NeoGenomics (NASDAQ:NEO) reported fourth-quarter and full-year 2025 results that management said reflected improving execution through the year, highlighted by record quarterly revenue, continued growth in its clinical business, and progress on long-term initiatives in next-generation sequencing (NGS) and minimal residual disease (MRD).
Fourth-quarter and full-year financial results
For the fourth quarter of 2025, the company reported total revenue of $190 million, up 11% year over year. Clinical revenue grew 16% from the prior year, while non-clinical revenue declined by over 25%, consistent with expectations discussed on the call.
For full-year 2025, NeoGenomics reported total revenue of $727 million, up 10% versus 2024. Clinical revenue increased 15% (or 13% excluding the PathLine acquisition), while non-clinical revenue declined 24% for the year. Adjusted gross profit increased $23 million, or 8%, to $335 million, and adjusted EBITDA rose 9% to $43.4 million. Cash flow from operations was positive $5 million in 2025, and the company reported that free cash flow improved by over 35% compared with 2024.
Clinical volumes, pricing, and mix shift
In the fourth quarter, total test volumes rose 11% and average unit price (AUP) increased 5%, according to Sherman. Same-store revenue excluding PathLine was $170 million, up 14%, driven by a 6% increase in test volumes and a 7% increase in AUP.
Management emphasized that volume trends were affected by an intentional decision to reduce exposure to certain high-volume, lower-value business. CEO Tony Zook said the company was shifting capacity toward more therapy-guided and higher-value testing, positioning AUP expansion as a more significant driver of revenue growth relative to volume. In Q&A, the company described exiting a low-value arrangement with AUPs “in the low $200 range,” and suggested a forward model that “inverts” prior expectations: AUP in the upper single-digit range with volume in the lower- to mid-single-digit range. Abhishek Jain, EVP of Finance and incoming CFO, added that sequential volume could be down in early 2026 as the company prioritizes higher-margin testing, with volumes expected to be roughly year-over-year flat in Q2 and growing in Q3 and Q4.
NGS performance and PanTracer portfolio updates
NeoGenomics said NGS revenue grew 23% year over year in the fourth quarter and represented about one-third of total clinical revenue. Sherman said AUP improved sequentially from Q3 by $12 (or 3%) and was up 5% year over year; excluding PathLine, AUP rose $15 sequentially and was up 7% year over year. Management attributed AUP improvement to higher-value test mix (including NGS), managed care pricing increases, and revenue cycle management initiatives.
Zook said five NGS products launched in 2023 contributed 22% of clinical revenue in the quarter. He also highlighted continued demand for non-NGS modalities and said all modalities were growing above market rates.
On solid tumor therapy selection, Zook said PanTracer Tissue delivered strong growth through 2025, with volumes doubling from 2023 to 2024 and nearly doubling again from 2024 to 2025, alongside continued AUP growth. He also announced the launch of PanTracer Pro, which integrates broad genomic profiling with diagnosis-directed IHC and ancillary testing “in a single order,” aimed at streamlining ordering and providing actionable insights for therapy selection.
For PanTracer LBx (liquid biopsy), Zook said the company has submitted the test to MolDX and is awaiting a reimbursement decision. Management guided to only a modest contribution in 2026 assuming a favorable decision, with the timing weighted to the back half of the year. In Q&A, the company said it had responded to MolDX questions and characterized reimbursement timing uncertainty as the primary reason for conservatism in guidance.
RaDaR ST launch, MolDX coverage, and MRD strategy
The company’s MRD priorities centered on a planned full clinical launch of RaDaR ST by the end of the month. Zook said a bridging study presented in November showed RaDaR ST demonstrated 97% concordance and maintained equivalent sensitivity with RaDaR 1.0, and that the data supported MolDX reimbursement in two previously approved indications: HPV-negative head and neck cancer and a subset of breast cancers. Zook described the initial commercial focus as HPV-negative head and neck and HER2-negative breast.
Management also said it has submitted two additional solid tumor indications to MolDX but is not disclosing the cancer types for competitive reasons. Zook said the company believes approval would “effectively double” the eligible patient opportunity for RaDaR ST, and he suggested additional indications could be available in the latter half of the year, which would represent upside to guidance if received.
To support the MRD opportunity, management said it is expanding the sales force, including a dedicated initial effort targeting ENT physicians for HPV-negative head and neck cancer. The company said it expects to add more than 25 oncology sales specialists by the third quarter, and the expanded team will sell across the oncology portfolio rather than being MRD-only.
Looking further out, Zook said the company is investing in next-generation MRD—an “ultrasensitive whole genome solution for lower shedding cancer types”—with data generation and MolDX submissions planned for next year and a potential clinical launch as early as 2028.
2026 outlook: revenue, profitability, and operational initiatives
For 2026, Jain guided to revenue of $793 million to $801 million. The midpoint assumes RaDaR ST revenue in the mid-single-digit millions for approved indications, a modest contribution from PanTracer liquid, and continued softness in non-clinical revenue, which management expects to exit 2026 down low- to mid-single digits.
While the company did not provide quarterly guidance, Jain offered an expected growth cadence of roughly 10% year-over-year growth in Q1, 8%–9% in Q2, 9%–10% in Q3, and “slightly above” 10% in Q4. He also noted that extreme weather early in the year had caused some provider office closures and rescheduled appointments, and said the resulting impact to Q1 volumes and revenue was contemplated in the full-year guide.
NeoGenomics guided to adjusted EBITDA of $55 million to $57 million in 2026, representing 27%–31% year-over-year growth, with EBITDA growth expected to be in the low 20% range in the first half and low 30% range in the second half. In Q&A, Jain said the company anticipates gross margin expansion of roughly 100 to 120 basis points in 2026, driven by pricing actions, portfolio rationalization toward higher-value testing, and lab efficiency work, with most of that improvement flowing through to adjusted EBITDA.
On operations, management discussed a multi-year laboratory information management system (LIMS) consolidation, moving from eight systems to one. The company said it is approaching implementation “modality by modality, site by site,” with benefits beginning to emerge later in 2026 but more pronounced impact expected in 2027 and 2028 as legacy systems are retired.
Separately, Zook said the company expects continued modest erosion in the pharma book of business in 2026—at a slower pace than in 2025—and reiterated a view that a return to growth in that segment is more likely in 2027, with RaDaR ST positioned as a key contributor.
About NeoGenomics (NASDAQ:NEO)
NeoGenomics, traded on the Nasdaq under the symbol NEO, is a leading provider of cancer-focused genetic and molecular testing services. Headquartered in Fort Myers, Florida, the company operates an integrated network of CAP-accredited and CLIA-certified laboratories across the United States, Europe and Asia. NeoGenomics delivers diagnostic insights that support oncologists, pathologists and healthcare institutions in the detection, prognosis and treatment of hematologic and solid tumor cancers.
The company’s core service offerings include flow cytometry, immunohistochemistry, fluorescence in situ hybridization (FISH), karyotyping and advanced molecular assays such as next-generation sequencing (NGS) panels and polymerase chain reaction (PCR) tests.
