Neuronetics Reports First Quarter 2026 Financial and Operating Results
Rhea-AI Summary
Neuronetics (NASDAQ: STIM) reported Q1 2026 revenue of $34.5 million, up 8% year‑over‑year, with U.S. clinic revenue of $21.5 million (up 15%). GAAP gross margin was 46.9%. Net loss narrowed to $10.8 million (‑$0.16/share). Cash on hand was $19.0 million.
Company reiterated 2026 guidance: total revenue $160–166M, gross margin 47–49%, operating expenses $100–105M, and expected negative operating cash flow of $13–17M.
AI-generated analysis. Not financial advice.
Positive
- U.S. clinic revenue +15% to $21.5M in Q1 2026
- Net loss improved to $10.8M from $12.7M (>10% improvement)
- Operating cash use reduced by $7.6M to $9.4M in Q1 2026
Negative
- Gross margin down 230 basis points to 46.9% in Q1 2026
- Cash balance declined to $19.0M from $34.1M at year-end 2025
- Full‑year cash flow outlook negative $13M to $17M for 2026
News Market Reaction – STIM
On the day this news was published, STIM gained 7.43%, reflecting a notable positive market reaction. Argus tracked a peak move of +16.9% during that session. Argus tracked a trough of -11.0% from its starting point during tracking. Our momentum scanner triggered 34 alerts that day, indicating elevated trading interest and price volatility. This price movement added approximately $12M to the company's valuation, bringing the market cap to $171.86M at that time. Trading volume was above average at 1.7x the daily average, suggesting increased trading activity.
Data tracked by StockTitan Argus on the day of publication.
Key Figures
Market Reality Check
Peers on Argus
Peers showed mixed, stock-specific moves: BSGM +39.91%, TLSI +2.06% versus CVRX -2.07%, ELMD -0.51%, BWAY -2.52%, with no broad sector momentum flagged.
Previous Earnings Reports
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| Mar 17 | Q4/FY25 earnings | Positive | -9.9% | Strong Q4 and 2025 revenue growth but ongoing net loss and lower margins. |
| Feb 10 | Prelim FY25 results | Positive | +23.3% | Preliminary Q4 and 2025 revenue growth with positive operating cash flow. |
| Nov 04 | Q3 2025 earnings | Neutral | +3.6% | Q3 revenue growth from clinics offset by margin compression and net loss. |
| Aug 05 | Q2 2025 earnings | Positive | -2.5% | Record clinic revenue and reduced cash burn with maintained 2025 guidance. |
| May 06 | Q1 2025 earnings | Positive | +0.0% | Strong revenue growth post-Greenbrook and raised 2025 revenue guidance. |
Earnings releases have produced modest average moves of 2.9%, with mostly aligned but occasionally divergent price reactions to generally growth-focused results.
Recent earnings for Neuronetics emphasized rapid revenue growth driven by the Greenbrook clinic acquisition and expanding TMS adoption. Q2 and Q3 2025 results highlighted higher clinic revenue, additional funding, and declining but still pressured gross margins. Q4 2025 and full-year 2025 maintained this growth narrative, with guidance for 2026 revenue of $160M–$166M and tighter operating expenses. The current Q1 2026 report continues that trajectory with 8% revenue growth, improved operating cash usage, and reaffirmed full-year guidance metrics.
Historical Comparison
Across the last 5 earnings releases, average next-day move was 2.9%, with results consistently highlighting revenue growth and evolving margin and cash-flow trends similar to this Q1 2026 update.
Earnings updates from Q1 2025 through Q4 2025 showed revenue scaling after the Greenbrook acquisition, record clinic contributions, and guidance converging on $160M–$166M for 2026. The Q1 2026 report extends this progression with additional top-line growth, lower operating expenses, and improved operating cash usage while reiterating the same full-year revenue, margin, and expense framework.
Regulatory & Risk Context
An effective S-3 shelf dated March 17, 2026 registers up to 20,737,061 common shares for resale by existing stockholders, primarily Madryn-related entities. The company will receive no proceeds from these sales, but the filing notes that this sizeable block could impact the market price if sold in concentrated fashion.
Market Pulse Summary
The stock moved +7.4% in the session following this news. A strong positive reaction aligns with Neuronetics’ pattern of earnings-driven interest, where prior reports showed an average 2.9% move and highlighted steady revenue growth after the Greenbrook acquisition. Investors have also seen improved operating expense control and better operating cash trends. However, persistent net losses, lower gross margins, and an effective resale shelf for 20,737,061 shares could temper the durability of any sharp upside move.
Key Terms
transcranial magnetic stimulation medical
tms medical
major depressive disorder medical
mdd medical
AI-generated analysis. Not financial advice.
MALVERN, Pa., May 05, 2026 (GLOBE NEWSWIRE) -- Neuronetics, Inc. (NASDAQ: STIM) (the “Company” or “Neuronetics”), a vertically integrated, commercial stage, medical technology and healthcare company with a strategic vision of transforming the lives of patients whenever and wherever they need help, with the leading neurohealth therapies in the world, today announced its financial and operating results for the first quarter of 2026.
First Quarter 2026 Highlights
- First quarter 2026 revenue of
$34.5 million , up8% compared to the first quarter 2025 - U.S. clinic revenue of
$21.5 million , up15% compared to the first quarter 2025 - Shipped 34 NeuroStar systems in the US; a
10% increase compared to the first quarter 2025 - Net cash used in operations of
$9.4 million , a reduction of$7.6 million compared to$17.0 million in the first quarter 2025
Recent Operational Highlights
- Optum/UHC/UBH expanded its TMS clinical policy to allow nurse practitioners to order, supervise, and administer NeuroStar Advanced Therapy
“I'm encouraged by our first quarter performance, which reflects the team’s continued execution on revenue growth, operational efficiency, and cash management. Our clinic business delivered double-digit growth, we reduced operating expenses, and we meaningfully improved our operating cash flow versus the first quarter of last year,” said Dan Reuvers, President and Chief Executive Officer of Neuronetics. “Looking ahead, I believe there is significant value in this business that has yet to be fully realized. We have the leading technology in TMS, a national clinic platform with real growth runway, and a team that is driving operational execution. Our team is focused on delivering better outcomes for our customers and patients, as well as long term value for our shareholders.”
First Quarter 2026 Financial and Operating Results for the Three Months Ended March 31, 2026
| Revenues by Geography | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Amount | Amount | % Change | ||||||
| (Unaudited; in thousands, except percentages) | ||||||||
| U.S. | $ | 34,226 | $ | 31,483 | 9 | % | ||
| International | 228 | 492 | (54 | )% | ||||
| Total revenues | $ | 34,454 | $ | 31,975 | 8 | % | ||
Total revenue for the three months ended March 31, 2026 was
| U.S. Revenues by Product Category | ||||||||
| Three Months Ended March 31, | ||||||||
| 2026 | 2025 | |||||||
| Amount | Amount | % Change | ||||||
| (Unaudited; in thousands, except percentages) | ||||||||
| NeuroStar Advanced Therapy System | $ | 3,203 | $ | 2,846 | 13 | % | ||
| Treatment sessions | 9,122 | 9,612 | (5 | )% | ||||
| Clinic revenue | 21,529 | 18,659 | 15 | % | ||||
| Other | 372 | 366 | 2 | % | ||||
| Total U.S. revenues | $ | 34,226 | $ | 31,483 | 9 | % | ||
U.S. NeuroStar Advanced Therapy System revenue for the three months ended March 31, 2026 was
U.S. treatment session revenue was
U.S. clinic revenue was
Gross margin for the first quarter of 2026 was
Operating expenses during the first quarter of 2026 were
Net loss for the first quarter of 2026 was
As of March 31, 2026, the Company held
Optum/UHC/UBH expanded its TMS clinical policy to allow Nurse Practitioners to order, supervise, and administer NeuroStar Advanced Therapy
Optum/United Healthcare/United Behavioral Health (“Optum/UHC/UBH”) has expanded its transcranial magnetic stimulation (“TMS”) clinical policy to allow psychiatric mental health nurse practitioners (“PMHNPs”) to order, supervise, and administer NeuroStar Advanced Therapy, significantly broadening access to this non-drug, non-invasive treatment for major depressive disorder (“MDD”). Previously limited to psychiatrists, the updated policy applies to PMHNPs practicing in states with full practice authority and extends access across 26 states and Washington, D.C., reaching approximately 34.8 million covered lives. This milestone policy change is expected to enhance patient access—particularly in underserved communities—by enabling more qualified providers to deliver NeuroStar TMS Therapy, a clinically proven option for patients who have not achieved adequate relief from antidepressant medications.
Business Outlook
For the second quarter of 2026, the Company expects total revenue growth in the mid-single digits.
For the full year 2026, Neuronetics continues to expect:
- Total revenue between
$160 million and$166 million ; - Gross margin between
47% and49% ; - Operating expenses between
$100 million and$105 million , inclusive of approximately$8.5 million of non-cash stock-based compensation; - Cash flow from operations between negative
$13 million and negative$17 million ;
Webcast and Conference Call Information
The conference call will be broadcast live in listen-only mode via webcast at https://edge.media-server.com/mmc/p/3pztkve5. To listen to the conference call on your telephone, you may register for the call here. While it is not required, it is recommended you join 10 minutes prior to the event start.
About Neuronetics
Neuronetics, Inc. believes that mental health is as important as physical health. As a global leader in neuroscience, Neuronetics is delivering more treatment options to patients and physicians by offering exceptional in-office treatments that produce extraordinary results. NeuroStar Advanced Therapy is a non-drug, noninvasive treatment that can improve the quality of life for people suffering from neurohealth conditions when traditional medication has not helped. In addition to selling the NeuroStar Advanced Therapy System and associated treatment sessions to customers, Neuronetics operates Greenbrook TMS Inc. (“Greenbrook”) treatment centers across the United States, offering NeuroStar Advanced Therapy for the treatment of MDD and other mental health disorders. NeuroStar Advanced Therapy is the leading TMS treatment for MDD in adults and is backed by what we believe is the largest clinical data set of any TMS treatment system for depression. Greenbrook treatment centers also offer SPRAVATO® (esketamine) Nasal Spray, a prescription medicine indicated for the treatment of treatment-resistant depression (“TRD”) in adults as monotherapy or in conjunction with an oral antidepressant. It is also indicated for depressive symptoms in adults with MDD with acute suicidal ideation or behavior in conjunction with an oral antidepressant.1
The NeuroStar Advanced Therapy System is cleared by the U.S. Food and Drug Administration for adults with MDD, as an adjunct for adults with obsessive-compulsive disorder, to decrease anxiety symptoms in adult patients with MDD that may exhibit comorbid anxiety symptoms (anxious depression), and as a first line adjunct for the treatment of MDD in adolescent patients aged 15-21. For safety information and indications for use, visit NeuroStar.com.
“Safe harbor” statement under the Private Securities Litigation Reform Act of 1995:
Certain statements in this press release, including the documents incorporated by reference herein, include “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), Section 21E of the Securities Exchange Act of 1934, as amended, which are intended to be covered by the safe harbors created by those laws and other applicable laws and “forward-looking information” within the meaning of applicable Canadian securities laws. Statements in this press release that are not historical facts constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements may be identified by terms such as “may,” “will,” “would,” “should,” “expect,” “plan,” “design,” “anticipate,” “could,” “intend,” “target,” “project,” “contemplate,” “believe,” “estimate,” “predict,” “potential,” “outlook” or “continue” as well as the negative of these terms and similar expressions. These statements include those relating to the Company’s business outlook and current expectations for upcoming quarters and fiscal year 2026, including with respect to revenue, expenses, growth, and any statements of assumptions underlying any of the foregoing items. These statements are subject to significant risks and uncertainties and actual results could differ materially from those projected. The Company cautions investors not to place undue reliance on the forward-looking statements contained in this press release. These risks and uncertainties include, without limitation, risks and uncertainties related to: the effect of the transaction with Greenbrook on our business relationships; operating results and business generally; our ability to execute our business strategy; our ability to achieve or sustain profitable operations due to our history of losses; our reliance on the sale and usage of our NeuroStar Advanced Therapy System to generate revenues; the scale and efficacy of our salesforce; our ability to retain talent; availability of coverage and reimbursement from third-party payors for treatments using our products; physician and patient demand for treatments using our products; developments in respect of competing technologies and therapies for the indications that our products treat; product defects; our ability to obtain and maintain intellectual property protection for our technology; developments in clinical trials or regulatory review of the NeuroStar Advanced Therapy System for additional indications; developments in regulation in the U.S. and other applicable jurisdictions; potential effects of evolving and/or extensive government regulation; the terms of our credit facility; and our self-sustainability and existing cash balance; and our ability to achieve positive cash flows. For a discussion of these and other related risks, please refer to the Company’s recent filings with the U.S. Securities and Exchange Commission (the “SEC”), which are available on the SEC’s website at www.sec.gov, including, without limitation, the factors described under the heading “Risk Factors” in Neuronetics’ Annual Report on Form 10-K for the fiscal year ended December 31, 2025 and the company’s Quarterly Report on Form 10-Q for the quarter ending March 31, 2026, as may be updated or supplemented by subsequent reports that Neuronetics has filed or files with the SEC. These forward-looking statements are based on the Company’s expectations and assumptions as of the date of this press release. Except as required by law, the Company undertakes no duty or obligation to update any forward-looking statements contained in this press release as a result of new information, future events, or changes in the Company’s expectations.
Investor Contact:
Mike Vallie or Mark Klausner
ICR Healthcare
443-213-0499
ir@neuronetics.com
Media Contact:
EvolveMKD
646-517-4220
NeuroStar@evolvemkd.com
| NEURONETICS, INC. Consolidated Statements of Operations (Unaudited; In thousands, except per share data) | |||||||
| Three Months ended | |||||||
| March 31, | |||||||
| 2026 | 2025 | ||||||
| Revenues | |||||||
| Products and other | $ | 12,925 | $ | 13,316 | |||
| Services | 21,529 | 18,659 | |||||
| Total Revenue | 34,454 | 31,975 | |||||
| Cost of revenues | |||||||
| Products and other | 2,858 | 3,150 | |||||
| Services | 15,442 | 13,087 | |||||
| Total Cost of revenues | 18,300 | 16,237 | |||||
| Gross profit | 16,154 | 15,738 | |||||
| Operating expenses: | |||||||
| Sales and marketing | 10,737 | 11,999 | |||||
| General and administrative | 13,048 | 13,137 | |||||
| Research and development | 1,364 | 1,616 | |||||
| Total operating expenses | 25,149 | 26,752 | |||||
| Loss from operations | (8,995 | ) | (11,014 | ) | |||
| Other (income) expense: | |||||||
| Interest expense | 2,266 | 1,922 | |||||
| Loss on extinguishment of debt | 539 | — | |||||
| Other income, net | (1,020 | ) | (247 | ) | |||
| Net loss | $ | (10,780 | ) | $ | (12,689 | ) | |
| Less: Net gain (loss) attributable to non-controlling interest | 10 | (14 | ) | ||||
| Net loss attributable to Neuronetics stockholders’ | (10,790 | ) | (12,675 | ) | |||
| Net loss per share of common stock outstanding, basic and diluted attributable to Neuronetics stockholders | $ | (0.16 | ) | $ | (0.21 | ) | |
| Weighted average common shares outstanding, basic and diluted | 69,589 | 61,465 | |||||
| NEURONETICS, INC. Consolidated Balance Sheets (Unaudited; In thousands, except per share data) | |||||||
| March 31, | December 31, | ||||||
| 2026 | 2025 | ||||||
| Assets | |||||||
| Current assets: | |||||||
| Cash and cash equivalents | $ | 13,214 | $ | 28,134 | |||
| Restricted cash | 5,750 | 6,000 | |||||
| Accounts receivable, net of allowance for credit losses of | 15,809 | 16,469 | |||||
| Inventory | 4,715 | 4,327 | |||||
| Current portion of net investments in sales-type leases | 257 | 225 | |||||
| Current portion of prepaid commission expense | 2,900 | 3,050 | |||||
| Current portion of note receivables | 401 | 424 | |||||
| Prepaid expenses and other current assets | 4,129 | 2,922 | |||||
| Total current assets | 47,175 | 61,551 | |||||
| Property and equipment, net | 3,874 | 4,466 | |||||
| Goodwill | 23,622 | 23,622 | |||||
| Intangible assets, net | 17,785 | 18,149 | |||||
| Operating lease right-of-use assets | 23,069 | 23,560 | |||||
| Net investments in sales-type leases | 108 | 98 | |||||
| Prepaid commission expense | 7,464 | 7,972 | |||||
| Long-term notes receivable | 92 | 151 | |||||
| Other assets | 2,251 | 1,982 | |||||
| Total assets | $ | 125,440 | $ | 141,551 | |||
| Liabilities and Equity | |||||||
| Current liabilities: | |||||||
| Accounts payable | $ | 11,433 | $ | 10,739 | |||
| Accrued expenses | 9,596 | 12,316 | |||||
| Current portion of deferred revenue | 833 | 753 | |||||
| Deferred and contingent consideration | 250 | 500 | |||||
| Other payables | 751 | 652 | |||||
| Current portion of operating lease liabilities | 5,422 | 5,561 | |||||
| Total current liabilities | 28,285 | 30,521 | |||||
| Long-term debt, net | 61,297 | 65,807 | |||||
| Other long term liabilities | 71 | — | |||||
| Deferred revenue | 58 | 48 | |||||
| Operating lease liabilities | 18,669 | 18,935 | |||||
| Total liabilities | 108,380 | 115,311 | |||||
| Commitments and contingencies | |||||||
| Equity: | |||||||
| Preferred stock, | — | — | |||||
| Common stock, | 696 | 690 | |||||
| Additional paid-in capital | 482,146 | 480,475 | |||||
| Accumulated deficit | (469,577 | ) | (458,787 | ) | |||
| Total Stockholders' equity | 13,265 | 22,378 | |||||
| Non-controlling interest | 3,795 | 3,862 | |||||
| Total equity | 17,060 | 26,240 | |||||
| Total liabilities and equity | $ | 125,440 | $ | 141,551 | |||
| NEURONETICS, INC. Consolidated Statements of Cash Flows (Unaudited; In thousands) | |||||||
| Three months ended March 31, | |||||||
| 2026 | 2025 | ||||||
| Cash flows from operating activities: | |||||||
| Net loss | $ | (10,780 | ) | $ | (12,689 | ) | |
| Adjustments to reconcile net loss to net cash used in operating activities: | |||||||
| Depreciation and amortization | 745 | 911 | |||||
| Allowance for credit losses | (267 | ) | — | ||||
| Inventory impairment | (30 | ) | 5 | ||||
| Share-based compensation | 1,677 | 1,444 | |||||
| Non-cash interest expense | 256 | 189 | |||||
| Loss on extinguishment of debt | 539 | — | |||||
| Loss on disposal of property and equipment | 270 | — | |||||
| Changes in certain assets and liabilities: | |||||||
| Accounts receivable, net | 1,008 | (2,627 | ) | ||||
| Inventory | (432 | ) | 175 | ||||
| Net investments in sales-type leases | (43 | ) | 14 | ||||
| Prepaid commission expense | 658 | 401 | |||||
| Prepaid expenses and other assets | (1,121 | ) | 1,785 | ||||
| Accounts payable | 559 | (2,638 | ) | ||||
| Accrued expenses | (2,720 | ) | (3,511 | ) | |||
| Other liabilities | 170 | (193 | ) | ||||
| Deferred revenue | 90 | (259 | ) | ||||
| Net cash used in operating activities | (9,421 | ) | (16,993 | ) | |||
| Cash flows from investing activities: | |||||||
| Purchases of property and equipment and capitalized software | (197 | ) | (219 | ) | |||
| Proceeds from the sale of property and equipment | 25 | — | |||||
| Net cash used in investing activities | (172 | ) | (219 | ) | |||
| Cash flows from financing activities: | |||||||
| Repayment of deferred and contingent consideration | (250 | ) | — | ||||
| Repayment of long-term debt | (5,000 | ) | — | ||||
| Payment for debt extinguishment cost | (250 | ) | — | ||||
| Proceeds from the issuance of common stock | — | 20,700 | |||||
| Payments of common stock offering issuance costs | — | (1,731 | ) | ||||
| Distribution to non-controlling interest | (77 | ) | — | ||||
| Proceeds from exercises of stock options | — | 8 | |||||
| Net cash (used in) provided by financing activities | (5,577 | ) | 18,977 | ||||
| Net increase (decrease) in Cash, Cash equivalents and Restricted cash | (15,170 | ) | 1,765 | ||||
| Cash and cash equivalents and restricted cash and cash equivalents, beginning of period | 34,134 | 19,459 | |||||
| Cash and cash equivalents and restricted cash and cash equivalents, end of period | $ | 18,964 | $ | 21,224 | |||
| Reconciliation of cash, cash equivalents and restricted cash to the consolidated balance sheet: | |||||||
| Cash and cash equivalents | 13,214 | 20,224 | |||||
| Restricted cash and cash equivalents | 5,750 | 1,000 | |||||
| Total cash, cash equivalents and restricted cash | $ | 18,964 | $ | 21,224 | |||
Non-GAAP Financial Measures (Unaudited)
EBITDA and Adjusted EBITDA are not measures of financial performance under generally accepted accounting principles in the U.S. (“GAAP”), and should not be construed as a substitute for, or superior to, GAAP net loss. However, management uses both the GAAP and non-GAAP financial measures internally to evaluate and manage the Company’s operations and to better understand its business. Further, management believes that the addition of the non-GAAP financial measures provides meaningful supplementary information to, and facilitates analysis by, investors in evaluating the Company’s financial performance, results of operations and trends. The Company’s calculation of EBITDA and Adjusted EBITDA may not be comparable to similarly designated measures reported by other companies, because companies and investors may differ as to what type of events warrant adjustment.
The following table reconciles reported net loss to EBITDA and Adjusted EBITDA:
| Three Months ended | |||||||||||
| March 31, | |||||||||||
| 2026 | 2025 | ||||||||||
| (in thousands) | |||||||||||
| Net loss attributable to Neuronetics stockholders’ | $ | (10,790 | ) | $ | (12,675 | ) | |||||
| Interest expense, net | 1,246 | 1,675 | |||||||||
| Income taxes | — | — | |||||||||
| Depreciation and amortization | 745 | 911 | |||||||||
| EBITDA | $ | (8,799 | ) | $ | (10,089 | ) | |||||
| Stock based compensation (Note. 1) | 1,677 | 1,444 | |||||||||
| Loss on extinguishment of debt (Note.2) | 539 | — | |||||||||
| Adjusted EBITDA | $ | (6,583 | ) | $ | (8,645 | ) | |||||
Footnotes
- Stock-based compensation consists of expenses related to restricted stock units. We exclude these expenses from our non-GAAP financial measures because they are non-cash charges that we do not consider reflective of our core ongoing operational performance. While share-based compensation is a recurring expense and a key part of our employee retention strategy, excluding it allows management and investors to compare our operational profitability more consistently against prior periods and industry peers.
- In connection with its
$5 million repayment of debt in the first quarter of 2026 to Perceptive Advisors, LLC, the Company recorded a total loss on partial debt extinguishment of approximately$0.5 million . This infrequent and non-recurring expense is removed from EBITDA in order to provide a more accurate reflection of the Company’s core operational performance for the period presented.
References
1 The effectiveness of SPRAVATO® in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO® does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after an initial dose of SPRAVATO®. For more important safety information about SPRAVATO®, please visit spravatohcp.com.
