Lumexa Imaging Q1 Earnings Call Highlights

Key Points

• Q1 results were broadly in line with expectations, with revenue up 3% year over year to $253 million and adjusted EBITDA essentially flat at $51.2 million. Management said weather disruptions and seasonal volume pressure, especially in routine scans, held back margins.
• Advanced imaging remains the main growth driver, as advanced modality volumes rose 7%, led by PET up 23.1% and MRI up 8.2%. Lumexa said these higher-reimbursing services helped offset weakness in routine imaging and support revenue per unit.
• The company reaffirmed its 2026 guidance and growth plan, targeting revenue of $1.045 billion to $1.097 billion and adjusted EBITDA of $234 million to $242 million. It also highlighted new center openings, acquisitions, and technology initiatives as key contributors to future growth.

Lumexa Imaging NASDAQ: LMRI reported first-quarter results that management said were in line with expectations, as growth in advanced imaging modalities helped offset seasonal volume pressure and weather-related disruptions.

Chief Executive Officer Caitlin Zulla said the company “recovered our momentum” as volumes improved throughout March. She said Lumexa is focused this year on same-center growth, expanding its mix of advanced modalities, opening de novo centers, ramping newly opened centers, building strategic service lines and broadening its geographic footprint.

“We move forward into Q2 with confidence fueled by strong execution and a sense that at Lumexa Imaging, we are in the early innings of capitalizing on the opportunities ahead of us,” Zulla said.

Revenue Rises 3% as Advanced Modalities Grow

Chief Financial Officer Tony Martin said consolidated revenue rose 3% year over year to $253 million in the first quarter. System-wide revenue, which includes all centers the company operates, increased 4%, with about two-thirds of that growth coming from volume and one-third from rate.

Outpatient net patient service revenue grew 4% to $138 million, while professional fee revenue increased 1% to $59 million. Management fee and other revenue rose 5% to $55 million. Martin said roughly $21 million of management fee revenue came from operating sites in Lumexa’s health system joint ventures, while the remaining $34 million represented zero-margin passthrough costs.

Advanced modality volumes increased 7% year over year on both a consolidated and system-wide basis. Zulla said Positron Emission Tomography volumes grew 23.1%, while Magnetic Resonance Imaging volumes rose 8.2%.

Martin said advanced modalities reimburse at three to four times the rate of routine modalities and were a key driver of revenue per unit. He said routine scans were essentially flat in the quarter, with mammography taking longer to rebound after storms.

Weather and Seasonality Weigh on EBITDA

Lumexa reported net income of $2 million, compared with a net loss of $8 million in the prior-year period. GAAP earnings per share were $0.02, while adjusted earnings per share were $0.18.

Adjusted EBITDA was $51.2 million, essentially flat with $51.1 million a year earlier. Martin said the company estimated that enhanced seasonality and weather disruptions affected first-quarter EBITDA by about $4 million, consistent with expectations discussed on the company’s prior call.

“There were four separate weather events that were a pretty big deal in a number of markets,” Martin said during the question-and-answer session, adding that the impact was “more meaningful” than in a typical year.

Adjusted EBITDA margin was 20.3%, compared with 20.8% in the first quarter of 2025. Martin said the impact reflected softer volumes against a partially fixed cost structure, including staffing, equipment and facility costs that do not flex proportionally during short-term disruptions.

Interest expense was $16 million, down $14 million from the prior-year quarter, reflecting the company’s use of IPO proceeds to pay down debt. Martin said the refinancing frees up more than $50 million in annual cash that Lumexa plans to invest in growth.

Guidance Maintained for 2026

Lumexa reaffirmed its full-year 2026 outlook. The company expects:

• Revenue of $1.045 billion to $1.097 billion;
• Adjusted EBITDA of $234 million to $242 million, including about $7 million of public company costs not incurred in 2025;
• Adjusted earnings per share of $0.71 to $0.77.

Martin said Lumexa expects a gradual sequential ramp in Adjusted EBITDA through the remaining quarters, with about 55% of full-year Adjusted EBITDA expected in the second half. He cited same-center growth, geographic expansion, strategic service line growth and efficiency initiatives as drivers.

Operating cash flow was $3 million in the first quarter, a $17 million improvement from the prior-year period, while free cash flow was negative $2 million, a $13 million improvement. Martin said the first quarter is traditionally the company’s lowest cash flow quarter due to working capital patterns and seasonality. He said free cash flow is expected to be more heavily weighted toward the second half of the year.

New Centers, Joint Ventures and Acquisitions

Zulla said Lumexa completed two acquisitions and opened two de novo centers so far this year. The acquisitions were single sites: one in Pennsylvania through Lumexa’s joint venture with University of Pittsburgh Medical Center and another in North Carolina with Advocate Health. The de novo centers are wholly owned locations in South Carolina and Niceville, Florida.

Zulla said the Pennsylvania acquisition marks the first site in Lumexa’s new UPMC joint venture. She said the company is “actively advancing site planning” with UPMC and expects to announce at least a few de novo locations with the health system this year.

Management reiterated a goal of opening eight to 10 de novo centers annually. Zulla said the 2024 and 2025 de novo cohorts are tracking in line with expectations and that the 15 centers opened since late 2024 are ramping.

The acquired sites are expected to contribute minimally in 2026 as Lumexa works through payer enrollment, integration, equipment and volume optimization. Zulla said the sites demonstrate the company’s model and position it for 2027 and beyond.

Technology Initiatives and Cybersecurity Disclosure

Zulla said Lumexa continues to deploy technology and artificial intelligence across its operations. The company is expanding its AI-powered breast arterial calcification program, which launched in New Jersey and has been extended to New York. She described the offering as a cash add-on assessment for cardiac health in women and said patient uptake has remained strong.

The company is also expanding FastScan technology for MRI. Zulla said Lumexa began the year with FastScan on 51% of its MRI fleet and remains on track to reach roughly two-thirds adoption by year-end 2026. She also cited Virtual Cockpit remote MRI scanning as a tool to reduce downtime, support staffing flexibility and extend patient service hours.

Zulla said Lumexa is using technology and AI in operational productivity, scheduling, revenue cycle functions, strategic service lines and radiologist support. She mentioned work with Ferrum Health, RadPair and Rad AI for clinical workflow tools.

The company also disclosed that one of its vendors recently experienced a cybersecurity incident involving a breach of Lumexa data. Zulla said Lumexa has responded swiftly and is taking steps to address the situation, protect patients and comply with applicable laws and regulations. She said the company does not believe the incident will have a material impact on its business or financial results.

“Given the nature of the event, we cannot say more at this time and will, of course, provide updates in the future as we have them,” Zulla said.

About Lumexa Imaging NASDAQ: LMRI

We are one of the largest national providers of diagnostic imaging services(1). Our platform is integrated, scalable and has a proven track record of creating value for our stakeholders. As of September 30, 2025, we and our affiliates operated the second largest(1) outpatient imaging center footprint in the United States. It spans 184 centers(2)across 13 states and includes eight joint venture partnerships with health systems. Our centers are in attractive metropolitan statistical areas (“MSAs”).

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