture more of this large and rapidly growing MRD market, we have also submitted two additional solid tumor cancer indications for MolDX for approval. While we are not disclosing these cancer types yet for competitive reasons, we believe that upon securing coverage, we will effectively double the market opportunity of patients eligible for RADAR ST testing. To expand our reach, we secure additional MolDX approvals, we expect to add more than 25 oncology sales specialists, or OSSs, by the third quarter. From a financial perspective, we believe 2026 will see modest revenue contributions from RADAR ST as adoption ramps, and we gain reimbursement approval in the additional indications. We expect revenue growth to accelerate in 2027 and beyond. In parallel with our RADAR ST launch preparedness activities and efforts to gain coverage for additional indications, we also continue to focus our R&D investment in next-generation MRD, setting cancer types. This assay will be an ultra-sensitive whole genome solution for lower. We are working on product development now with data generation and MolDX submissions slated for next year, and a potential clinical launch as early as 2028. Turning now to our PANTRASER portfolio of products for solid tumor therapy selection. Pan tracer is designated is designed for solid and liquid to work together empowering oncologists with actionable genomic insights for confident, real-time treatment decisions. The test can be ordered independently or as complementary tests depending on a patient's individual needs. Pan tracer LVX is a noninvasive blood-based test that analyzes circulating tumor DNA to identify key genomic alterations that inform treatment decisions in patients with advanced stage solid tumors. Importantly, pan tracer LBX fills a gap in our portfolio that providers keep been asking for, allowing them to further consolidate the number of labs they use. We have submitted to MolDX for clinical reimbursement coverage of the LVX test and are awaiting a decision. Assuming a favorable decision, we anticipate that LVX will contribute modestly to revenue in 2026 as adoption ramps throughout the year. Another product in the Pantracer family, pan tracer tissue had strong growth throughout 2025. We doubled the volume of tests ordered from 2023 to 2024, and then nearly doubled again from 2024 to 2025, while continuing to grow AUPs. This represents another proof point of our ability to pull higher value tests through our community channel, leveraging our e leadership position. 75% of community oncologists who were new to NEO in 2025 ordered five or more tests, a strong leading indicator of our continued growth and success penetrating the community channel. I am pleased to share today that Pantracer portfolio is growing. Last week, we launched Pantracer Pro as part of the expanded solid tumor therapy selection portfolio. The test integrates broad genomic profiling with diagnosis-directed IH and ancillary testing, intelligently selected based on tumor type and clinical context, to provide oncologists with actionable insights for therapy selection in a single order. PanTracer Pro runs rounds out the portfolio it will help streamline the ordering and testing process, delivering timely, relevant results, helping clinicians personalize treatment strategies, and improve patient outcomes. At the end of 2024, moving into 2025, we invested in our commercial organization, specifically our oncology sales specialists. We added 35 people to this group who target community oncologists, and as these individuals mature in their roles, we are seeing a continued uptake in NGS testing accounting for a larger portion of our total clinical revenue. As we increase our reach and frequency. This penetration speaks to the strength of our commercial channel as well. We have launched five eNTS products since March 2023, and even though we were later to market to some of our peers with these products, we are still seeing very good uptake. Pan tracer tissue highlighted earlier was one of the five products which reflects the breadth and strength of our menu, and our ability to capture market share when we introduce new products. With the success of our NGS products, we now have the to be more selective with the volumes that we prioritize. We are intentionally shifting testing capacity towards more guided and higher value testing, which is expected to make AUP expansion a more significant driver of revenue growth relative to volume. And with that, I will hand it over to Jeff to further discuss our results for the quarter and full year. Thanks, Tony, and good morning.
Jeffrey S. Sherman: Fourth quarter total revenue increased by 11% over prior year, $190,000,000. Total clinical revenue continued with strong double-digit growth and increased 16% from prior year. As expected, nonclinical revenue declined by over 25% in the fourth quarter. Adjusted gross profit improved by $5.8 million, or 7% over prior year, and adjusted EBITDA was $13.4 million, up 10%. Q4 was the tenth consecutive quarter of positive earnings, with adjusted EBITDA and margins improving sequentially each quarter in 2025. Clinical volumes and revenues continued with robust growth in the quarter. Public test volumes increased by 11% in the fourth quarter with AUP growth of 5%. Same store revenue without Pathline was $170,000,000, representing growth of 14%, driven by a 6% increase in test volumes and a 7% increase in AUP. Volumes were negatively impacted in the fourth quarter as we intentionally rationalized our exposure to higher volume, lower value test clients. We are continuing to see strength across our portfolio with above market growth rates across modalities we offer. NGS revenues grew by 23% over prior year in the quarter and accounted for around a third of total clinical revenue. Average revenue per clinical test increased sequentially from Q3 by $12, or 3%, and was up 5% from prior year. Excluding Pathline, AUP increased by $15, or 3% from Q3, and was up 7% over prior year. A larger percentage of higher value tests, including NGS, as well as recent managed care pricing increases and RCM initiatives are helping to drive higher AUP. Total operating expenses in the quarter were $97,000,000, an increase of $1,000,000 or 1% over prior year. Cash flow from operations was a positive $1,000,000 in the quarter. We ended the quarter with total cash of $160,000,000, down slightly from Q3. Our balance sheet and expected cash flow will enable us to continue to invest in our business to drive organic growth through new product development and Salesforce expansion, while also increasing operating efficiencies through investments in technology and automation. Turning to full year 2025 results. Revenue is up 10% versus prior year to $727,000,000, driven by deeper penetration into the community setting, a continuing shift to higher margin modalities, and execution of revenue cycle management initiatives. Total clinical revenue increased 15% and growth was 13% excluding Pathline. Nonclinical revenue declined 24% for the year, in line with our revised expectations. Adjusted gross profit increased $23,000,000, or 8 percent, $335,000,000. This represents an aggressive adjusted gross margin of 46%, or decline of 111 basis points mostly driven by Pathline, the decline in nonclinical revenue, and the operating cost of the clinical liquid biopsy launch. Cash flow from operations was positive $5,000,000 in 2025 with free cash flow improving by over 35% as compared to 2024. Adjusted EBITDA increased by $4,000,000 to positive $43,400,000.0, an improvement of 9% over prior year. And now I will hand it over to Abhishek to introduce our 2026 guidance.
Abhishek Jain: Thank you, Jeff. I would like to begin by thanking my colleagues at NEO for their warm welcome. Over the past month, I spent time with investors and analysts, attended our global sales meeting, visited our labs, and gained deeper insights into our strategy and the opportunities ahead. It has been a productive and energizing first month. With that context, let me share our 2026 guidance. For the full year, we expect revenues of $793,000,000 to $801,000,000. The midpoint of our 2026 revenue guidance assumes RADAR ST revenue in mid-single-digit millions for our approved indications, a modest revenue contribution from PANCRACER liquid, and sustained softness in nonclinical through the year, exiting 2026 down low to mid-single digits. While we do not provide quarterly guidance, let me provide some color on quarterly cadence that is impacted by the Pathline acquisition and revenue assumptions for RADAR ST and PANTRASER Liquid, which are weighted towards the back half of the year. I suggest modeling approximately 10% year-over-year growth in the first quarter, 8% to 9% in the second, 9% to 10% in the third, and slightly above 10% in the fourth quarter of 2026. Regarding the extreme weather throughout the country so far this year, we know some providers had to close their offices and appointments have been rescheduled. As a result, there will be some impact on volumes and revenue for Q1. This has been contemplated in our full year 2026 guide and cadence by quarter. We expect adjusted EBITDA to be in the range of $55 million to $57,000,000 for 2026, representing year-over-year growth of approximately 27% to 31%. We expect adjusted EBITDA to grow by low 20% year over year in the first and the second quarter, and low 30% year over year in the third and the fourth quarter, respectively. We will continue to take a balanced approach to investments, strategically increasing sales and marketing and R&D spend for new product initiative and clinical programs that support payer reimbursement and drive top-line growth while improving liquidity with the goal of becoming free cash flow positive this year. Now let me turn the call back to Tony.
Anthony P. Zook: Thanks, Abhishek, and welcome to the team. To recap, during the fourth quarter, we again delivered very strong clinical volumes and revenue, while advancing NGS and MRD initiatives that we believe will contribute to accelerating our growth for years to come. Looking forward to 2026, in our clinical business, the focus is on strategic, profitable growth driven by continued expansion of NGS revenues and market penetration for the PAN TRACER family and RADAR ST. Simultaneously, we are implementing tools and solutions we believe will enhance the productivity of the entire sales organization and working to enhance customer workflows through solutions like our EPIC four integrations. In parallel, with our product and service offerings to grow revenue, we are making targeted investments to drive top-line growth and margin expansion. There is a very strong financial discipline embedded throughout the organization, we are going to build on that as we continue to grow revenue and improve operating efficiencies and margins. Thank you for your continued interest in NeoGenomics, Inc. And Operator, this concludes our prepared remarks, so please open the line for questions.
Operator: Certainly. The floor is now open for questions. If you have any questions or comments, please press 1 on your phone at this time. We ask that while posing your question, you please pick up your handset if listening on a speakerphone to provide optimum sound quality. Please hold just a few moments while we poll for questions. Your first question is coming from David Michael Westenberg with Piper Sandler. Please pose your question. Your line is live.
Jeffrey S. Sherman: Hi. Thank you so much, and good morning.
David Michael Westenberg: So I will just ask one question, but it will be, you know, kind of on the longer side. I will just ask it upfront. You talked about the intimate intimate launch of RADAR SP. Can you provide a little bit more specifics? You mentioned specific or submissions to MolDX. Can you give us more specific timing? I get that, you know, this is trying to predict government, but, you know, is this end of the year? Is this, you know, potentially dragged into the next year, etcetera? And then you mentioned also 25 sales reps. I just want a clarification that is specific to MRD or esoteric tests in general. And then on those sales reps, do you plan on just going after the head and neck, the sub indications of breast, or are you actually in fact, thinking about some of those future MolDX exhibitions that you have there. And then lastly, I get this is really long, but, you know, just talk about the complementarity with PANTRASER liquid. Thanks so much.
Jeffrey S. Sherman: Okay. So, David, there is a lot to unpack there.
Anthony P. Zook: Why do I not I will I will try and start it and kick us off and then look to Warren to address, follow-up questions six, seven, and eight. Okay, Warren. So get ready for that. Relative to RADAR ST, Dave, you were right that the intention is we go out the end of this month for our full launch. Relative to focus, it will be focused, Dave, on the initial indications of head and neck and the subsets of breasts that we have articulated. HPV negative, and the HR HER2 negative breast. So that will remain the focal point for the initial launch activity. So that was one of your questions. As far as additional indication flow, as you say, you know, all we can do is submit and put the best packages forward that we believe are are possible for MolDX to work their way through. For our own assumptions, we believe, Dave, that those additional indications will be available in the latter half of this year for us. And so it is still possible to potentially generate some revenue from those in this year, but that would be upside against our guide. We are not counting on those and certainly will help fuel additional robust growth going into 2027. Relative to the actual field force expansion, I am going to turn that over to Warren because what we wanted to do, Dave, was do two things. First and foremost, we wanted to take advantage of the HPV-negative indication because we believe we will be the only MolDX-approved product for HPV negative. And it is a very specialized group of physicians that account for that bulk of that business. There is a fairly clear road map to how we can get to those. And so Warren’s team is initially now expanding to cover that group. And then he will build the additional reps over time for the added indications that we have. And yes, Dave, they are intended to be complementary to MRD and NGS. They will not be specific only to MRD. So, Warren, maybe a little bit more color on the coverage aspect.
Abhishek Jain: Absolutely. Thanks, Tony, and and morning, Dave. So, yeah,
Warren Stone: the the expansion is taking place. There is an initial expansion happening sort of as we speak that is to to really address the RADAR ST launch and particularly head and neck, HPV negative. And the reason why we felt we needed to do small initial expansion is one of the primary call points for head and neck HPV is the ENT, and that has not been a traditional core point for us up until now. So we actually are investing in a small team dedicated towards ENTs, and they will be almost exclusively focused on the RADAR head and neck indication. They will have an option to represent other parts of the portfolio, but we feel that their focus will be largely focused on the RADAR ST. The as we have done in the past, and very successfully, I might add, as we expect new products and, in this case, new indications to come to market, we do expand our sales force because we want to increase reach and frequency. And we will be doing that in in quarter two and in quarter three in anticipation of the additional indications that we expect from from MolDX. Again, these these team members will be oncology sales specialists. They will be responsible for selling our oncology portfolio, which is therapy selection for heme and solid tumor, as well as MRD. It is probably a bundle of about 12 or 14 tests if you really look at it. But we see a 100% call point overlap between our portfolio for therapy selection as well as MRD. And today, based on our size of our sales team, we feel we get more value by consolidating sales activities within one resource versus having specialized sales teams. Although we will get some good lessons from our dedicated ENT group that we are establishing as we speak.
Jeffrey S. Sherman: Thanks, Dave. Alright. Thank you, guys.
Operator: Your next question is coming from Bill Bonello with Craig Hallum. Please pose your question. Your line is live.
Andrew Brackmann: Hey, guys. Hoping to sneak in a couple of the
Michael Stephen Matson: but the first would be just on the on the clinical volume. Is any chance you could quantify the impact of exiting the low value business and then maybe clarify whether there is, you know, more business that that you will still be exiting in future quarters so we can have some sense of of how to think about volume growth as we progress through the year.
Anthony P. Zook: Sure, Bill. I will I will kick that off. And, again, if I I will look to Abhishek or or Jeff to add in any additional color. Bill, can you just step back and you look at us historically? Right, and if you looked at how the revenue models were built, you know, volume represented for us typically, you know, this upper to single digits growth, and and AUP was more in the low single digit growth. There are two factors that are driving our thinking now. First of those is this constant and purposeful penetration into therapy selection in MRD. With that, we will be the beneficiaries of higher AUPs, and therefore a better impact on our margins and business overall. So that is point number one. We expect our AUPs to continue to grow. And then the second point, Bill, was this idea we want to make sure we secure the right ball. We want to be a business that is growing our revenue as well as our margins over time. And you recall that we had we talked about a contract throughout last year that was a high volume, low value added opportunity for us. The AUPs still in that were, like, in the low $200 range. We entered into that with the potential opportunity to secure longer-term growth into higher value tests. But if things do not materialize, we had to look at it in the macro sense. And for us, we believe the better course of judgment here was to say, our resources are better used and focused in the areas where we are seeing higher margin opportunities and higher growth. And so the model now kind of inverts a little bit. What you should be expecting is AUP now in the upper single digit range with volume in the lower to mid single digit range. But that being said, I just want to make sure we clarify this, Bill, because it is an important point. We are still growing all the right volumes. Right? We are going to continue to grow by modality. We we have no desire to pull back in that area. We continue to expect NGS to have robust growth as well. And so that is going to continue. We saw robust NGS volume and AUP growth in 2025. We would expect similar results in 2026, and so the right volume will come through. And on that MTS business, again, you know, it is over a third of our clinical business. And an interesting fact, Bill, is that, you know, that third of our clinical revenue gets actually being supported with only 9% to 10% of our laws. And and so it is the right volume that is generating these kinds of growth numbers. So I would expect most of this to be evident through Q1 and Q2. And then from that point on, we will be back to kind of normal growth trends. That help, Bill?
Michael Stephen Matson: It it it it does. And I mean, it should we think even a bit lower perhaps as as we get into Q2 and Q3 just then on the the volume growth, sounds like maybe a little to still come? Is this a pretty good proxy?
Abhishek Jain: So let me take that one, Bill. So we are like, for example, what we have seen in Q4 results are sequential volume growth was slightly down. And we are anticipating as we kind of go in Q1, our numbers will be sequentially down in similar vein, as we kind of start to focus on these high margin high value tests. And this is very intentional from our strategy standpoint, and that is the reason we are moving in that direction. But as we get into Q2, we will basically be year over year flattish, and that is where we will start to grow our volumes in Q3 and Q4 on a year over year as well as on the basis.
Michael Stephen Matson: Okay. That is really helpful. Thank you.
Anthony P. Zook: Thanks, Bill.
Operator: Your next question is coming from Andrew with William Blair. Hi, guys. Good morning. Thanks for taking the questions.
Anthony P. Zook: Maybe just also a similar line of questioning to Bill here just sort of around guidance. By my math, it looks like the core clinical business when I exclude Pathline and some of these new contributions from LBX and MRD, it looks like that core is called the sort of growing that high thing digit to maybe 10% year over year. You maybe just unpack some of the underlying assumptions there for the export book of business. And I guess, in particular, just sort of reconciling that to the I think you did 14% same store sales growth in Q4. Just sort of reconciling that to that to that high single to 10% growth. Thanks. Yeah, Andrew. Again, I will I will kick it off, and and I will look to Abhishek and and Jeff to add additional color. So, yes. In 2025, you saw, you know, ex Pathline, we were about 13% growth on the clinical side. And, you know, we are anticipating, you know, double-digit growth on the clinical. And so what is within there? First, there will be the full year of Pathline that will be built into the numbers as well. As I just mentioned with Bill, that one contract that we exited that has an impact in the totality of the clinical side. And then of course, in the guide itself, Andrew, just to be clear, we wanted to be prudent relative to the back half with LDX. Since we still do not have LBX approval in hand, we thought it better to only pack in revenue for the second half of the year at a modest rate. And so we do not really see the benefits of that coming through in the current guide. If we, in fact, get LDX support for LDX earlier than that, then it would represent upside in our total growth and of course, that would be on the backs of the total clinical business. And so, again, I hope that gives you some color and, Abhishek, if I missed any key points, please. Call out for Andrew. No. I think you have covered it well, Tony. And, Andrew,
Abhishek Jain: we are expecting the clinical business to be growing at about 11 points based on our low mid single digit on the nonclinical side. So it is kind of in the range that we have been expecting the company to be growing in, like, at about 10. That is what we have called out, and that is where our midpoint currently is $797,000,000. Is pretty close to that 10%. I think the guide is pretty prudent to the extent that it gives us a very high degree of confidence to be able to meet these numbers. And then we will, of course, see if the people pan out as we are anticipating, it gives us some room to actually do better than the expectation.
Operator: Yeah. Okay. That is helpful. And then
Anthony P. Zook: yeah. That that is very, very helpful. Thanks for thanks for all that color. Then just just on the LIMS rollout here, you know, obviously, that is a that is a multiyear process for for that rollout. But anything you can maybe share with respect to how that might be impacting the model or sort of just sort of the the workflow in 2026? Thanks. Yeah. Yeah. Great question. Thank you for that. As you know, historically we were built for effectiveness, not necessarily for efficiency. And moving to a common LIMS system, we think, is foundational for us to continue to advance towards ever improving margins and efficiencies for the company. What we will see through the course of 2026, Andrew, we have these eight existing LIMS systems. We will be on a path to migrating to one common system. What we want to do, though, is manage that effectively over time. And so we are going modality by modality, site by site. We are not going to just do kind of a big bang theory and put any risk at all into the business. And so that means the benefits of LIMS only start to become evident for us in the latter part of this year. Now there are some natural efficiencies that Warren’s team are already seeing, and I will look to him to add some of that added color for you. But the more pronounced impact will be in 2027 and 2028 as we can retire all the legacy systems and build upon the existing LIMS architecture. So you already added color.
Warren Stone: Yeah. Thanks, Tony. Andrew, I think, yeah, in terms of sort of technical debt benefit, that is coming in 2027, to be clear. But yeah, as we put the LIMS system in now, we are actually not just replacing our existing eight LIMS with a new LIMS. We are actually looking at the workflows and optimizing the workflows based on on how we understand the business and how it is likely to develop over time. So as we get each modality in place or in in each site, we start to see workflow efficiency there. So that is sort of well, something that will start to come through in operational efficiency. I think the other big benefit that we are getting is is far greater capability inefficiencies lie from an analytics and insight point of view to really understand where within our workflows, and and that analytics and and sort of transparency will also help us translate a better customer experience by providing visibility to real-time sample tracking, etcetera, which is one of our key initiatives for 2026.
Anthony P. Zook: And I would say, Andrew, again, this is foundational for us because it affords us then the opportunity to build on that which is why I maintain that we are still in the early innings relative to gross margin expansion opportunities for ourselves. So, you know, we throw in LIMS and then we look out of the platform off opportunities like, you know, TX and things that Warren and his team can do with digital pathology and automation. We believe that the gross margins are in early, and we can continue to build not just revenue, but margin expansion as well. Okay. Appreciate all the color. Thanks, guys.
Jeffrey S. Sherman: Thank you. Okay.
Operator: Your next question is coming from Subbu Nambi with Guggenheim. Please close your question. Your line is live. Hey, guys. Thank you for all the color in different businesses.
Andrew Harris Cooper: Given some longer selling cycles and maybe some evening of the funding pressure, where do you see pharma ordering playing out this year between first half and second half? And what products do you expect to leave the order book from Carmel?
Anthony P. Zook: Could you repeat the second half of the question, please?
Andrew Harris Cooper: What products do you expect to lead the order book for pharma?
Anthony P. Zook: Okay. Got it. So relative to pharma, I would say that my views certainly have not changed from where we were about six to eight months ago. We we anticipated, you know, that there is some erosion that we were experiencing on the pharma side of the business would continue into 2026, albeit not at the same rate we saw in 2025. So I have always been of the belief that it would be 2027 before we would see a return to growth for that book of business. And that is how we built the guide. So we expect still to see modest erosion in the pharma book of business for 2026. Certainly, it will be much reduced from where it was, but still in that, you know, mid to upper, you know, 5% to 10% range for the pharma side of business. I think the big part of return to growth there is based on RADAR ST. That will be one of the key growth drivers for us in that book of business. There, you know, we have had, you know, pretty good conversations. We have been well received. Know, we are back at the table with RADAR ST. There seems to be a really good sense of interest in it. And that portfolio of opportunities continues to grow. And so relative to the year, again, the guide would still anticipate a modest erosion in the pharma side of the business. If we can get that back flat, that would then represent upside opportunity for us. Warren, I know the long lead cycle times, but perhaps you talk about RADAR ST and how that is being received. Yeah. Tell you, maybe a couple of
Warren Stone: comments there, Suvi. So first and foremost, in terms of the focus, you know, a little bit like on the clinical side, really our focus is to protect our position in diagnosis, but really look to grow in therapy selection in MRD. We we look at pharma in a very similar way. You know, we are we are very well known from an IH perspective, and we continue to focus on IHC because it is very relevant for pharma from an antibody drug conjugate perspective. And it is a it is a good door opener for us, but expect our focus to really lie towards therapy selection and MRD. So there is a strong a strong alignment here between what we are doing in clinical and with pharma. As Tony said, robust opportunity pipeline that developing with regards to RADAR ST and pharma. Some legacy users and many new users, and expect first bookings to materialize shortly. And and I do appreciate the question. You know, this gives us the opportunity to clarify. The other thing I just would remind the group, this is
Anthony P. Zook: a relatively small portion of our overall business talking it is about 5% to 6% of our overall business. And so we continue to put the primary focus and energies on the clinical side of the business with the intent to stabilize this business and return to growth in 2027. So thanks for the question.
Andrew Harris Cooper: Absolutely. Thank you for clarifying this. Can you talk about the framework for LIMS integration this year? What is being finished? What is left to go? And then maybe how that will show up in earnings in 2026.
Warren Stone: So I I would say where our focus is today. So we have completed flow. So one of our our key modalities. Our next step right now is around accessioning, and NGS is really where our focus is. Again, aligning to our strategic priority, looking to be able to provide increased value both from an efficiency perspective and customer traceability. Those would certainly be things that you would look to conclude in 2026. Probably for other modalities as well rolling into that. But we can certainly take it offline and provide more granular detail if you like. But those are the key focus areas for us from 2026 is molecular and and accessioning.
Andrew Harris Cooper: Okay. You so much, miss.
Operator: Your next question is coming from Mike Matson with Needham. Please pose your question. Your line is live.
Anthony P. Zook: Hi. Thanks, everybody, for taking our questions. This is Joseph on for Mike. Just, I guess, in terms of the guide for RADAR for 2026 in the mid single digit millions, I am just kinda wondering framing up your guys' confidence and the ability to hit that mid single digit number. I guess just trying to understand how much of that is is the clinical side versus the the bio side. You know, maybe for both of those, you know, which do you see to have the the the higher potential to drive upside to that mid single digit number? Yeah. Thanks for the question, Mike. I I would say, first and foremost, we do have a high degree of confidence in that. That is why it is in the guide at the midpoint level. So we we do have a high degree of confidence
Operator: there.
Anthony P. Zook: Relative to the mix, you know, I I think it would be fair to say in the early part of the launch, you would expect a heavier component of that to probably be more on the pharma side,
Abhishek Jain: than the clinical side,
Anthony P. Zook: only because the clinical launch just takes time to build. Right? Know, we will have the indications of head and neck and breast, and then you will build and you will start to see a slow build of that activity. And and just with the lead times of the product, you start to see the clinical effect of that probably in the latter part of the year. Whereas pharma have the opportunity to take on a little bit more of a pan orientation and can secure pricing sooner. And then as we build the indications over time, you are going to see the clinical side of the business certainly accelerate, and that would be the largest of the drivers moving into the outer years with RADAR ST. Abhishek, anything else of No. I think, Tony, you have covered it very well.
Abhishek Jain: As I basically discussed in our prepared remarks, we are actually launching RADAR ST by the end of this month, and that gives us very high degree of confidence of the numbers that we are putting in in our guide.
Anthony P. Zook: Thank you.
Jeffrey S. Sherman: Okay. Yeah. Great. And then maybe just
Anthony P. Zook: one more quick one. Can you maybe just talk about the know, the potential for continued ASP growth? You know, I I think you guys were
Warren Stone: kind of, talking about high single digits.
Anthony P. Zook: Or, you know, upper single digits maybe for 2026. But you know, the the the potential for that to continue with with any additional reimbursement announcements. So you know, what is currently approved and reimbursed in your pipeline, you know, of the NGS products, pan tracer, as it stands today without, LBX.
Jeffrey S. Sherman: Yeah. I will start, and, Abhish, I can join you. This is Jeff. So I think, look, the the shift in the NGS is going to be continue to be the big driver of our AUP growth as it was in in 2025 as well. So I think that that is one factor. We expect to continue to have success with direct line bill pricing increases, which only going into the first quarter of the year. And we also are continuing to have success with managed care pricing which started in the back half of last year. We are expecting full year impact of those that hit in 2026 as well as new new agreements and new increases approved. And then finally, we are we are still working on other RCM initiatives to kind of close that gap between what we expect to be paid and what we are being paid. And so, you know, that AUP growth will come for those drivers. To the extent we get additional, you know, indications or or tests approved, that will be incremental on top of that growth.
Abhishek Jain: Thank you.
Operator: Your next question is coming from Tycho Peterson with Jefferies.
Michael Stephen Matson: Hey. Thanks. Maybe one for Warren. Just on on the Salesforce, I your color on go forward additions. But as we look back over the last year, obviously, ramping the sales force was a big focus. Maybe with that cohort matured, can you just talk about where they are in terms of productivity? I think you called out over five tests ordered. You know, on providers, but maybe just any other metrics we can know, look to to to track, you know, the the the scaling up of the Salesforce over the last year. And then separately, are you baking anything in for, you know, Adaptive-related revenues this year and any metrics, you know, you can provide there?
Warren Stone: Thanks, Tycho. Yeah. Absolutely. As you out, we did expand our sales force late 2024 and into the 2025. We kinda see that sort of six to nine month ramp up period, and I would say that that sort of maturing or that productivity of those resource was a big contributor to our success in next year of 2025. And we anticipate that that is going to be a tailwind for us in in the first half of the year, for sure, as that sort of momentum continues to annualize into this year. Again, the focus of those resources, they are oncology sales specialists, so they are really focusing in on therapy selection, and they are going to be supporting our launch from a RADAR ST perspective in MRD. So that is that is where where where the focus is. I would say that those resources are at productivity now, so sort of in stride. The positive is we have seen very, very low attrition as well. It is not like there has been a high churn or anything. So I feel we are we are executing well, and we are starting to see general increased productivity across our entire sales team, not just the 35 that we brought on board in 2025. The the sort of entire 140 or so that we have within our our complement today.
Abhishek Jain: And, Tycho, the only other
Jeffrey S. Sherman: few points, I will do a little bragging for Warren and his team.
Anthony P. Zook: He may be a little humble here. I think if you look to how that expansion has taken place, there are some proof points that we could look to. I mean, first foremost, you do got to look at that NPS score. Right? You know, to have an NPS score of 79, which is a step up from where it was already, and that is heavily basic now with feedback from oncologists. So I think that is a really positive sign that the reaching frequency model is beginning to have an effect. And then within the subsegments of our own data, when you start to see your 14% of oncologists and pathologists are now ordering five or more NEO tests. I mean, I think that is another proof point that this model is taking effect, and we have now over 40%, we estimate, of oncology pathologists prescribing five or more tests. I think these these things are what is fueling the NGS growth opportunities for us, and I think to take the Salesforce on that journey over the past, you know, 12 to 16 months has been an incredible one and one we are proud of and one we are going to continue to build on. And then relative to your second question, I I would say that from a revenue perspective, we look at the Adaptive partnership much probably more strategically than economically. We see it as an offering that we can offer our customers. It offers them then an expansive portfolio of opportunities for us. Over time, we will see we will be a company that can offer flow MRD. We can offer EM MRD. We will have RADAR ST. We will have next-gen MRD. And so that that whole suite of product, we think, is an important one to offer and to have an outstanding partner like Adaptive is is more strategic than I would say it is economic, at least for us. But we are going to continue to work and manage that relationship to the best of our ability. Thanks for the questions.
Abhishek Jain: I can
Operator: Your next question is coming from Dan Brennan with TD Cowen. Please pose your question. Your line is live.
Jeffrey S. Sherman: Great. Thank you.
Michael Stephen Matson: Just to start off just on Pantracer. I understand the conservatism there. Just any more color about
Daniel Gregory Brennan: kind of the back and forth. It sounds like it is imminent. But the blood market is growing a lot faster than the tissue CGP market. So you have had really good success on tissue volumes. Just, you know, is is it just conservatism, or, like, what do you expect, you know, once that is really dialed in? For that pan trace of liquid to grow at from a volume basis?
Anthony P. Zook: Yeah. I will I will I will kick us off and then have a second Warren could add a little bit more. So, yeah, Dan, we have responded to all the questions that MolDX had relative to LBX, and so we are just, you know, kind of in a waiting a response mode. Now what we have seen is across it is not just us, but across the sector. It has been averaging about four to five turns through MolDX new offerings. And so that puts us right around, you know, four turns is right around the 12-month mark. And so that is kind of where we sit today. You know? So we are confident. We we see this as a when we get it, not an if we get it. Then we that is why we thought, yes, it was prudent to not include revenue for the first half of the year and then just kind of a modest and slow build in the second half of the year? And anything that would come before that will then be opportunistic upside for us. Relative to kind of modeling at the high level, again, you called it out 2023 to 2024 doubled. We saw the same, almost nearly doubling in 2024 to 2025. We think that is probably a a decent predicate as a way to look at LBX over time. And so we look to our total NGS portfolio, of which the 2026 and beyond. It is certainly in line with 2025. And then depending on MolDX time, it could be better than 2025. So hopefully, that gives you a little bit more color. And and, Warren, I if you want to get any more specific to the hubs you are seeing with LBX and tissue
Warren Stone: Yeah. I I would say the following. I think, Dan, you are you are right that the liquid market is growing faster. Since the the launch of a PANTRASER liquid, we have actually seen a good acceleration across the category. We saw increase in utilization of PANTRASER tissue, and we have seen attractive uptake of PAN tracer liquid as well. And we feel and, actually, we launched PANTRASER Pro very late last week and and expect that be another inflection point in terms of how this solution for solid tumor therapy selection is positioned for the market. So we are I am very confident in terms of the outlook here. It is really just around an unknowns with regards to MolDX reimbursement timing, I think, what you are you are seeing within the thought process from a guide’s point of view. Yeah. We launched PANCRACER Tissue in end of Q1 of 2023.
Jeffrey S. Sherman: And, you know, it started to build throughout 2023. And then we really saw a big uptake in the first and second quarter 2024. And and that was a big driver of our NGS growth during that time.
Abhishek Jain: Thanks, Dan. Great.
Operator: Your next question is coming from Puneet Souda with Please pose your question. Your line is live.
Andrew Brackmann: Yes. Hi, guys. Thanks for the questions here. So just clarifying, given the guide here,
Vidyun Bais: is the long term, LRP that you had put out earlier, I believe, 12% to 13%, is that still in consideration, or is that off the table? And then if I look at the same store sales versus new test, 5% revenue per test growth reported versus 7% same store sales. Can you elaborate on how do you expect to convert these new customers to sort of higher value test? How long would that take for us to, you know, start to see an impact there? Thank you.
Anthony P. Zook: Okay. So, for me, first on the first question, you know, we are we are not talking LRP. We have tried to make it clear as we can that, you know, we are taking our feet and firmly planting them in the year we are in. And so I am not projecting it out. I would simply say that I believe that we will this guide are very confident in. I think we will end the year in a very strong position with accelerated growth opportunities as we head into 2027, and we would start to then see the full benefit of RADAR ST and Pan Tracer LBX coming through the system. So I have I will not go into any more relative to LRP discussion. The second question,
Jeffrey S. Sherman: Yeah. From from an A AUP perspective, you know, with, you know, with the guy going on I think adding those tests, and and coming in the back half of year, you should expect AUP will will grow as we add those incremental tests over time. And I think that is 2025 was kind of a good example of that.
Abhishek Jain: Yeah. No. But my sense is also that AUPs, we kind of move into these high value tests. Right? Because in any case, these are going to be priced at a much better rate, and we expect the AUP will grow as we move in this direction.
Andrew Brackmann: Yep.
Jeffrey S. Sherman: And as you said, you know, Pete, so the same store, excluding Pathline, was was higher. It is in the mid single digit, and the quarter. And I think over time, adding these tests in the back half of of 2026 will will help drive AUP growth as well. Yeah.
Warren Stone: So and and, Pradeep, maybe building on this sort of opportunity to penetrate and how long again, coming back to that commercial strategy to protect, expand, acquire, a really good job of protecting that sort of hole in the bucket is really something that has improved and the NPS score sort of helps to to drive that. But the expand element of the strategy is very much around taking new products and selling them to existing customers. That is an active part of the strategy. And we do that both on the the the pathology side of the business for the TVMs where relevant, but very specifically, on the oncology side as well with oncology sales specialists. And as we bring on more and more new oncology practices, you know, we we we typically lead in with a heme solution because that is where we differentiate it, and then we use that as a basis to expand into solid tumor. Yeah. It is difficult to give you a finite example of exactly how long it takes because every practice is different. But sales cycles here are relatively quick. And as as soon as we can put sort of interfaces in place to streamline workflows, introduce things like Pantracer Pro, we expect that acceleration to to or the speed to accelerate through 2026 and into 2027 as well. So the active part of the strategy, I am very confident in our ability to pull that through based on past experiences.
Abhishek Jain: Thank you. And on the thank
Vidyun Bais: And and and just very quickly on on the leading with heme and then entering with solid tumor into those accounts. Could you just elaborate on sort of what you see as the competitive landscape in tissue CGP today and also liquid, obviously, significant penetration in the market, multiple competitors out there. Maybe just give a sense of how you think your position today in the community setting versus the competition that you are seeing in the community setting. Thank you.
Warren Stone: Puneet, I would say that we have not seen a marked change in terms of what is happening from a landscape perspective on the solid tumor side as things in the community setting where we are focused. As we have said before, we we tend to bump into most of the the normal competitors in different parts of the country, etcetera. We find our portfolio to be very well received based on the fact that we focus on actionability and a high degree of service. And and you know, a stat that Tony shared earlier that 75% of three out of four new oncologists that try us tend to stay with us. And that is not only unique in in the heme side of things. It happens through on the solid tumor side of things as well. So certainly, is a competitive landscape, but I cannot say I have seen any material changes. And we are seeing success on the liquid side of things as well despite the fact that we are a late entrant. And I have put that down to the fact that we have a broad portfolio and physician practices are looking to to simplify their workflows and standardize on vendors, and that places NeoGenomics, Inc. in a very favorable position.
Daniel Gregory Brennan: Thank you. Thank you.
Operator: Your next question is coming from Mason Owen Carrico with Stephens Inc. Please pose your question. Your line is live.
Jeffrey S. Sherman: Hey, guys.
Anthony P. Zook: On MRD for the two indication that you submitted, do you plan on launching RADAR for those indications ahead of MolDX approval to start building that volume stream? Or do you plan on launching you gain coverage? Yeah. As I tried to convey earlier, we are going to stay focused on the two initial indications of head and neck and the subsets of breast in the initial launch period. And then we will expand accordingly as we get MolDX coming through the system. You know, there there is certainly be enough on our plate in the short term with just those two. And then we will build in the latter half of the year.
Abhishek Jain: Got it.
Anthony P. Zook: And then on the 23% NGS growth in the quarter, could you provide any additional detail, I guess, on how much of that may be came from the core existing business versus pull through tied to the Pathline acquisition?
Jeffrey S. Sherman: The bulk of it would still be the business with with with top line starting to ramp is how I would characterize it.
Daniel Gregory Brennan: We are certainly seeing, increased,
Warren Stone: activity and penetration in Northeast, but just the the the center of gravity lies towards the other business. So therefore, that is where the lion's share is still coming from.
Anthony P. Zook: Got it. Okay. Thanks.
Operator: Your next question is coming from Mark Massaro with BTIG. Please pose your question. Your line is live.
Anthony P. Zook: Hey, guys. Thanks for taking the questions.
Vidyun Bais: I will keep it to one. Can you just speak about
Jeffrey S. Sherman: how we should think about gross margins in 2026?
Vidyun Bais: 2025 was obviously down. When we put sort of the
Jeffrey S. Sherman: different, you know, increase in NextGen, I could see how there could be a path to gross margins increasing in 2026, but however, there are some other headwinds as well. So can you just give us a sense if
Vidyun Bais: if you think gross margins can grow this year and any
Daniel Gregory Brennan: ability to quantify that would be helpful.
Abhishek Jain: Sure. Absolutely, Mark. Let me take this question. So most of us are just stated with the margin expansion in the current year. In in 2026, is is going to be coming from the gross margin. So we are anticipating the gross margins to at about, like, 100 basis points, and that is going to basically drop to the adjusted EBITDA margin expansion as well. And there are multiple reasons, of course, on the margin expansion as we kind of look at our price increases as well as we rationalize our portfolio to the high value, high margin products as well as the the the work that our labs are doing to be more efficient being there. So the gross margin is expected to improve about 100 to 120 basis points in 2026, and most of that is going to be dropping to our bottom line on the adjusted EBITDA.
Anthony P. Zook: Great. Thank you.
Andrew Harris Cooper: Thanks, Paul. Your next question is coming from Andrew Harris Cooper with Raymond James. Please pose your question. Your line is live.
Daniel Gregory Brennan: Hey, everybody. Thanks for the question. Maybe first, Tony, I think you said you expected NGS growth to look pretty similar in 2026 to 2025. I know the target
Anthony P. Zook: is 25%. You know, you were you were almost there, but not quite.
Andrew Harris Cooper: You had some of these tailwinds when we think about NTRASE or liquid coming on at least in the back half. I do not know if you will count MRD in kind of that bucket with NGS when you think about the target. But how do we think about that trending through the year, especially in context of
Anthony P. Zook: a Salesforce that will be essentially tripled or quadrupled by the time you are done adding?
Abhishek Jain: Yeah. I I think
Anthony P. Zook: as you you rightly put it out, we showed about 23% for the quarter, about 22% year over year for NGS growth. I I would expect that we should be able to do that in 2026. If not, we are have slightly better than that. And that is going to be driven, as you say, by the momentum of the Salesforce that we have, the addition of LDX into the portfolio, PANCREAZE for PRO. So we expect that we should do at least as well as we did in 2025. We ought opportunity to maybe even meet that slightly. And much of that will be dependent on the timing of LVX. And so I think that is a safe assumption to take into the year.
Andrew Harris Cooper: Okay. That is helpful. And then maybe just lastly, for for Jeff or Abhishek or Tony, if you want to chime in as well. But
Jeffrey S. Sherman: know, when we think about that shift of growth being
Andrew Brackmann: heavier volume versus ASP to the other way around and more ASP or AUP driving that growth? How does that change the way you think about that margin drop through over
Anthony P. Zook: longer term? It sounds like when we think about 2026, there is certainly some
Vidyun Bais: that is probably eating up a bit of the flow through that would be there otherwise. But
Anthony P. Zook: how does that change the way you think about sort of the long-term trajectory from a margin perspective, if at all?
Warren Stone: Yeah. Great question. No. That is a great question, Andrew. And, that is that is
Abhishek Jain: I think, the key strategic question that we have with Neo that we have a broad range of portfolio here. We have tested, like, $102,100 dollars AUP, and then we have very high value tests of the NGS side. Now that also basically kind of differentiates us from some of the other specialty diagnostic labs as to how we are thinking about our volumes. Now when we look at our capacity, when we are in when we are looking at our full, we would definitely would want to be selling to the customers that are giving us the business, which is not only the low value, but also either there is a portfolio which combines the low value test with the high value testing. And then that becomes more positive for us. But if a client is only giving us the low order value test, then this is a natural shift that we do not want to be kind of taking those up particular business. And that is where we are looking at more carefully as to, okay, what is what are those tests that we would want to be in. So from the margin standpoint, in the long term, as we kind of shift towards the high value, high margin test, that could definitely be accretive for our gross margins as we kind of also going to be able to improve our operational efficiencies using our lab infrastructure. Thank you. Okay. Thank you.
Operator: This does conclude today’s question and answer session. I would now like to turn the floor over to Tony Zook.
Anthony P. Zook: I would just like to thank everybody for joining us on the call, and I would also like to thank our roughly 2,400 teammates for their unwavering commitment to our mission and their hard work throughout all of 2025. I am very excited for the year ahead for our company, our oncology physician customers, and their patients. I look forward to our next quarterly update in April, where we will report our first quarter results. Thank you again, and have a great day.
Operator: Thank you, everyone. This does conclude today’s conference call. You may disconnect your phone lines at this time, and have a wonderful day. Thank you for your participation.