iRhythm Holdings, Inc.

Hello, everyone. Thank you for attending today's iRhythm Holdings Inc. Q4 2025 Earnings Conference Call. My name is William, and I will be your moderator today. All lines will be muted during the presentation portion of the call with an opportunity for questions and answers at the end. If you would like to ask a question, please press star 1 on your telephone keypad. At this time, I would now like to pass the conference over to our host, Stephanie. Stephanie Zakovich, Senior Director of Investor Relations with iRhythm. Stephanie. Stephanie.

Thank you all for participating in today's call. Earlier today, I rhythm released financial results for the fourth quarter and full year ended December 31st, 2025. Before we begin, I'd like to remind you that management will make statements during this call that include forward-looking statements within the meaning of federal securities laws pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that are not statements of historical fact should be deemed to be forward-looking statements. These are based upon our current estimates and various assumptions and reflect management's intentions, beliefs, and expectations about future events, strategies, competition, products, operating plans, and performance. These statements involve risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward-looking statements. Accordingly, you should not place undue reliance on these statements. For a list and description of the risks and uncertainties associated with our business, please refer to the risk factors section of our most recent annual report on Form 10-K, filed with the Securities and Exchange Commission. Our discussion today will also include certain financial measures that are not calculated in accordance with generally accepted accounting principles, or GAAP. We believe these non-GAAP financial measures provide additional information pertinent to our business performance. These non-GAAP financial measures should be read together with the most directly comparable GAAP financial measures. Please refer to the tables in our earnings release in 10-K for reconciliation of these measures to their most directly comparable GAAP financial measures. This conference call contains time-sensitive information and is accurate only as of the live broadcast today, February 19th, 2026. iRhythm disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events, or otherwise. And with that, I'll turn the call over to Quintin Blackford, iRhythm's president and CEO.

Thank you, Stephanie. Good afternoon, everyone, and thank you for joining us. I'm pleased to be here with Dan Wilson, our chief financial officer, to discuss our fourth quarter and full year 2025 performance and how we're positioning the company for 2026 and beyond. Dan will walk through our financial shortly, but I want to begin by framing where we stand today and where we're headed. 2025 was a breakout year for iRhythm. We delivered strong volume-led revenue growth and meaningfully expanded margins as we exited the year with momentum across cardiology, primary care, innovative channels, and international markets. At the same time, we strengthened the underlying platform that will fuel the next several years of value creation. Growth in the quarter and for the full year continued to be driven by volume across all channels. With growth in the fourth quarter of 27%, this marked our fifth consecutive quarter of revenue growth above 20%. reinforcing the durability of our platform and breadth of our growth drivers. Our leadership in long-term continuous monitoring remains strong with nearly 72% share in a segment growing in the high teens, supported by more than 135 scientific publications to date. On profitability, we also made great progress as we reached a key inflection point, finishing the year with positive free cashflow results for the first time in our company's history and exceeding expectations with respect to adjusted EBITDA margins. In the fourth quarter, adjusted EBITDA margins meaningfully exceeded the 15% goal that we have identified as we approach $1 billion in revenue, demonstrating the profitable scalability of our business. But this year was about more than financial milestones. It was about validating the strategic direction we've set, moving from episodic detection to proactive, integrated, and increasingly predictive care. The need for long-term continuous monitoring continues to grow. Arrhythmias remain episodic. often invisible until they cause downstream complications, and they are consistently missed by short-duration or symptom-driven diagnostics. Data demonstrates that nearly 65% of all arrhythmias, whether symptomatic or asymptomatic, are found after 48 hours of monitoring, reinforcing the need for longer duration. Yet, nearly 2 million short-duration Holter and event monitors continue to be prescribed in the U.S. market on an annual basis. We estimate that at least 27 million people in the U.S. are living with significant risk of undiagnosed arrhythmias, a staggering and costly gap in care. At the same time, the healthcare system is constrained. Nearly half of U.S. counties and close to 90% of rural counties have no cardiologists. Access is not improving, which means the point of arrhythmia detection must shift. In 2025, we demonstrated the power of enabling that shift. More than one-third of our volume originated in primary care settings, supported by our expanding footprint and integrated delivery networks, EHR integrated workflows, and innovative channel partnerships. We now serve approximately 40,000 primary care physicians, creating a scalable, proactive care model that aligns with a growing focus on value-based care and population health. This is not a shift away from cardiology. Rather, it expands the market for these important customers as our ability to help rule in and rule out patients can enable cardiology to focus on the highest acuity patients, while primary care becomes an effective front door for earlier detection, meeting the majority of our patients where they are most often being seen. Helping to fuel this move upstream is the power of our EHR integration strategy. More than half of our volume now flows through EHR integrated accounts, and 75 of our top 100 customers are fully integrated. These integrations are not simply workflow enhancements. They create meaningful stickiness, increase prescribing consistency, and drive long-term account durability. We also advanced our predictive AI capabilities significantly in 2025. With nearly 3 billion hours of curated ECG data, we're now combining internal and external data sets, such as claims and EHR information, to identify patients at risk of arrhythmias before diagnosis. Early pilots through our partnership with Lucem Health show more than 85% accuracy in pre-identifying patients with clinically relevant arrhythmias. While early, these programs reaffirm our conviction that iRhythm is positioned not just to detect disease, but to help predict risk earlier and ultimately to help prevent it. Our initial programs focus on high-risk populations, such as patients with diabetes, CKD, CAD, COPD, sleep, and heart failure. where arrhythmias are common and costly. These programs are not just about diagnosing more patients. They are focused on doing so in a way that improves the efficiency, quality, and cost of care delivery. Xeo provides a definitive diagnosis, enabling providers to stratify risk, route patients appropriately, and reduce unnecessary downstream healthcare utilization, resulting in early indications of better patient outcomes and reduced cost of care. As an independent diagnostic provider, iRhythm delivers objective, clinically validated results that integrate directly into existing workflows and care pathways, which helps protect providers and systems in increasingly audit-sensitive risk-bearing environments. Within our MCT business, our current ZOAT offering continues to perform exceptionally well, with unit growth running more than twice the company average for the year. The strength continues to be supported by new account wins, expanding utilization within existing accounts, and increased prescribing alongside XeoMonitor. This notable and sustained performance, even before bringing an exciting new product to market, reinforces our view that XeoAT is a durable growth driver resonating with physicians today and that we will continue to gain market share in the near term. Consistent with our prior comments, we are incredibly excited about our next-gen MCT device, featuring a 21-day wear time, an improved form factor aligned with our XeoMonitor, and enhanced algorithms, which is currently under FDA review. We remain in active dialogue with the agency as we work through their questions and continue to expect to release the product in the first half of 2027. We believe the combination of a strong ZOAT offering today and a thoughtfully architected next generation device sets us up to meaningfully expand our presence in the MCT market, where we hold roughly 15% market share compared to our 72% market share in long-term cardiac monitoring. Every 10 points of market share gains represents roughly 80 to $100 million of incremental annual revenue. International markets continue to represent a compelling long-term growth opportunity. We are now commercial in the UK, select EU markets, and Japan, markets that collectively conduct over 3 million ambulatory cardiac monitoring tests annually and where iRhythm holds less than 1% share. In the UK, we delivered our largest quarter of volume ever and will be participating in pilots under the NHS supply chain's value-based procurement program. In Japan, we are now generating in-country evidence to support future applications to the MHLW for reimbursement reconsideration. Across all regions, our focus remains on disciplined execution, evidence generation, and reimbursement progression as we scale these markets thoughtfully. We've also made encouraging progress with our sleep pilots. Early feedback continues to reaffirm the meaningful opportunity ahead as we address longstanding challenges in the sleep diagnostic market. With nearly 40 million sleep apnea patients in the U.S. and significant overlap with arrhythmia populations, we believe we are well positioned to extend our workflow-driven model into this adjacent space as care continues to shift upstream. iRhythm today sits at the intersection of several powerful trends. An aging population, increasing prevalence of arrhythmias, movement toward value-based care, and growing demand for proactive health management. We believe the market opportunity ahead is significantly larger than it has historically been viewed and that our platform, spanning biosensors, AI, and workflow, positions us well to lead that expansion. As we enter 2026, our focus is clear and consistent. One, deliver durable, volume-led growth across cardiology, primary care, and innovative channels. Two, expand margins through sustained operational efficiencies and scale benefits. Three, advance platform innovation, including our next generation MCT and predictive AI. Four, scale international and adjacent markets with discipline and rigor. And five, maintain operational excellence and compliance in a rapidly evolving healthcare environment. With this focus, we are confident in our ability to execute this expansion in a way that creates long-term value for patients, physicians, providers, payers, and shareholders. Finally, as the industry grapples with heightened scrutiny around medical documentation practices, including recent attention on chart scraping behaviors, we want to be explicit about our position. iRhythm operates as an independent diagnostic provider with objective, clinically validated reports that integrate directly into provider workflows. Our product is prescribed directly by a physician and enables a confirmatory diagnosis. Our processes are designed to support accurate diagnosis, while reducing administrative burden and audit exposure for providers and payers. We are an effective tool providing exactly what oversight bodies are asking for in terms of confirmed diagnosis and are excited about the potential tailwinds from the emerging expectations of a more accountable, audit-sensitive environment. Thank you again for joining us today. 2026 marks iRhythm's 20th anniversary and represents a very important year as we aim to become a billion-dollar company in 2027. whose truest measures are lives touched, innovations delivered, and transformational leadership serving the patients who are counting on us. With that, I'll now turn the call over to Dan to walk through our financial results and outlook.