Neuronetics, Inc.

are on a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during this session, you will need to press star 1-1 on your telephone. You will then hear an automated message advising you your hand is raised. To withdraw your question, please press star 1-1 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Mark Klossner. Please go ahead.

Good morning, and thank you for joining us for the Neuronetics fourth quarter 2024 conference call. Joining me on today's call are Neuronetics President and Chief Executive Officer Keith Sullivan and Chief Financial Officer Steve Furlong. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements covered under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements related to our business, strategy, financial and revenue guidance, the Greenbrook acquisition, and other operational issues and metrics. Actual results can differ materially from those stated or implied by these forward-looking statements due to risks and uncertainties associated with the company's business. For a discussion of risks and uncertainties associated with Neuronetics business, I encourage you to review the company's filings with the Securities and Exchange Commission, including the company's annual report on Form 10-K which will be filed later this month. The company disclaims any obligation to update any forward-looking statements made during the course of this call, except as required by law. During the call, we'll also discuss certain information on a non-GAAP basis, including EBITDA. Management believes that non-GAAP financial information taken in conjunction with U.S. GAAP financial measures provide useful information for both management and investors by excluding certain non-cash and other expenses that are not indicative of trends in our operating results. Management uses non-GAAP financial measures to compare our performance relative to forecast and strategic plans, to benchmark our performance externally against competitors, and for certain compensation decisions. Reconciliations between U.S. GAAP and non-GAAP results are presented in the tables accompanying our press release, which can be viewed on our website. With that, it's my pleasure to turn the call over to Neuronetics President and Chief Executive Officer Keith Sullivan. Thanks for the introduction, Mark.

Good morning, everyone, and thank you for joining us today. I'll begin by providing an overview of our recent performance and key accomplishments in 2024. Steve will review our financial results, and I'll conclude with some thoughts on 2025 before turning to Q&A. Let me start with our performance in the quarter, which includes nearly one month of Greenbrook operations. Total revenue was $22.5 million, an increase of 11% over the fourth quarter of 2023. During the quarter, NeuroStar system revenue was $3.8 million, with 46 systems shipped. U.S. treatment session revenue was $12.9 million, and U.S. clinic revenue, which represents Greenbrook revenue, was $4.4 million. Reflecting a solid quarter for the company, and continued positive momentum. 2024 was truly a transformative year for Neuronetics, marked by a number of significant achievements, which include number one, transforming our business to become a vertically integrated mental health care provider through the acquisition of Greenbrook TMS. Second, significantly expanding our Better Me provider program based on its tremendous success. Third, securing an FDA clearance for the Neurostar system to treat adolescent patients, making Neurostar the first and only TMS option available to treat this underserved patient population. Fourth, refinancing our debt facility to provide more financial flexibility and strength to our balance sheet. And fifth, although a 2025 event, we further strengthened our balance sheet to support our growth trajectory with our recent 18.9 million capital raise. Steve and I will be discussing each of these achievements during our prepared remarks today. I'd like to begin by reviewing the success of the BMP program. This program is establishing a nationwide network of accounts that follow patient care and responsiveness standards that were developed in collaboration with expert TMS clinicians. aimed at delivering timely and consistent care to those who need it most. The program was piloted within a select group of customer sites in 2023 and the first half of 2024. Based on the success of the pilot, we began the process of a nationwide rollout in July of 2024, expanding participation to over 350 sites. Demand to participate in the BMP program remains strong. There are currently more than 125 additional sites committed to the program that are actively working to achieve the five standards prior to the next enrollment date of April 15, 2025. Through a combination of an increased number of training classes through Neurostar University and enforced adherence to our best practices, This program has been a massive success. When practices begin to implement the program standards, their patient volume on average increases by 36%, simply by providing a timely response to patients by a staff member that have the knowledge to educate patients about the benefits of the Neurostar therapy. Once practices are fully in the BMP program, they are treating three times more patients per site per quarter than practices who are not in the program. On average, these sites went from treating three patients per quarter to over 10 patients per quarter. In addition, customer sites who participate in the BMP program are addressing patients in need materially faster, roughly 2.2 times faster when comparing results of 2024 versus 2023. The outcomes demonstrated by BMP validate the benefits of our model for teaching practices how to better serve their patients with NeuroStar. Another milestone achieved during 2024 was our acquisition of Greenbrook TMS. As our largest customer for many years, we intimately understood their business and saw a unique opportunity to combine two leading TMS companies, creating an organization with the scale and expertise to revolutionize mental health care in the U.S. This combination makes Neuronetics a leading TMS supplier and provider in the United States. By combining our innovative technology platform, proven training process, and the BMP program with Greenbrook's established treatment center network, we are positioned to expand patient access to lifesaving mental health treatments while improving our growth and financial position. Our integrated network now serves a broader patient population while maintaining exceptional care standards across markets. An exciting acquisition benefit is our ability to implement BMP lessons across the entire Greenbrook network, We have a clear roadmap to enhance operational efficiency and patient care by implementing BMP's comprehensive standards and workflows at Greenbrook's existing sites. We view these implementations, along with a number of other Greenbrook commercial initiatives, as key growth drivers for 2025. Beyond growth opportunities, we have identified significant cost synergies across both organizations. By the end of 2024, we captured over 90% of the identified $22 million in annualized cost synergies, surpassing initial targets. Combined with ongoing cost structure optimization, these synergies will create a more efficient organization and give us confidence in becoming cash flow positive in the third quarter of 2025. Further strengthening our market position in March of 2024 NeuroStar received FDA clearance as the first and only TMS treatment approved as a first-line therapy for depression in adolescents age 15 to 21. Real-world data showed 78% of adolescent patients achieved clinically meaningful improvement. This milestone expands our total addressable market for major depressive disorder. We have quickly gained traction with wins in adolescent insurance coverage, making it easier for adolescents to qualify for treatment. Treatment sessions volume ramped up throughout 2024, yielding 10% growth in new patient starts versus 2023. Since clearance, we have seen an 18% increase in customer sites treating adolescent patients, which now includes more than half of our customer base. The increase in insurance coverage positions us for continued growth in this segment through 2025. 2024 was about building a stronger, more integrated Neuronetics. Through our successful Better Me provider program, expanding our market opportunity with the adolescent clearance and the strategic Greenbrook acquisition, we have created multiple growth drivers that work in tandem while at the same time strengthening our balance sheet. These factors position us for accelerated, sustainable and profitable expansion in 2025. I'll now turn the call over to Steve to review the financial results.