NeoGenomics, Inc.

Good morning, and welcome to the Neogenomics Fourth Quarter and Full Year 2025 Financial Results Call. Please be advised that today's conference is being recorded. I will now turn the call over to Kendra Webster with Neogenomics. The floor is yours.

Thank you, Kelly, and good morning, everyone. Welcome to the Neogenomics Fourth Quarter and Full Year 2025 Financial Results Call. With me today to discuss the results are Tony Zook, Chief Executive Officer, Jeff Sherman, Chief Financial Officer, and Abhishek Jain, EVP of Finance. Additional members of the management team will be available for the Q&A portion of our call. This call is being simultaneously webcast. For reference, concurrent with today's call, we posted a short slide presentation to the Investors tab on our website at ir.neogenomics.com. During this call, we will make forward-looking statements regarding our future financial and business performance, business strategy, the timing and outcome of reimbursement decisions, and financial guidance. We caution you that the actual events or results could differ materially from those expressed or implied by the forward-looking statements. These forward-looking statements made during the call speak only as of the original date of the call, and we undertake no obligation to update or revise any of these statements. Please refer to the information disclosed on the Safe Harbor Statement slide and the deck posted on our website, as well as the information under the heading Risk Factors in our most recent Forms 10-K, 10-Q, and 8-K that we filed with the SEC to identify important risks and other factors that may cause our actual results to differ materially from the forward-looking statement. These documents can be found in the Investors section of our website or on the SEC's website. During this call, we also refer to certain non-GAAP financial measures that include adjustments to GAAP results. The non-GAAP financial measures presented should not be considered an alternative to the financial measures required by GAAP, should not be considered measures of liquidity, and are unlikely to be comparable to non-GAAP financial measures provided by other companies. Any non-GAAP financial measures referenced on this call are reconciled to the most directly comparable GAAP financial measures in a table available in the press release we issued this morning and in the slide deck available in the investor section of our website. I will now turn the call over to Tony.

Thanks, Kendra. Well, good morning, everyone. Thank you for joining us today. As been our practice, I'll begin with a discussion of Q4 highlights and key business growth drivers before turning the call over to Jeff for a deep dive into our 2025 financial results. Our new EVP and incoming CFO, Abhishek Jain, will then introduce our 2026 guidance. Afterwards, we'll open up the call for your questions. Our mission and vision guidance through 2025 to deliver improving results throughout the year. Let's get into the recent highlights. As we covered in our pre-announcement, during the fourth quarter of 2025, we delivered record revenues while making meaningful progress advancing our NGS and MRD long-term growth initiatives, including preparing for a full clinical launch of our RadarST MRD assay this month. I'll cover these initiatives in more detail shortly. Total revenue for Q4 was $190 million, representing double-digit growth of 11% year-over-year. Our clinical business continued its robust growth, with revenue increasing 16% year over year. The clinical performance was driven by effective execution of our key commercial strategy, enabling volume and share gains in key segments. In the fourth quarter, we again saw a sequential improvement in AUP, continued growth in test volumes and NGS revenue growth of 23%, well ahead of NGS market growth rate. The five NGS products launched in 2023 contributed 23% of clinical revenue in the quarter. We continue to see demand for our non-NGS modalities as well, with all modalities continuing to grow at above market grade. Our full year total revenue was $727 million, which represents 10% growth over full year 2024. We ended the year with significant momentum, and I attribute this to several factors. We're a pure-play oncology solutions provider driving rapid dissemination and adoption of innovation through our best-in-class commercial organization in the community setting. Studies have shown that as much as 80% of all cancer care is now delivered in the community setting, which has historically lagged NCI-designated cancer centers when it comes to introducing the latest in cancer testing innovation. How are we winning in the community? We believe community oncologists are guideline-driven and focused on certainty, not possibility. and they choose partners that remove friction and enable confident treatment decisions under operational, economic, and time pressures. Reimbursement coverage also is critical. The results of several meetings of our scientific advisory board, as well as independent market research that we commissioned, reveal several reasons why community oncologists look to us. Neogenomics offers ease of ordering, simple to interpret test reports, fast and consistent test turnaround times, access to medical expertise, And most importantly, our comprehensive test menu spanning diagnosis, therapy selection, and MRD. Our net promoter score of 79 reflects strong physician satisfaction among our current customer base with our NPS score continuing to improve in 25, even with record test volumes. Two, we enjoy a leadership position in the hematology testing market with greater than 25% share across diagnostics and therapy selections. And as pathologists and oncologists consolidate the number of vendors they use, we are successfully leveraging this heme leadership position to create enhanced test demand, particularly in high-value areas such as therapy selection and MRD. In fact, in 2025, we saw 14% growth in the total number of pathologists and oncologists ordering five or more tests from NEO. On top of that, we estimate that approximately 40% of all active pathologists and oncologists have ordered five or more tests of ours during the year. While we're proud of that reach, it also means that over half of practicing providers are still available to us to bring over to NEO. Three, we've built a geographically balanced lab network that allows us to be responsive to customer needs, including offering some of the fastest test turnaround times in the industry. when faster, more accurate treatment decisions can have a material impact on patient outcomes. This network was further strengthened by our acquisition of New Jersey-based Pathline last year, which gives us a meaningful presence in the number three cancer market in the country. We're on track to capture operational efficiencies and synergies from the Pathline acquisition that we anticipate will be accretive to profitability beginning this year. In four, we have one of the broadest cancer test menus in the industry, expanding diagnosis to therapy selection to MRD for both heme and solid tumor cancers, including over 300 commercial payer contracts, which enables us to be the partner of choice among community hospitals and community oncologists. We're highly differentiated from both large reference labs as well as specialty oncology labs, and this optimally positions us to address underpenetrated markets in therapy selection and MRD in excess of $30 billion, while potentially improving outcomes for patients as they advance along the cancer care journey. We're enabling precision oncology in the community setting. Turning now to RadarST. In November, we presented new research for the RadarST assay for circulating tumor DNA detection across solid tumor types. The data from this bridging study showed that RadarST demonstrated 97% concordance and maintained equivalent sensitivity with Radar 1.0. This bridging study was used to secure multi-X reimbursement in the two previously approved indications, HPV negative head and neck cancer and a subset of breast cancers. This decision paves the way for us to broadly commercialize RadarST, formerly Radar 1.1. To that end, we're on track to execute a full clinical launch of RadarST by the end of this month. As part of our go-to market strategy, we're expanding our sales force to help us penetrate the head and neck market. We believe adding feet on the ground will help us penetrate this market with the only Moldex-approved HPV negative test currently available to patients. To ensure that we're well-positioned to capture more of this large and rapidly growing MRD market, we have also submitted two additional solid tumor cancer indications for Moldex for approval. While we're not disclosing these cancer types yet for competitive reasons, we believe that upon securing coverage, we will effectively double the market opportunity of patients eligible for RadarST testing. To expand our reach, as we secure additional mold DX approvals, we expect to add more than 25 oncology sales specialists, or OSSs, by the third quarter. From a financial perspective, we believe 2026 will see modest revenue contributions from RadarST as adoption ramps, and we gain reimbursement approval in the additional indications. We expect revenue growth to accelerate in 2027 and beyond. In parallel with our RadarST launch preparedness activities and efforts to gain coverage for additional indications, we also continue to focus our R&D investment in next-generation MRD. This assay will be an ultra-sensitive, whole-genome solution for lower-shedding cancer types. We're working on product development now, with data generation and mold DX submissions slated for next year, and a potential clinical launch as early as 2028. Turning now to our Pantracer portfolio of products for solid tumor therapy selections. Pantracer is designed for solid and liquid to work together, empowering oncologists with actionable genomic insights for confident, real-time treatment decisions. The tests can be ordered independently or as complementary tests, depending on a patient's individual needs. Pantracer LBX is a non-invasive blood-based test that analyzes circulating tumor DNA to identify key genomic alterations that inform treatment decisions in patients with advanced stage solid tumors. Importantly, Pantracer LBX fills a gap in our portfolio that providers have been asking for, allowing them to further consolidate the number of labs they use. We have submitted to MoldDX for clinical reimbursement coverage of the LBX test and are awaiting a decision. Assuming a favorable decision, we anticipate that LBX will contribute modestly to revenue in 2026 as adoption ramps throughout the year. Another product in the Pantracer family, Pantracer Tissue had strong growth throughout 2025. We doubled the volume of tests ordered from 23 to 24 and then nearly doubled again from 24 to 25 while continuing to grow AUPs. This represents another proof point of our ability to pull higher value tests through our community channel, leveraging our heme leadership position. 75% of community oncologists who were new to NEO in 2025 ordered five or more tests a strong leading indicator of our continued growth and success penetrating the community channel. I'm pleased to share today that the Pantracer portfolio is growing. Last week, we launched Pantracer Pro as part of the expanded solid tumor therapy selection portfolio. The test integrates broad genomic profiling with diagnosis-directed IHC and ancillary testing, intelligently selected based on tumor type and clinical context to provide oncologists with actionable insights for therapy selection in a single order. Pantracer Pro rounds out the portfolio and it will help streamline the ordering and testing process, delivering timely, relevant results, helping clinicians personalize treatment strategies and improve patient outcomes. At the end of 2024 and moving into 2025, we invested in our commercial organization, specifically our oncology sales specialist. We added 35 people to this group who target community oncologists. And as these individuals mature in their roles, we're seeing a continued uptake in NTS testing accounting for a larger portion of our total clinical revenue as we increase our reach and frequency. This penetration speaks to the strength of our commercial channel as well. We have launched five NTS products since March of 2023, and even though we were later to market to some of our peers with these products, we are still seeing very good uptake. Pantracer Tissue, highlighted earlier, was one of the five products which reflects the breadth and strength of our menu, and our ability to capture market share when we introduce new products. With the success of our NGS products, we now have the opportunity to be more selective with the volumes that we prioritize. We are intentionally shifting testing capacity towards more therapy-guided and higher-value testing, which is expected to make AUP expansion a more significant driver of revenue growth relative to volume. And with that, I'll hand it over to Jeff to further discuss our results in the quarter and full year.

Thanks, Tony, and good morning. Fourth quarter total revenue increased by 11% over prior year to $190 million. Total clinical revenue continued with strong double-digit growth and increased 16% from prior year. As expected, non-clinical revenue declined by over 25% in the fourth quarter. Adjusted gross profit improved by $5.8 million or 7% over prior year, and adjusted EBITDA was $13.4 million, up 10%. Q4 was the 10th consecutive quarter of positive earnings with adjusted EBITDA and margins improving sequentially each quarter in 2025. Clinical volumes and revenues continued with robust growth in the quarter. Public test volumes increased by 11% in the fourth quarter with AUP growth of 5%. Same-store revenue without PATHLINE was $170 million representing growth of 14%, driven by a 6% increase in test volumes and a 7% increase in AUP. Volumes were negatively impacted in the fourth quarter as we intentionally rationalized our exposure to higher-volume, lower-value test clients. We are continuing to see strength across our portfolio with above-market growth rates across the modalities we offer. NGS revenues grew by 23% over prior year in the quarter and accounted for around a third of total clinical revenue. Average revenue per clinical test increased sequentially from Q3 by $12 or 3% and was up 5% from prior year. Excluding Pathline, AUP increased by $15 or 3% from Q3 and was up 7% over prior year. A larger percentage of higher value tests, including NGS, as well as recent managed care pricing increases and RCM initiatives, are helping to drive higher AUP. Total operating expenses in the quarter were $97 million, an increase of $1 million, or 1% over prior year. Cash flow from operations was a positive $1 million in the quarter, and we ended the quarter with total cash of $160 million, down slightly from Q3. Our balance sheet and expected cash flow will enable us to continue to invest in our business to drive organic growth through new product development and Salesforce expansion, while also increasing operating efficiencies through investments in technology and automation. Turning the full year 2025 results, revenue is up 10% versus prior year to $727 million, driven by deeper penetration into the community setting, a continuing shift to higher margin modalities, and execution of revenue cycle management initiatives. Total clinical revenue increased 15% and growth was 13% excluding pathline. Non-clinical revenue declined 24% for the year in line with our revised expectations. Adjusted gross profit increased 23 million or 8% to 335 million. This represented an adjusted gross margin of 46% or a decline of 111 basis points mostly driven by pathline, the decline in non-clinical revenue, and the operating costs of the clinical liquid biopsy launch. Cash flow from operations was positive $5 million in 2025, with free cash flow improving by over 35% as compared to 2024. Adjustability increased by $4 million to positive $43.4 million, an improvement of 9% over the prior year. And now I'll hand it over to Abhishek to introduce our 2026 guidance.

Thank you, Jeff. I would like to begin by thanking my colleagues at NEO for their warm welcome. Over the past month, I spent time with investors and analysts, attended our global sales meeting, visited our labs, and gained deeper insights into our strategy and the opportunities ahead. It has been a productive and energizing first month. With that context, let me share our 2026 guidance. For the full year, we expect revenues of $793 million to $801 million. The midpoint of our 2026 revenue guidance assumes rate our ST revenue in mid-single-digit millions for our approved indications. A modest revenue contribution from Pantracer Liquid and sustained softness in non-clinical through the year exiting 2026 down low to mid-single-digits. While we do not provide quarterly guidance, let me provide some color on quarterly cadence that is impacted by the PATH9 acquisition and revenue assumptions for radar ST and Pantracer liquid, which are weighted towards the back half of the year. I suggest modeling approximately 10% year-over-year growth in the first quarter, 8% to 9% in the second, 9% to 10% in the third, and slightly above 10% in the fourth quarter of 2026. Regarding the extreme weather throughout the country so far this year, we know some providers had to close their offices and appointments had been rescheduled. As a result, there will be some impact on volumes and revenue for Q1. This has been contemplated in our full year 2026 guide and cadence by quarter. We expect adjusted EBITDA to be in the range of 55 to 57 million for 2026, representing year-over-year growth of approximately 27 to 31%. We expect adjusted EBITDA to grow by low 20% year-over-year in the first and the second quarter and low 30% year-over-year in the third and the fourth quarter, respectively. We will continue to take balanced approach to investments, strategically increasing sales and marketing and R&D spend for new product initiatives and clinical programs that support payer reimbursement and drive top-line growth while improving liquidity with the goal of becoming free cash flow positive this year. Now, let me turn the call back to Tony.

Thanks, Abhishek, and welcome to the team. To recap, during the fourth quarter, we again delivered very strong clinical volumes and revenue while advancing NGS and MRD initiatives that we believe will contribute to accelerating our growth for years to come. Looking forward to 2026, in our clinical business, the focus is on strategic, profitable growth driven by continued expansion of NGS revenues and market penetration for the Pantracer family and Radar STs. Simultaneously, we're implementing tools and solutions we believe will enhance the productivity of the entire sales organization and working to enhance customer workflows through solutions like our Epic Aura integrations. In parallel with our product and service offerings to grow revenue, we are making targeted investments to drive top-line growth and margin expansion. There is a very strong financial discipline embedded throughout the organization, and we're going to build on that as we continue to grow revenue and improve operating efficiencies and margins. Thank you for your continued interest in neogenomics. And operator, this concludes our prepared remarks, so please open the line for questions.

Certainly. The floor is now open for questions. If you have any questions or comments, please press star 1 on your phone at this time. We ask that while posing your question, you please pick up your handset if listening on a speakerphone to provide optimum sound quality. Please hold just a few moments while we poll for questions. Your first question is coming from David Westenberg with Piper Sandler. Please pose your question. Your line is live.

Hi. Thank you so much, and good morning. So I'll just ask one question, but it will be kind of on the longer side. I'll just ask it up front. You talked about the intimate launch of Radar SDE. Can you provide a little bit more specifics? You mentioned submissions to Moldeaxe. Can you give us more specific timing? I get that this is trying to predict government, but is this end of the year? Is this potentially dragged into the next year, et cetera? And then you mentioned also 25 sales reps. I just want a clarification that is specific to MRD or esoteric tests in general. And then on those sales reps, do you plan on just going after the head and neck, the subindications of breast, or are you actually, in fact, thinking about some of those future moldy exhumations that you have there? And then lastly, I get this is really long, but, you know, just talk about the complementarity with pan, tracer, liquid. Thanks so much.

Okay. So Dave, there's a lot to unpack there. Why don't I, I'll try and start it and kick us off and then look to Warren to address perhaps follow-up questions six, seven, and eight. Okay, Warren, so get ready for that. Relative to RadarST, Dave, you were right. The intention is we go out the end of this month for our full launch. Relative to focus, it will be focused, Dave, on the initial indications of head, neck, and the subsets of breast that we have articulated, HPV negative, and the HR HER2 negative breast. So, that will remain the focal point for the initial launch activity. So, that was one of your questions. As far as additional indication flow, as you say, you know, all we can do is submit and put the best packages forward that we believe are possible for MultDx to work their way through. For our own assumptions, we believe, Dave, that those additional indications would be available in the latter half of this year for us. And so it's still possible to potentially generate some revenue from those in this year, but that would be upside against our guide, Dave. We're not counting on those and certainly will help fuel additional robust growth going into 2027. Relative to the actual field force expansion, I'm going to turn that over to Warren because What we wanted to do, Dave, was do two things. First and foremost, we wanted to take advantage of the HPV negative indication because we believe we'll be the only Moldex approved product for HPV negative. And it's a very specialized group of positions that account for that bulk of that business. And there's a fairly clear roadmap to how we can get to those. And so Warren's team is initially now expanding to cover that group. And then he will build the additional reps over time for the added indications that we have. And yes, Dave, they are intended to be complementary to MRD and NGS. They won't be specific only to MRD. So, Warren, maybe a little bit more color on the coverage aspect.

Absolutely. Thanks, Tony and Dave. So, yeah, the expansion is taking place. There's an initial expansion happening sort of as we speak. That is to really address the radar ST launch and particularly head and neck HPV negative. And the reason why we felt we needed to do a small initial expansion is one of the primary call points for head and neck HPV negative is the ENT, and that hasn't been a traditional call point for us up until now. So we actually are investing in a small team dedicated towards ENTs, and they will be almost exclusively focused on the radar head and neck indications. They will have an option to represent other parts of the portfolio, but we feel that their focus would be largely focused on the radar ST. As we've done in the past, and very successfully, I might add, as we expect new products, and in this case, new indications to come to market, we do expand our sales force because we want to increase reach and frequency. And we will be doing that in quarter two and in quarter three in anticipation of the additional indications that we expect from all the X. Again, these team members will be oncology sales specialists. They will be responsible for selling our oncology portfolio, which is therapy selection for heme and solid tumor, as well as MRD. It's probably a bundle of about 12 or 14 tests if you really look at it. But we see a 100% core point overlap between our portfolio for therapy selection as well as MRD. And today, based on our size of our sales team, we feel we get more value by consolidating sales activities within one resource versus having specialized sales teams. Although we will get some good lessons from our dedicated ENT group that we're establishing as we speak.

Thank you. Thank you, guys.

Your next question is coming from Bill Bonello with Craig Hallam. Please pose your question. Your line is live.

Hey, guys. Hoping to sneak in a couple. But the first would be just on the clinical volume. Any chance you could quantify the impact of exiting the low-value business and then maybe clarify whether there's more business that you will still be exiting in future quarters so we can have some sense of how to think about volume growth as we progress through the year.

Sure, Bill. I'll kick that off. And again, I'll look to Abhishek or Jeff to add in any additional color. So, Bill, if you just step back and you look at us historically, If you looked at how the revenue models were built, volume represented for us typically this upper to single digits growth. And AUP was more in the low single digit growth. There's two factors that are driving our thinking now. First of those is this constant and purposeful penetration into therapy selection and MRD. With that, we will be the beneficiaries of higher AUPs and, therefore, a better impact on our margins and business overall. So that's point number one. We expect our AUPs to continue to grow. And then the second point, Bill, was this idea we want to make sure we secure the right ball. We want to be a business that's growing our revenue as well as our margins over time. And you'll recall that we talked about a contract throughout last year that was a high-value, low-value added opportunity for us. The AUPs bill and that were like in the low $200 range. We entered into that with the potential opportunity to secure longer-term growth into higher-value tests. But if those don't materialize, we had to look at it in the macro sense. And for us, we believe the better course of judgment here was to say our resources are better used and focused in the areas where we're seeing higher margin opportunities and higher growth. And so the model now kind of inverts a little bit. What you should be expecting is AUP now in the upper single-digit range with volume in the lower to mid single-digit range. But that being said, I just want to make sure we clarify this, Bill, because it's an important point. We're still growing all the right volumes, right? We're going to continue to grow by modality. We have no desire to pull back in that area. We continue to expect NGS to have robust growth as well. And so that's going to continue. We saw robust NGS volume and AUP growth in 2025. We would expect similar results in 2026. And so the right volume will come through. And on that NGS business, again, you know, it's now over a third of our clinical business. And an interesting fact, Bill, is that, you know, that third of our clinical revenue, it's actually being supported with only 9% to 10% of our volume. And so it's the right volume that's generating these kinds of growth numbers. So I would expect most of this to be evident through Q1 and Q2. And then from that point on, we'll be back to kind of normal growth trends.

Does that help, Phil? It does, and I mean, should we think even a bit lower, perhaps, as we get into Q2 and Q3 just then on the volume growth? It sounds like maybe a little does still come, or is this a pretty good proxy?

So let me take that one, Bill. So we are, like, for example, what you have seen in Q4 is our sequential volume growth was slightly down. And we are anticipating as we kind of go in Q1, our numbers will be sequentially down in a similar vein as we kind of start to focus on these high margin, high value tests. And this is very intentional from our strategy standpoint, and that's the reason we are moving in that direction. But as we get into Q2, we'll basically be year-over-year flattish, and that's where we will start to grow our volumes in Q3 and Q4 on a year-over-year as well as on the sequential basis.

Okay, that's really helpful. Thank you. Thanks, Bill.

Your next question is coming from Andrew Brackman with William Blair. Please pose your question. Your line is live.

Hi, guys. Good morning. Thanks for taking the questions. Maybe just also a similar line of questioning to Bill's here, just sort of around guidance. By my math, it looks like the core clinical business, when I exclude Pathline and some of these new contributions from LBX and MRD, it looks like that core is called the sort of growing that high single digit to maybe 10% year over year. Can you maybe just unpack some of the underlying assumptions there for that core book of business? And I guess in particular, just sort of reconciling that to the, I think you did 14% same store sales growth in Q4. So just sort of reconciling that to that high single to 10% growth. Thanks.

Yeah, Andrew, again, I'll kick it off and I'll look to Abhishek and Jeff to add additional color. So, yes, in 2025, you saw, you know, ex-pathline, we were about 13% growth on the clinical side. And, you know, we are anticipating, you know, double-digit growth on the clinical. And so what's within there? First, there will be the four-year pathline that will be built into the numbers as well. As I just mentioned with Bill, That one contract that we exited, that has an impact in the totality of the clinical side. And then, of course, in the guide itself, Andrew, just to be clear, we wanted to be prudent relative to the back half with LBX. Since we still do not have LBX approval in hand, we thought it better to only pack in revenue for the second half of the year at a modest rate. And so we don't really see the benefits of that coming through in the current guide. If we, in fact, get all DX support for LBX earlier than that, then it would represent upside in our total growth. And of course, that would be on the backs of the total clinical business. And so again, I hope that gives you some color. And Abhishek, if I missed any key points, please call out for Andrew.

No, I think you have covered it well, Tony. And Andrew, we are expecting the clinical business to be growing at about 11 points based on our low to mid-single digit on the non-clinical side. So it's kind of in the range that we have been expecting the company to be growing in, like at about 10 points. That's what we have called out. And that's where our midpoint currently is $797 million. is pretty close to that 10%. I think the guide is pretty prudent to the extent that it gives us a very high degree of confidence to be able to meet these numbers. And then we will, of course, see if the things were to pan out as we are anticipating, it gives us some room to actually do better than the expectation.

That's helpful. Yeah, that's very, very helpful. Thanks for all that, Keller. And then just on the LIMS rollout here, you know, obviously that's a multi-year process for that rollout. But anything you can maybe share with respect to how that might be impacting the model or sort of just sort of the workflow in 2026? Thanks.

Yeah, great question. Thank you for that. As you know, historically, we were built for effectiveness, not necessarily for efficiency. And moving to a common LIMS system, we think, is foundational for us. to continue to advance towards ever improving margins and efficiencies for the company. What we will see through the course of 2026, and you know we have these eight existing LIMS systems, we'll be on a path to migrating to one common system. What we want to do, though, is manage that effectively over time. And so we are going modality by modality, site by site. We're not going to just do kind of a big bang theory and put any risk at all into the business. And so that means the benefits of LIMS only start to become evident for us in the latter part of this year. Now, there are some natural efficiencies that Warren's team are already seeing, and I'll look to him to add some of that added color for you. But the more pronounced impact will be in 27 and 28 as we can retire all the legacy systems and build upon the existing LIMS architecture. So, Warren, any added color?

Yeah, thanks, Tony. Andrew, I think in terms of sort of technical debt benefit, that's coming in 2027, to be clear. But as we put the LIMS system in now, we're actually not just replacing our existing eight LIMS or the new LIMS. We're actually looking at the workflows and optimizing the workflows based on on how we understand the business and how it's likely to develop over time. So as we get each modality in place or in each site, we start to see workflow efficiency there. So that's sort of something that will start to come through in operational efficiency. I think the other big benefit that we're getting is far greater capabilities from the analytics and insight point of view to really understand where inefficiencies lie. within our workflows, and that analytics and sort of transparency will also help us translate a better customer experience by providing visibility to real-time sample tracking, et cetera, which is one of our key initiatives for 2026.

And I would say, Andrew, again, this is foundational for us because it affords us then the opportunity to build on that, which is why I maintain that we're still in the early endings relative to gross margin expansion opportunities for ourselves. You know, when you throw in limbs and you look at other platform opportunities like, you know, DX and things that Warren and his team can do with digital pathology and automation, we believe that the gross margins are in early and we can continue to build not just revenue but margin expansion as well.

Okay. I appreciate all the time. Thanks, guys. Thank you.

Your next question is coming from Subu Nambi with Guggenheim. Please pose your question. Your line is live.

Hey, guys. Thank you for all the different businesses. Given some longer selling cycles and maybe some easing of the funding pressure, where do you see pharma ordering playing out this year between first half and second half? And what products do you expect to leave the order book for pharma?

Could you repeat the second half of the question, please?

What products do you expect to leave the order book for pharma?

Okay, got it. So relative to pharma, I would say that my views certainly have not changed from where we were about six to eight months ago. We anticipated, you know, that this erosion that we were experiencing on the pharma side of the business would continue into 2026, albeit not at the same rate that we saw in 2025. So I have always been of the belief that it would be 2027 before we would see a return to growth for that book of businesses. And that's how we built the guide. So we expect still to see modest erosion in the pharma book of business for 2026. Certainly it'll be much reduced from where it was, but still in that, you know, mid to upper, you know, five to 10% range for the pharma side of business. I think the big part of the return to growth there is based on radar ST. That will be one of the key road drivers for us in that book of business. There, you know, we've had pretty good conversations. We've been well received. You know, we're back at the table with RadarST. There seems to be a really good sense of interest in it, and that portfolio of opportunities continues to grow. And so relative to the year, again, the guide would still anticipate a modest erosion in the pharma side of the business. If we can get that back flat, that would then represent upside opportunity for us. So, Warren, I know the long lead cycle times, but perhaps if you talk about radar ST and how that's being received.

Yeah, I'll tell you, maybe a couple of comments there, Suvi. So, first and foremost, in terms of the focus, you know, a little bit like on the clinical side, really our focus is to protect our position in diagnosis, but really look to grow in therapy selection and MRD. We look at pharma in a very similar way. Yeah, we're very well known from an IHC perspective, and we continue to focus on IHC because it's very relevant for pharma from an antibiotic drug conjugate perspective. And it's a good for us, but expect our focus to really lie towards therapy selection and MRD. So there's a strong alignment here between what we're doing in clinical and with pharma. As Tony said, robust opportunity pipeline that's developing with regards to radar, ST, and pharma. some legacy users, and many new users, and expect first bookings to materialize shortly.

I do appreciate the question. It gives us the opportunity to clarify it. The other thing I just would remind the group, this is a relatively small portion of our overall business. We're talking about 5% to 6% of our overall business. And so we continue to put the primary focus and energies on the clinical side of the business with the intent to stabilize this business and return to growth in 2017. So thanks for the question.

Absolutely. Thank you for clarifying this. Can you talk about the framework for LIMS integration this year, what's been finished, what's left to go, and then maybe how that will show up in earnings in 2026?

So I'd say where our focus is today, so we've completed flow, so one of our key modalities Our next step right now is around accessioning and NGS is really where our focus is. Again, aligning to our strategic priority, looking to be able to provide increased value, both from an efficiency perspective and customer trustability. Those would certainly be things that you would look to conclude in 2026. Probably other modalities as well rolling into that, but We can certainly take that offline and provide more granular detail if you like, but those are the key focus areas for us in 2026 is molecular and accessioning.

Thank you.

Thank you so much, Chris.

Your next question is coming from Mike Mattson with Needham. Please pose your question. Your line is live.

Hi. Thanks, everybody, for taking our questions. This is Joseph on for Mike. Just, I guess, in terms of the guide for radar for 2026 in the mid single digit millions, I'm just kind of wondering, framing up your guys' confidence and the ability to hit that mid single digits number. And I guess just trying to understand how much of that is the clinical side versus the biopharma side. You know, maybe for both of those, you know, which do you see to have the higher potential to drive upside to that mid-single-digit number?

Yeah, thanks for the question. I would say, first and foremost, we do have a high degree of confidence in that. That's why it's in the guide at the midpoint level. So we do have a high degree of confidence there. Relative to the mix, I think it would be fair to say in the early part of the launch, you would expect a heavier component of that to probably be more on the pharma side than the clinical side, only because the clinical launch just takes time to build, right? You know, we'll have the indications of head and neck and breast, and then you'll build and you'll start to see a slow build of that activity. And just with the lead times of the product, you know, you start to see the clinical effect of that probably in the latter part of the year. Whereas pharma, you have the opportunity to take on a little bit more of a pan orientation and can secure pricing sooner. And then as we build the indications, over time, you're going to see the clinical side of the business certainly accelerate, and that would be the largest of the drivers moving into the outer years with radar ST. Abhishek, anything else?

No, I think Tony, you have covered it very well. As we basically discussed in our prepared remarks, we are actually launching rate RST by the end of this month, and that gives us very high degree of confidence of the numbers that we are putting in in our guide.

Thank you.

Okay, yeah, great. And then maybe just one more quick one. Can you maybe just talk about the, you know, the potential for continued ASP growth? You know, I think you guys were kind of talking about high single digits. Or, you know, upper single digits maybe for 2026. But, you know, the potential for that to continue without any additional reimbursement announcements. So, you know, what is currently approved and reimbursed in your pipeline? You know, NGS products, Pantracer, as it stands today without LBX.

Yeah, I'll start and Abhishek can join us, Jeff. So I think, look, the continued shift in the NGS is going to be, continue to be the big driver of our AEP growth, as it was in 2025 as well. So I think that that is one factor. We expect to continue to have success with direct client-built pricing increases, which is only going in the first quarter of the year. And we also are continuing to have success with managed care pricing increases, which started in the back half of last year. We're expecting full year impact of those to hit in twenty six as well as new new agreements and new increases approved. And then finally, we're still working on other initiatives to kind of close that gap between what we expect to be paid. and what we are being paid. And so, you know, that AUP growth will come for those drivers to the extent we get additional, you know, indications or tests approved. That will be incremental on top of that growth.

Thank you.

Your next question is coming from Tycho Peterson with Jefferies. Please pose your question. Your line is live.

Hey, thanks. Um, maybe one for Warren just on, on the Salesforce. I appreciate your, you know, color on, on go forward additions. But as we look back, you know, over the last year, obviously, you know, ramping the Salesforce was a big focus, maybe with that cohort matured, can you just talk about, you know, where they are in terms of productivity? I think, you know, you called out over five tests orders, you know, on providers, but maybe just any other metrics we can, you know, look to, to, to track, you know, the, the, the scaling up of the Salesforce over the last year. And then separately, are you baking anything in for, you know, adaptive related revenues this year and any metrics, you know, you can provide there?

Thanks, Tycho. Yeah, absolutely. As you pointed out, we did expand our sales force late 24 and into the beginning of 2025. We kind of see that sort of six to nine month ramp up period. And I would say that sort of maturing or that productivity of those resources was a big contributor to our success in age two of 2025. And we anticipate that that's going to be a tailwind for us in the first half of the year, for sure, as that sort of momentum continues to annualize into this year. Again, the focus of those resources, they're oncology sales specialists, so they're really focusing in on therapy selection, and they're going to be supporting our launch from a radar ST perspective and MRD. So that's really where the focus is. I would say that those resources are at productivity now. So we're sort of in stride. The positive is we've seen very, very low attrition as well. So it's not like there's been a high churn or anything. So I feel we're executing well and we're starting to see general increased productivity across our entire sales team, not just the 35 that we brought on board in 2025. The sort of entire 140 or so that we have within our complement today.

And Tygo, the only other few points, I'll do a little bragging for Warren and his team. He may be a little humble here. I think if you look at how that expansion has taken place, there are some proof points that we can look to. I mean, first and foremost, you do got to look at that NPS score, right? You know, to have an NPS score of 79, which is a step up from where it was already, and that's heavily based now with feedback from oncologists. So, I think that is a really positive sign that the reaching frequency model is beginning to have an effect. And then, Within the subsegments of our own data, when you start to see your 14% of oncologists and pathologists are now ordering five or more neo-tests, I mean, I think that's another proof point that this model is taking effect, and we have now over 40%, we estimate, of oncologists and pathologists prescribing five or more tests. I think these things are what's fueling the NGS growth opportunities for us, and I think to take the sales force on that journey over the past 12 to 16 months has been an we're proud of and what we're going to continue to build on. And then relative to your second question, I would say that from a revenue perspective, we look at the adaptive partnership probably more strategically than economically. You know, we see it as an offering that we can offer our customers that offers them then an expansive portfolio of opportunities for us. Over time, we will see we'll be a company that can offer flow MRD. We can offer heme MRD. We'll have radar ST. We'll have next-gen MRD. And so that whole suite of products we think is an important one to offer and to have an outstanding partner like Adaptive is more strategic than I would say it's economic, at least for us. But we're going to continue to work and manage that relationship to the best of our ability.

Thanks for the questions. Thank you.

Your next question is coming from Dan Brennan with TD Cowan. Please pose your question. Your line is left.

Great. Thank you. Maybe just to start off just on Pantracer. I understand the conservatism there. Just any more color about kind of the back and forth. It sounds like it's imminent. But the blood market is growing a lot faster than the tissue CGP market. So you've had really good success on tissue volumes. Is it just conservatism or like what do you expect once that's really dialed in for that Pantracer liquid to grow at from a volume basis?

Yeah, I'll kick us off, and then Abhishek and Warren could add a little bit more. So, yeah, Dan, we have responded to all the questions that MoldDX had relative to LBX, and so we're just kind of in a waiting and response mode. Now, what we have seen is across, it's not just us, but across the sector, it's been averaging about four to five turns through MoldDX for new offerings, and so that puts us right around four turns is right around the 12-month mark. And so that's kind of where we sit today. You know, so we are confident. We see this as a when we get it, not an if we get it. And then that's why we thought just it was prudent to not include revenue for the first half of the year and then just kind of a modest and slow build in the second half of the year. And anything that would come before that would then be opportunistic upside for us. relative to kind of modeling at the high level, again, you called it out. Pantracer tissue is enjoying robust growth. We highlighted before the volumes for 23 to 24 doubled. We saw the same almost nearly doubling in 24 to 25. We think that's probably a decent predicate as a way to look at LBX over time. And so we look to our total NGS portfolio, of which the Pantracer family is a big driver of that, you know, to experience a robust growth again in 2026 and beyond. It's certainly in line with 2025, and then depending on mold DX time, it could be better than 2025. So hopefully that gives you a little bit more color and more, and I don't know if you want to get any more specifics about how you're seeing with LDX and tissue

Yeah, I'd say the following. I think, Dan, you're right that the liquid market is growing faster. Since the launch of a Pantracer liquid, we've actually seen a good acceleration across the category. We saw increase in utilization of Pantracer tissue, and we've seen attractive uptake of Pantracer liquid as well. And we feel, and actually we launched Pantracer Pro very late last week and expect there to be another inflection point in terms of how this solution for solid tumor therapy selection is positioned for the market. So, we're, I'm very confident in terms of the outlook here. It's really just around unknowns with regards to mold X reimbursement timing, I think, is what you're seeing within the thought process from a guy's point of view.

Yeah, we launched Pantracer tissue in the Q1 of 23 and, you know, it started to build throughout 23, and then we really saw a big uptake in the first and second quarter of 2024. And that was a big driver of our MGS growth during that time. Thanks, Dan.

Great.

Your next question is coming from Puneet Suda with Lering. Please pose your question. Your line is live.

Hi, guys. Thanks for the questions here. So just clarifying, given the guide here, is the long-term LRP that you had put out earlier, I believe 12% to 13%, is that still in consideration or is that off the table? And then if I look at the same store sales versus new tests, 5% revenue per test growth reported versus 7% same store sales, can you elaborate on how do you expect to convert these new customers to sort of higher value tests and how long would that take? for us to, you know, start to see an impact there. Thank you.

Okay. So, first on the first question, you know, we're not talking LRP. You know, we've tried to make it clear as we can that, you know, we're taking our feet and firmly planting them in the year we are in. And so, I'm not projecting out. I would simply say that I believe that we will, this guide we are very confident in. I think we will end the year. in a very strong position with accelerated growth opportunities as we head into 27, and we would start to then see the full benefit of radar ST and Pantracer LBX coming through the system. But I won't go into any more relative to an LRP discussion. The second question?

Yeah, from an AUP perspective, you know, with the guide going on, I think adding those tests and coming in the back half of the year, you should expect AUP will grow as we add those incremental tests over time. And I think that's, 25 is kind of a good example of that.

Yeah, no, my sense is also that AUP as we kind of move into these high value tests, right? Because in any case, these are going to be priced at a much better rate and we expect the AUP Uh, we'll grow as we move with this. Yep.

And as you said, you know, so the same store, including half line was was higher than a big single digit and in the quarter. And I think over time, adding these tests in the back half of twenty six will will help drive as well.

And, Puneet, maybe building on this sort of opportunity to penetrate an hour long, you know, again, coming back to that commercial strategy to protect, expand, acquire, you've done a really good job of protecting that sort of hole in the bucket is really something that has improved significantly, and the NPS score sort of helps to drive that. But the expand element of the strategy is very much around taking new products and selling them to existing customers. That's an active part of the strategy. And we do that both on the pathology side of the business for the TVMs where relevant, but very specifically on the oncology side as well with the oncology sales specialists. And as we bring on more and more new oncology practices, we typically lead in with a heme solution because that's where we differentiate it. And then we use that as a basis to expand into solid tumor treatments. It's difficult to give you a finite example of exactly how long it takes because every practice is different. But sales cycles here are relatively quick. And as soon as we can put sort of interfaces in place to streamline workflows, introduce things like Pantracer Pro, we expect that acceleration to, or the speed to accelerate through 26 and into 27 as well. So the active part of the strategy, a very confident ability to pull that through based on past experiences.

And on that, thanks. And just very quickly on the leading with heme and then entering with solid tumor. into those accounts. Could you just elaborate on, you know, sort of what you see as the competitive landscape in, you know, in tissue, CGP today, and also liquid, obviously, you know, significant penetration in the market, multiple competitors out there. Maybe just give a sense of how you think your position today in the community setting versus the competition that you're seeing in the community setting. Thank you.

Benny, I'd say that We haven't seen a marked change in terms of what's happening from a landscape perspective on the solid tumor side of things in the community setting where we are focused. As you've said before, we tend to bump into most of the normal competitors in different parts of the country, et cetera. We find our portfolio to be very well received based on the fact that we focus on actionability. and a high degree of service. And, you know, a step that Tony shared earlier that seventy-five percent or three out of four new oncologists that try us tend to stay with us. And that's not only unique in the heme side of things that happens through on the solid tumor side of things as well. So, certainly, it is a competitive landscape, but I can't say I've seen any material changes. And we're seeing success on the liquid side of things as well, despite the fact that we're a late entrance. And I put that down to the fact that we have a broad portfolio, and physician practices are looking to simplify their workflows and standardize on vendors, and that places Neogenomics in a very favorable position.

Thank you. Thank you.

Your next question is coming from Mason Carrico with Steven Zink. Please pose your question. Your line is live.

Hey, guys. On MRD, for the two indications that you submitted, do you plan on launching radar for those indications ahead of mold DX approval to start building that volume stream? Or do you plan on launching after you gain coverage?

Yeah, as I tried to convey earlier, we're going to stay focused on the two initial indications of head and neck and the subsets of breast in the initial launch period, and then we will expand accordingly as we get mold DX coming through the system. You know, there certainly would be enough on our plate in the short term with just those two, and then we'll build in the latter half of the year.

Got it. And then on the 23% NGS growth in the quarter, could you provide any additional detail, I guess, on how much of that maybe came from the core existing business versus pull-through tied to the Pathline acquisition?

The bulk of it would still be the existing business, with Pathline starting to ramp is how I would characterize it.

We're certainly seeing increased activity and penetration in the northeast, but just the center of gravity lies towards the other business, so therefore that's where the lion's share is still coming from.

Got it. Okay, thanks.

Your next question is coming from Mark Massaro with BTIG. Please pose your question. Your line is live.

Hey, guys. Thanks for taking the questions. I'll keep it to one. Can you just speak about how we should think about gross margins in 2026? 2025 was obviously down. When we put sort of the different, you know, increase in next-gen, I could see how there could be a path to gross margins increasing in 2026. However, there are some other headwinds as well. So, can you just give us a sense if you think gross margins can grow this year and any ability to quantify that would be helpful?

Sure. Absolutely, Mark. Let me take this question. So, most of us are just with our margin expansion in the current year, in 2026, is going to be coming from the gross margin. So we are anticipating the growth margins to expand at about like 100 basis points, and that's going to basically drop to the adjusted bit of margin expansion as well. And there are multiple reasons, of course, in the growth margin expansion as we kind of look at our pricing increases, as well as we rationalize our portfolio to the higher value, higher margin product, as well as the work that our labs are doing to be more efficient being there. So the growth margin is expected to improve. at about 100 to 120 basis points in 2026, and most of that is going to be dropping to our bottom line on the adjusted EBITDA.

Great. Thank you. Thanks, Mark.

Your next question is coming from Andrew Cooper with Raymond James. Please pose your question. Your line is live.

Hey, everybody. Thanks for the question. Maybe first, Tony, I think you said you expected NGS growth to look pretty similar in 26 to 2025. I know the target's 25%. You know, you were you were almost there, but not quite. You have some of these tailwinds when we think about and tracer liquid coming on, at least in the back half. I don't know if you'll count MRV and kind of that bucket with NGS when you think about the target. But how do we think about that trending through the year, especially in context of a sales force that will be essentially tripled or quadrupled by the time you're done adding?

Yeah, I think As you rightly put it out, we showed about 23% for the quarter, about 22% year-over-year for NGS growth. I would expect that we should be able to do that in 2026, if not even slightly better than that. And that's going to be driven, as you say, by the momentum of the sales force that we have, the addition of LDX. into the portfolio, Pantrace or CRO. So we expect that we should do at least as well as we did in 2025 with the opportunity to maybe even beat that slightly. And much of that will be dependent on the timing of LDX. And so I think that's a safe assumption to take into the year.

Okay. That's helpful. Maybe just lastly for Jeff or Abhishek or Tony, if you want to chime in as well, but when we think about that shift of growth being heavier volume versus AST to the other way around and more AST or AUP driving that growth, How does that change the way you think about that margin drop through over the longer term? It sounds like, you know, when we think about 26, there's certainly some reinvestment that's probably eating up a bit of the flow through that would be there otherwise. But how does that change the way you think about sort of the long-term trajectory from a margin perspective, if at all?

Yeah, great question.

No, that's a great question, Andrew. And that's, I think, the key strategy question that we have with Neo, that we have a broad range of portfolio here. we have tests that are like $100, $200 AUP, and then we have very high-value tests on the NGA side. Now, that also basically kind of differentiates us from some of the other specialty diagnostic labs as to how we are thinking about our volumes. Now, when we look at our capacity, when we're looking at our portfolio, we definitely would want to be selling to the customers that are giving us the business, which is not only the low value, but also either there's a portfolio which combines the low value test with the high value testing, and then that becomes more positive for us. But if a client is only giving us the low order value test, then there is a natural shift that we do not want to be kind of taking that particular business. And that's where you're looking at more carefully as to, okay, what are those tests that we would want to be in? So from the margin standpoint in the long term, as we kind of shift towards the higher value, higher margin test, that will definitely be accretive to our growth margins as we kind of also going to be able to improve our operational efficiencies using our lab infrastructure.

Thank you.

Okay. Thank you. This does conclude today's question and answer session. I'd now like to turn the floor back over to Tony Zook.

I'd just like to thank everybody for joining us on the call, and I'd also like to thank our roughly 2,400 teammates for their unwavering commitment to our mission and their hard work throughout all of 2025. I'm very excited for the year ahead for our company, our oncology physician customers, and their patients. I look forward to our next quarterly update in April, where we'll report our first quarter results. Thank you again, and have a great day.

Thank you, everyone. This does conclude today's conference call. You may disconnect your phone lines at this time, and have a wonderful day. Thank you for your participation.