Neuronetics Q2 Earnings Call Highlights

Key Points

• Q2 results improved significantly: Revenue rose 9.1% year over year to $41.6 million, while the net loss narrowed to $3.4 million and adjusted EBITDA turned positive at $0.3 million.
• Greenbrook was the primary growth driver: Clinic revenue increased 16.8% to $26.9 million, supported by provider growth, pricing gains, better collections and revenue-cycle improvements. Management estimates some clinics have up to 40% unused capacity, creating further growth potential.
• Neuronetics broadened NeuroStar sales models and raised profitability targets: Customers can now purchase or lease systems in addition to using the traditional treatment-session model. Full-year guidance includes higher gross-margin expectations and lower operating expenses, although management warned that second-half revenue could be more variable during the transition.

Neuronetics NASDAQ: STIM reported second-quarter 2026 revenue growth, a sharply narrower net loss and positive adjusted EBITDA as its Greenbrook clinic business expanded and the company introduced additional commercial purchasing options for its NeuroStar transcranial magnetic stimulation, or TMS, systems.

Total revenue rose 9.1% year over year to $41.6 million, compared with $38.1 million in the second quarter of 2025. The company recorded a net loss of $3.4 million, or $0.05 per share, versus a $10.1 million loss, or $0.15 per share, a year earlier. Adjusted EBITDA turned positive at $0.3 million, improving from negative $5.6 million in the prior-year period.

Greenbrook Drives Revenue Growth

Greenbrook revenue increased 16.8% to $26.9 million, supported by provider growth and pricing improvement, Chief Financial Officer Nir Naor said. Chief Executive Officer Dan Reuvers said the clinic network benefited from operational work in revenue cycle management, including improved patient eligibility qualification, cleaner claims submissions, more efficient collections and payer contracting for both TMS and SPRAVATO treatments.

Cash collections grew faster than Greenbrook revenue during the quarter, according to Reuvers. The company also began using artificial intelligence in its insurance authorization process, which he said helped reduce operating costs.

Reuvers said occupancy remains a major opportunity because Greenbrook clinics have a largely fixed cost base and still have available capacity. In response to an analyst question, he said the company estimates that as much as 40% of capacity remains unconsumed at certain sites. Neuronetics is assessing its field-representative coverage, direct-to-consumer advertising and peer-to-peer education efforts in an effort to improve referrals and lower patient acquisition costs.

On treatment trends within Greenbrook, Reuvers said the company saw somewhat greater strength in SPRAVATO than in TMS. He said SPRAVATO patients tend to remain active in the network for longer periods after their initial course of treatment.

NeuroStar Adds Purchase and Leasing Options

Worldwide NeuroStar revenue totaled $14.7 million, down 2.7% year over year. The company said capital revenue increased by double digits while treatment-session revenue declined by double digits.

Neuronetics historically offered its systems largely through a treatment-session model that bundled a high-touch support relationship with the equipment. During the quarter, the company broadened a pilot program offering customers the ability to purchase a NeuroStar system outright or use lease financing. Customers that buy a system can select clinical and operational support services on an à la carte basis.

Reuvers said the additional models are intended to allow Neuronetics to compete for customers that prefer to acquire TMS equipment as a capital purchase. He said customers using the traditional session model will continue to receive the comprehensive support offering.

The decline in session revenue partly reflected continuing customer inventory normalization, with almost half of the reduction tied to inventory levels reaching what management considers sustainable lower levels. The remainder came from units that were no longer active. However, utilization among accounts that were active a year earlier rose about 10%, Reuvers said.

Management expects no further material inventory reduction in the second half of the year. Still, Reuvers cautioned that revenue could be “a bit choppier” in the second half as customers choose among the newer commercial models and revenue shifts among capital sales, service, consumables, leasing and sessions.

Because those choices alter the historical split between capital and session revenue, Naor said Neuronetics plans to report NeuroStar as a single revenue line going forward rather than emphasizing the prior revenue categories separately.

Neuronetics also announced in May a collaboration with ANT Neuro to co-promote ANT Neuro’s FDA-cleared neuro-navigation technology alongside the NeuroStar system. Reuvers said the offering is designed to provide clinicians with greater visualization, consistency and personalization in treatment planning and delivery.

Margins, Expenses and Cash Position Improve

Gross margin increased to 61.1% from 46.6% in the prior-year quarter. Naor attributed the improvement to revenue mix and revenue cycle management efforts. Reuvers said improved patient qualification, claims processing and collections increased the amount of revenue captured per billed dollar at Greenbrook, while pricing improvements from payer contracting also contributed.

Operating expenses fell 12% to $22.7 million from $25.8 million, primarily due to lower general and administrative expenses and lower sales and marketing expenses. The company’s cost-efficiency measures were a key contributor, Naor said.

As of June 30, Neuronetics had $25 million of total cash, cash equivalents and restricted cash, compared with $19 million at March 31. Cash used by operations and investing was $1.4 million in the quarter, compared with $3.8 million in the prior-year period. The company also raised $7.6 million in net proceeds through its at-the-market equity offering.

Guidance Updated as Company Targets Profitability

Neuronetics narrowed its 2026 total revenue guidance to $160 million to $164 million from a prior range of $160 million to $166 million. It raised expected gross margin to 48% to 50%, from 47% to 49%, and lowered operating-expense guidance to $95 million to $100 million from $100 million to $105 million.

The company said it will also provide operating-expense guidance excluding share-based compensation, which it expects to be $91 million to $96 million for the year. Its current estimate for share-based compensation is $4 million.

Neuronetics now expects combined cash flow from operations and investing to range from negative $10.5 million to negative $14.5 million for 2026. Management said it continues to target limited net cash utilization from operations and investing during the second half.

Looking ahead, Reuvers said the company is continuing preparations with Compass Pathways for a potential commercial launch of Compass’s psychedelic therapeutic for treatment-resistant depression, subject to Compass’s regulatory process. He said Greenbrook’s existing infrastructure for in-office drug delivery, monitoring, REMS programs, clinical staffing, benefits investigation and prior authorization could position the network to administer new therapies if they reach the market.

The company also made leadership changes, including Naor’s appointment as CFO, Cory Anderson’s promotion to executive vice president and general manager of Greenbrook, and Rob Greene’s appointment as senior vice president of sales. Reuvers said Neuronetics reduced executive headcount, flattened its organizational structure and consolidated certain marketing and operations roles. Chief Legal Officer Andrew Macan is expected to step down later in August.

About Neuronetics (NASDAQ:STIM)

Neuronetics, Inc is a commercial‐stage medical technology company that develops and markets non-invasive neuromodulation therapies for psychiatric and neurological disorders. The company's flagship product, the NeuroStar Advanced Therapy System, uses repetitive transcranial magnetic stimulation (rTMS) to deliver targeted magnetic pulses to areas of the brain implicated in major depressive disorder (MDD). NeuroStar Advanced Therapy has received U.S. Food and Drug Administration clearance for the treatment of adults with treatment-resistant depression and is supported by a growing body of clinical evidence demonstrating its safety and efficacy.

Founded in 2003 and headquartered in Malvern, Pennsylvania, Neuronetics focuses on advancing clinical care through innovation in neurostimulation.

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