Castle Biosciences (NASDAQ:CSTL) Announces Earnings Results, Beats Estimates By $0.22 EPS

Key Points

• Castle Biosciences reported a quarterly loss of $0.13 per share, beating the $0.35-per-share loss analysts expected, while revenue of $101.95 million exceeded the $92.77 million consensus.
• Strong revenue growth and TissueCypher demand led the company to raise its 2026 revenue guidance to $385 million–$395 million; TissueCypher test reports rose 47% year over year.
• Adjusted EBITDA and operating cash flow improved, but the GAAP net loss widened to $4.1 million as expenses rose. Medicare coverage uncertainty remains a headwind for DecisionDx-SCC.

Castle Biosciences (NASDAQ:CSTL - Get Free Report) released its earnings results on Thursday. The company reported ($0.13) earnings per share for the quarter, beating the consensus estimate of ($0.35) by $0.22, FiscalAI reports. The company had revenue of $101.95 million for the quarter, compared to the consensus estimate of $92.77 million. Castle Biosciences had a negative return on equity of 4.15% and a negative net margin of 5.43%.

Here are the key takeaways from Castle Biosciences' conference call:

• Revenue guidance increased substantially: Third-quarter revenue rose 24% year over year to $102.9 million, and Castle raised full-year 2026 guidance by $20 million at the midpoint to $385 million–$395 million, citing strong core-business performance, TissueCypher growth and ASP improvement.
• TissueCypher remained the main growth driver: Test reports increased 47% to 15,574, and the company reiterated its 50%–52% full-year volume-growth outlook. Management estimates market penetration at about 15%, while noting that seasonality and sales-team changes can make quarterly growth uneven.
• Cash generation and adjusted profitability strengthened: Adjusted EBITDA was $12.7 million versus $9.2 million a year earlier, and operating cash flow was $19.7 million for the quarter. Castle reported approximately $278 million in cash and investments and expects positive Adjusted EBITDA for 2026 and 2027.
• GAAP loss widened as expenses rose: Net loss increased to $4.1 million from $0.5 million in the year-ago quarter, while operating expenses including cost of sales grew to $105.6 million from $89.8 million, reflecting higher staffing and other costs.
• Medicare coverage remains a headwind for DecisionDx-SCC: Management said its 2027 revenue outlook does not assume a recovery in Medicare coverage, with a draft coverage decision possible in the coming months but no firm timeline provided.

Castle Biosciences Price Performance

NASDAQ CSTL traded down $1.55 during trading on Thursday, hitting $34.20. 701,872 shares of the stock traded hands, compared to its average volume of 350,710. The company has a quick ratio of 5.85, a current ratio of 6.04 and a debt-to-equity ratio of 0.02. The company has a market capitalization of $1.04 billion, a P/E ratio of -51.82 and a beta of 1.00. Castle Biosciences has a 12-month low of $17.72 and a 12-month high of $44.28. The firm has a 50-day simple moving average of $34.28 and a 200-day simple moving average of $28.57.

Insider Activity at Castle Biosciences

In other Castle Biosciences news, insider Tobin Juvenal sold 9,050 shares of the company's stock in a transaction that occurred on Tuesday, August 25th. The stock was sold at an average price of $35.04, for a total transaction of $317,112.00. Following the sale, the insider directly owned 66,914 shares in the company, valued at $2,344,666.56. This represents a 11.91% decrease in their ownership of the stock. The sale was disclosed in a document filed with the SEC, which is available at this link. The transaction was executed under a pre-arranged Rule 10b5-1 trading plan. Also, insider Derek J. Maetzold sold 12,428 shares of the firm's stock in a transaction that occurred on Friday, August 28th. The shares were sold at an average price of $33.20, for a total value of $412,609.60. Following the completion of the sale, the insider directly owned 21,479 shares of the company's stock, valued at $713,102.80. The trade was a 36.65% decrease in their ownership of the stock. The disclosure for this sale is available in the SEC filing. The transaction was executed under a pre-arranged Rule 10b5-1 trading plan. Over the last ninety days, insiders sold 126,184 shares of company stock valued at $4,324,506. 6.10% of the stock is owned by corporate insiders.

Wall Street Analysts Forecast Growth

A number of research firms have commented on CSTL. BTIG Research raised their target price on shares of Castle Biosciences from $40.00 to $44.00 and gave the stock a "buy" rating in a research note on Monday, August 3rd. Weiss Ratings reiterated a "sell (d-)" rating on shares of Castle Biosciences in a research report on Thursday, October 29th. Wall Street Zen raised shares of Castle Biosciences from a "hold" rating to a "buy" rating in a research note on Sunday. Mizuho began coverage on shares of Castle Biosciences in a research report on Thursday, October 29th. They set an "outperform" rating and a $60.00 price objective on the stock. Finally, Robert W. Baird set a $36.00 target price on shares of Castle Biosciences in a research note on Friday, July 31st. One investment analyst has rated the stock with a Strong Buy rating, eight have given a Buy rating, one has issued a Hold rating and one has issued a Sell rating to the company's stock. According to MarketBeat.com, the company currently has an average rating of "Moderate Buy" and a consensus target price of $44.25.

About Castle Biosciences

Castle Biosciences, Inc is a molecular diagnostics company that develops and commercializes tests designed to help physicians diagnose cancer, assess disease risk and guide treatment decisions. The company focuses on conditions in which additional biological information can complement traditional pathology and clinical assessment.

Its portfolio includes DecisionDx-Melanoma, which helps evaluate the risk of metastatic recurrence in patients with cutaneous melanoma; DecisionDx-SCC, which assesses metastatic risk in cutaneous squamous cell carcinoma; and DecisionDx-UM, a test for determining metastatic risk in uveal melanoma.

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