What Sera Prognostics (SERA) Said on Its Q3 Earnings Call

Key Points

• PreTRM test use accelerated: Q3 volume rose 54% from Q2 and was about five times Q1’s level, while the number of ordering physicians nearly tripled from Q1. Sera did not disclose absolute volumes or physician counts.
• Medicaid coverage is driving expansion: Illinois and Florida together represent about 7 million Medicaid lives and 140,000 births annually; Florida’s reimbursement rate is $450 per test. Sera aims for low-single-digit penetration in each state in year one, while management expects adoption to take time.
• Sera has four commercial-payer pilot programs and expects a health-economic analysis from its PRIME trial in Q4. It ended Q3 with $72.8 million in cash, expects funding into 2029, and plans flat or lower operating expenses in 2027.

Sera Prognostics NASDAQ: SERA reported a sharp increase in use of its PreTRM preterm birth risk test in the third quarter of 2026, as the company expanded its commercial efforts in Illinois and Florida following Medicaid coverage decisions in both states.

Test volume rose 54% from the second quarter and increased approximately fivefold from the first quarter, executives said on the Nov. 4 earnings call. The number of physicians ordering the test nearly tripled from the first quarter, according to President and Chief Executive Officer Zhenya Lindgardt. The company did not provide absolute test volumes or an ordering physician count on the call.

Management said it is shifting resources toward markets with reimbursement while working to control costs. Sera ended the quarter with $72.8 million in cash and cash equivalents and continues to expect that its cash will fund operations into 2029.

Medicaid Coverage Drives State Expansion

Illinois and Florida have established Medicaid coverage for PreTRM and added the test to their fee schedules, Chief Medical Officer Tiffany Inglis said. Together, the states represent approximately 7 million Medicaid lives and about 140,000 Medicaid births annually, according to the company.

Sera has completed credentialing with Illinois Medicaid and is in the final stages of enrollment in Florida, Inglis said. The company is also pursuing contracts with managed Medicaid organizations in both states.

Illinois has no prior authorization requirement, Inglis said. Asked about restrictions in Florida, Lindgardt said there were no restrictions on coverage for Medicaid recipients in either state. Chief Financial Officer Scott Gleason said Florida’s reimbursement rate is $450 per test. Lindgardt said the company can manage its cost of goods at that rate at scale.

Chief Commercial Officer Lee Anderson said Sera expanded its Illinois field team in late August. Over two months, the company onboarded nine providers and eight accounts in the state. Sera also hired additional representatives in Florida in October and began applying its Illinois commercial approach there.

Lindgardt said Sera hopes to achieve low-single-digit percentage penetration of births in each state in the first year, with faster growth afterward. Gleason cautioned that moving physicians from initial interest to broad adoption can take 12 to 18 months. He expects momentum to build in the second half of 2027.

Commercial Payer Talks and Evidence

Sera has four active commercial payer pilot programs, including two with major national health plans, and is discussing a potential multistate implementation in 2027 with a large managed care organization, Inglis said.

Asked whether that discussion could lead to national coverage, Lindgardt said she believes it will, but that the process would occur step by step and the timing remains uncertain. The company expects the pilot programs to produce results before national coverage decisions are made.

Sera expects to publish a health economic analysis from its PRIME randomized controlled trial in the fourth quarter. Inglis said the analysis would complete an evidence package sought by many payers, alongside analytical and clinical validation and evidence of clinical utility.

On Medicaid, Inglis said one additional state is actively pursuing similar legislation in early 2027, while a fourth state is evaluating options. Lindgardt said Sera hopes one or two more states will establish coverage in 2027.

Costs and International Plans

Operating expenses fell 11% sequentially, Gleason said, reflecting cost-saving efforts initiated after the second quarter, partly offset by commercial investments in Illinois and Florida. Sera expects operating expenses to be flat or lower in 2027 while significantly increasing the size of its commercial team.

The company’s average selling prices declined in the third quarter because a larger share of patients came from low- or non-reimbursed categories, Gleason said. He expects that trend to begin reversing in 2027 as Medicaid patients in Illinois and Florida and patients in paid commercial pilots make up a larger share of the testing mix.

Internationally, Lindgardt said Sera remains on track to pursue CE Mark approval in 2027 for PreTRM Global, a kit-based version of the test. The company has completed its registration study, is working with its notified body on the submission and is discussing potential partnerships with laboratory and in vitro diagnostic companies.

About Sera Prognostics (NASDAQ:SERA)

Sera Prognostics, Inc is a women's health diagnostics company focused on improving pregnancy outcomes through biomarker-based testing. The company uses proteomics, bioinformatics and clinical data to develop diagnostic and prognostic products designed to identify risks associated with pregnancy complications.

Its lead product is the PreTRM test, a blood-based test intended to assess a pregnant woman's risk of spontaneous preterm birth in a singleton pregnancy. The test measures specific protein biomarkers and is designed to provide physicians with information that may support risk assessment, patient management and care planning during pregnancy.

Founded in 2008 and headquartered in Salt Lake City, Utah, Sera Prognostics primarily serves the U.S.

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