Lumexa Imaging NASDAQ: LMRI reported second-quarter revenue growth, higher advanced-imaging volumes and a return to profitability, while narrowing its full-year adjusted EBITDA outlook and reiterating revenue and adjusted earnings-per-share guidance.
Chief Executive Officer Caitlin Zulla said the company continued to execute on its strategy of building an outpatient imaging platform through same-center growth, new center openings, strategic service lines and health system partnerships. She highlighted a record advanced-modality mix, progress in ramping recently opened centers and a new joint venture with Hospital for Special Surgery in the New York metropolitan area.
Second-Quarter Financial Results
Consolidated revenue rose 5.1% year over year to $264.2 million in the second quarter. System-wide revenue, which includes Lumexa-operated joint-venture sites in addition to wholly owned centers, increased 6%.
Outpatient net patient service revenue increased 3.5% to $143.7 million, while professional fee revenue rose 5% to $60 million. Management fee and other revenue totaled $60.4 million, including roughly $26 million of management fees from health system joint ventures. The remaining amount primarily represented zero-margin pass-through costs paid on behalf of joint ventures, Chief Financial Officer Tony Martin said.
Net income was $2.7 million, compared with a net loss of $7.2 million in the prior-year quarter. GAAP earnings were $0.03 per share, while adjusted EPS was $0.20.
Interest expense fell to $16.2 million, which Martin said was about $14 million below the second quarter of 2025. The decline reflected debt repayment using IPO proceeds last December. Lumexa also repriced its term loan during June, a move expected to reduce annual cash interest expense by an additional $4 million beginning in the third quarter.
Adjusted EBITDA was essentially unchanged at $56.4 million, compared with $56.3 million a year earlier. Adjusted EBITDA margin declined to 21.4% from 22.4%, partly reflecting $1.5 million in public-company costs. General and administrative expense also included higher stock-based compensation tied to the resetting of legacy equity plans during the company’s IPO.
- System-wide volume increased 3.1% year over year.
- Advanced-modality volumes rose 6.3% system-wide and 6.8% on a consolidated basis.
- Advanced modalities reached 37.4% of total volume, up 111 basis points from a year earlier.
- Same-site system-wide revenue increased 4.4%, consisting of 2.2% volume growth and 2.2% rate growth, according to Martin.
Cash Flow, Capital Spending and Outlook
Cash flow from operating activities was $32.8 million, up $31 million from the prior-year quarter. Free cash flow reached a company-record $23.1 million, compared with negative $2.5 million a year earlier. Martin said the improvement was largely driven by lower debt and interest payments, along with favorable working-capital timing and joint-venture distributions during the quarter.
Lumexa ended the quarter with $69.7 million in cash and cash equivalents, up from $51.2 million at the start of the quarter. Net leverage was 3.6 times as of June 30, compared with 5.7 times a year earlier.
Capital expenditures were $9.7 million during the quarter, above the company’s anticipated quarterly range of $5 million to $7 million. Martin said the increased spending reflected investment activity and that Lumexa could remain near the high end of its expected spending range as it pursues growth opportunities.
The company narrowed its 2026 adjusted EBITDA guidance to $235 million to $241 million from a previous range of $234 million to $242 million, maintaining the $238 million midpoint. Lumexa reiterated consolidated revenue guidance of $1.045 billion to $1.097 billion and adjusted EPS guidance of $0.71 to $0.77.
Martin said the company expected approximately 45% of annual earnings in the first half and 55% in the second half. Lumexa reported that 45.3% of expected annual earnings had been generated in the first half, supported by seasonal volume patterns and the ramp of recently opened centers.
Growth Initiatives and Health System Partnerships
Zulla said Lumexa opened two de novo centers during the first half and completed two acquisitions, including its first site in the UPMC joint venture. The company remains on track to open eight to 10 de novo centers in 2026, with most of the remaining openings expected later in the year.
The company also announced a joint venture with Hospital for Special Surgery, which Zulla described as Lumexa’s ninth health system partnership and its second new health system collaboration in the past 12 months, following UPMC. The partnership will initially focus on de novo development in the New York metropolitan area, where certificate-of-need requirements are expected to lengthen the development timeline.
Zulla said a market review identified nearly 100 health systems where Lumexa believes its model could address outpatient imaging needs. She characterized the partnership pipeline as robust, citing health system interest in adding imaging capacity, retaining patients and expanding outpatient access.
Advanced imaging remained a central growth priority. MRI volume increased 7.2% system-wide, while PET volume rose 23.2%. Lumexa had eight PET machines and intends to reach 11 this year. Two of three planned PET additions opened in July, in Arizona and South Carolina. The company is also expanding the use of radiotracers, including FES fluoroestradiol imaging for certain estrogen-positive breast cancer patients.
The company said mammography volumes improved during the quarter, rising 2.6% year over year after a slower start to the year. Lumexa also launched a lung cancer screening initiative and continued expanding an AI-powered breast arterial calcification program in New York and New Jersey.
Technology and Reimbursement Commentary
Lumexa introduced the name “Lumexa Imaging Connect” for its technology-enabled operating platform, which connects patients, referring physicians, radiologists and health system partners. The company said it remains on track to deploy FastScan technology across two-thirds of its centers by year-end to reduce MRI scan times and expand capacity. It is also advancing virtual MRI capabilities and AI-powered dictation and reporting tools for radiologists.
On reimbursement, Zulla said CMS’ proposed 2027 Hospital Outpatient Prospective Payment System rule could strengthen the rationale for health systems to build freestanding imaging capacity if site-neutral provisions are finalized. She emphasized that Lumexa does not depend on hospital outpatient reimbursement premiums and views the proposal as a multiyear catalyst rather than an immediate change to results.
The company’s planning assumptions call for approximately flat year-over-year government reimbursement and a 1% increase in commercial payer rates. Medicare Advantage and fee-for-service Medicare together account for about 20% of revenue, Zulla said. Commercial payer mix was 59% of consolidated revenue in the quarter, essentially unchanged from a year earlier, according to Martin.
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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