Neuronetics Reports Third Quarter 2025 Financial and Operating Results and Announces CEO Transition Plan
Neuronetics (NASDAQ: STIM) reported Q3 2025 revenue of $37.3M, up 11% adjusted pro forma versus Q3 2024 and up 101% on an unadjusted basis, driven largely by the Greenbrook acquisition. U.S. Greenbrook clinic revenue was $21.8M (adjusted pro forma +25%). Gross margin declined to 45.9% from 75.6% year-over-year, reflecting clinic mix. Net loss was $(9.4)M (EPS $(0.13)). Cash totaled $34.5M at quarter end and cash used in operations improved to $0.8M in Q3. The company secured an additional $10M debt tranche from Perceptive and raised $7.8M net via an ATM offering. CEO Keith J. Sullivan plans to retire effective June 30, 2026 with a successor search underway.
Full-year 2025 revenue guidance was updated to $147M–$150M and Q4 revenue is expected at $40M–$43M.
Neuronetics (NASDAQ: STIM) ha riportato entrate nel Q3 2025 di 37,3 milioni di dollari, in aumento dell'11% pro forma corretto rispetto al Q3 2024 e del 101% su base non rettificata, trainato principalmente dall'acquisizione Greenbrook. Le entrate delle cliniche Greenbrook negli Stati Uniti sono state di 21,8 milioni di dollari (pro forma corretto +25%). Il margine lordo è calato al 45,9% dal 75,6% anno su anno, riflettendo la composizione delle cliniche. La perdita netta è stata di (9,4) milioni di dollari (EPS (0,13)). La cassa ha totalizzato 34,5 milioni di dollari al termine del trimestre e l’uso della cassa nelle operazioni è migliorato a 0,8 milioni nel Q3. L’azienda ha assicurato un’ulteriore tranche di debito da 10 milioni di dollari da Perceptive e ha raccolto 7,8 milioni di dollari netti tramite un’offerta ATM. Il CEO Keith J. Sullivan prevede di ritirarsi entro il 30 giugno 2026, con una ricerca del successore in corso.
La guidance per l’intero 2025 è stata aggiornata a 147–150 milioni di dollari e i ricavi del Q4 sono attesi tra 40–43 milioni di dollari.
Neuronetics (NASDAQ: STIM) informó ingresos del 3T 2025 de 37,3 millones de dólares, un 11% más ajustado pro forma frente al 3T 2024 y un 101% más no ajustado, impulsado principalmente por la adquisición de Greenbrook. Los ingresos de las clínicas Greenbrook en EE. UU. fueron de 21,8 millones de dólares (pro forma ajustado +25%). El margen bruto cayó a 45,9% desde 75,6% interanual, reflejando la mezcla de clínicas. La pérdida neta fue de (9,4) millones (EPS (0,13)). La caja totalizó 34,5 millones al cierre del trimestre y el uso de caja en operaciones mejoró a 0,8 millones en el Q3. La empresa aseguró una tranche adicional de deuda de 10 millones de dólares de Perceptive y obtuvo 7,8 millones netos mediante una oferta ATM. El CEO Keith J. Sullivan planea retirarse el 30 de junio de 2026 y está en curso la búsqueda de un sucesor.
La guía de ingresos para 2025 completo se actualizó a 147–150 millones y se espera que los ingresos del Q4 sean de 40–43 millones.
Neuronetics (NASDAQ: STIM)은 2025년 3분기 매출 3,730만 달러를 보고했고, 조정된 프록인(프로 포마) 기준으로는 2024년 3분기 대비 11% 증가했고, 비조정 기준으로는 101% 증가했습니다. 이는 주로 Greenbrook 인수에 따른 것입니다. 미국 Greenbrook 클리닉 매출은 2,180만 달러로, (조정된 프로 포마 +25%)였습니다. 총마진은 전년동기 대비 45.9%로 하락했고, 이는 클리닉 구성의 영향 때문입니다. 순손실은 (9.4)백만 달러였고, 주당순이익은 (0.13)였습니다. 현금성 자산은 분기 말에 3450만 달러였고, 영업활동으로 인한 현금 사용은 Q3에 80만 달러로 개선되었습니다. 회사는 Perceptive로부터 1000만 달러의 추가 채무를 확보했고, ATM 공모를 통해 순이익 780만 달러를 조달했습니다. Keith J. Sullivan CEO는 2026년 6월 30일에 은퇴할 계획이며 후임자 선발이 진행 중입니다.
2025년 연간 가이던스는 1억 4700만~1억 5000만 달러로 업데이트되었고 4분기 매출은 4천만~4,3천만 달러로 예상됩니다.
Neuronetics (NASDAQ: STIM) a publié un chiffre d’affaires du T3 2025 de 37,3 M$, en hausse de 11% ajusté pro forma par rapport au T3 2024 et de 101% sur une base non ajustée, principalement porté par l’acquisition Greenbrook. Les revenus des cliniques Greenbrook aux États-Unis s’élevent à 21,8 M$ (pro forma ajusté +25%). La marge brute est déclinée à 45,9% contre 75,6% d’une année sur l’autre, reflétant la répartition des cliniques. La perte nette est de (9,4) M$ (EPS (0,13)). La trésorerie s’établit à 34,5 M$ à la fin du trimestre et l’utilisation de la trésorerie opérationnelle s’est améliorée à 0,8 M$ au T3. L’entreprise a obtenu une tranche d’endettement supplémentaire de 10 M$ de Perceptive et a levé 7,8 M$ nets via une offre ATM. Le PDG Keith J. Sullivan prévoit de prendre sa retraite le 30 juin 2026, avec une recherche de successeur en cours.
La prévision de chiffre d’affaires pour 2025 est mise à jour à 147–150 M$ et le chiffre d’affaires du T4 est attendu entre 40–43 M$.
Neuronetics (NASDAQ: STIM) meldete U3 2025 Umsatz von 37,3 Mio. USD, ein um 11% bereinigter Pro forma-Anstieg gegenüber Q3 2024 und ein Anstieg von 101% unberücksichtigt, maßgeblich getrieben durch die Greenbrook-Übernahme. U.S. Greenbrook-Klinikumsumsätze beliefen sich auf 21,8 Mio. USD (bereinigt pro forma +25%). Die Bruttomarge sank auf 45,9% von 75,6% im Vorjahr, bedingt durch die Klinik-Mix. Nettverlust betrug (9,4) Mio. USD (EPS (0,13)). Cash-Position betrug zum Quartalsende 34,5 Mio. USD und der Cash-Use aus operativer Tätigkeit verbesserte sich auf 0,8 Mio. USD im Q3. Das Unternehmen sicherte sich eine weitere Schuld-Tranche von 10 Mio. USD von Perceptive und sammelte durch ein ATM-Angebot netto 7,8 Mio. USD ein. CEO Keith J. Sullivan plant den Rücktritt zum 30. Juni 2026; eine Nachfolgesuche läuft.
Die Guidance für das Gesamtjahr 2025 wurde auf 147–150 Mio. USD aktualisiert und der Q4-Umsatz wird voraussichtlich 40–43 Mio. USD betragen.
Neuronetics (NASDAQ: STIM) أبلغت عن إيرادات الربع الثالث 2025 قدرها 37.3 مليون دولار, بارتفاع 11% مُعدلة وفقاً للنموذج الإفتراضي مقارنة بالربع الثالث 2024 وبزيادة 101% وفقاً غير المعدلة، مدفوعاً إلى حد كبير بالاستحواذ على Greenbrook. إيرادات عيادات Greenbrook الأمريكية بلغت 21.8 مليون دولار (معدلة وفقاً للنموذج +25%). هامش الربح الإجمالي انخفض إلى 45.9% من 75.6% على أساس سنوي، مما يعكس مزيج العيادات. الخسارة الصافية بلغت (9.4) مليون دولار (السهم المخفَّض (0.13)). النقدية الإجمالية بلغت 34.5 مليون دولار في نهاية الربع وتحسن استخدام النقد في العمليات إلى 0.8 مليون دولار في الربع الثالث. الشركة أتمت تحصلها على شريحة إضافية من الدين بقيمة 10 ملايين دولار من Perceptive وجمعت 7.8 ملايين دولار صافية من خلال عرض ATM. الرئيس التنفيذي كيث جي. سوليفان يخطط للتقاعد بنهاية 30 يونيو 2026 مع جارٍ البحث عن خليفة.
تحديث التوجيه لسنة 2025 كاملة إلى 147–150 مليون دولار ومن المتوقع أن يكون إيراد الربع الرابع بين 40–43 مليون دولار.
- Adjusted pro forma revenue +11% in Q3 2025
- Greenbrook clinic revenue $21.8M; pro forma +25%
- Cash at quarter end of $34.5M
- $10M additional Perceptive tranche secured
- Net ATM proceeds of $7.8M
- Operating cash use improved to $0.8M in Q3
- Gross margin declined to 45.9% from 75.6% YoY
- U.S. treatment session revenue down 21% YoY (pro forma -5.1%)
- NeuroStar Advanced Therapy System revenue down 15% YoY
- Net loss of $(9.4)M in Q3 2025
Insights
Revenue growth and clinic integration lift scale and cash stability, while margins compress and leadership transition adds near‑term uncertainty.
The company delivered
Key dependencies and risks include the shift in revenue mix that lowered gross margin to
Concrete items to watch over the next quarters: execution against Q4 revenue guidance of
Delivered
Generated Greenbrook clinic revenue of
Continued cash management improvement, with cash used in operations of
Strengthened balance sheet in Q3 2025, ending the quarter with
MALVERN, Pa., Nov. 04, 2025 (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 third quarter of 2025 and the intention of Keith J. Sullivan, Neuronetics’ President and Chief Executive Officer, to retire effective June 30, 2026.
Third Quarter 2025 Highlights
- Third quarter 2025 revenue of
$37.3 million , an11% increase as compared to the third quarter 2024 on an adjusted pro forma basis and a101% increase as compared to the third quarter 2024 on an unadjusted basis - U.S. Greenbrook clinic revenue of
$21.8 million in the quarter, representing25% growth on an adjusted pro forma basis as compared to the third quarter of 2024 - U.S. NeuroStar Advanced Therapy System revenue of
$3.5 million , shipping 40 system
Recent Operational Highlights
- Achieved milestone of over 229,429 global patients treated with 8.2 million treatment sessions
- New York State Medicaid Expands Coverage for TMS Therapy, Including NeuroStar Advanced Therapy, to Treat Major Depressive Disorder
- Received an additional
$10 million of funding under the Perceptive debt agreement, and extended the$2 million minimum liquidity requirement from September 2025 to September 2026 - Raised
$7.8 million in net proceeds through the sale of approximately 2.3 million shares of its common stock under its at-the-market (“ATM”) facility.
“Our third quarter results reflect continued progress as we integrate and optimize our combined operations,” said Keith Sullivan, President and Chief Executive Officer of Neuronetics “On an adjusted pro forma basis, we delivered
The Company also announced that Mr. Sullivan has informed the Board of Directors of his intention to retire as President and Chief Executive Officer on June 30, 2026. The Company has commenced a search for Mr. Sullivan’s successor. Once a successor is appointed, Mr. Sullivan has agreed to remain as a consultant after his retirement and will work closely with the new CEO to ensure a seamless transition.
“Keith has been instrumental in transforming Neuronetics in his five years as CEO. In particular, the strategic acquisition of Greenbrook TMS has vertically integrated the Company’s value chain and positioned the Company well for long-term growth,” said Rob Cascella, the Company’s Chairman of the Board. “We want to thank Keith for his dedication to the Company and look forward to his participation in our comprehensive search process to identify the ideal candidate to lead Neuronetics through its next stage of growth.”
Third Quarter 2025 Financial and Operating Results for the Three Months Ended September 30, 2025
| Revenues by Geography | |||||||||
| Three Months Ended September 30, | |||||||||
| 2025 | 2024 | ||||||||
| Amount | Amount | % Change | |||||||
| (Unaudited; in thousands, except percentages) | |||||||||
| U.S. | $ | 36,248 | $ | 17,922 | 102 | % | |||
| International | 1,049 | 608 | 73 | % | |||||
| Total revenues | $ | 37,297 | $ | 18,530 | 101 | % | |||
Total revenues for the three months ended September 30, 2025 was
| U.S. Revenues by Product Category | ||||||||||
| Three Months Ended September 30, | ||||||||||
| 2025 | 2024 | |||||||||
| Amount | Amount | % Change | ||||||||
| (Unaudited; in thousands, except percentages) | ||||||||||
| NeuroStar Advanced Therapy System | $ | 3,508 | $ | 4,108 | (15 | ) | % | |||
| Treatment sessions | 10,543 | 13,326 | (21 | ) | % | |||||
| Clinic revenue | 21,808 | — | — | % | ||||||
| Other | 389 | 488 | (20 | ) | % | |||||
| Total U.S. revenues | $ | 36,248 | $ | 17,922 | 102 | % | ||||
U.S. NeuroStar Advanced Therapy System revenue for the three months ended September 30, 2025 was
U.S. treatment session revenue for the three months ended September 30, 2025 was
U.S. clinic revenue, which represents revenue generated by treatment centers from the Greenbrook acquisition, was
Gross margin for the third quarter of 2025 was
Operating expenses during the third quarter of 2025 were
Net loss for the third quarter of 2025 was
As of September 30, 2025, the Company held
Company Secures
In August 2025, Neuronetics received
At-the-Market Equity Offering
During the period ended September 30, 2025, the Company sold an aggregate of 2,261,835 shares of its common stock under its ATM facility at an average price of
New York State Medicaid Expands Coverage for TMS Therapy, Including NeuroStar Advanced Therapy, to Treat Major Depressive Disorder
Neuronetics announced that New York State Medicaid will begin covering transcranial magnetic stimulation (“TMS”) therapy for adults diagnosed with major depressive disorder (“MDD”), expanding access to over 5 million members statewide. Coverage took effect October 1, 2025, for fee-for-service Medicaid members and November 1, 2025, for those in managed care plans. This milestone underscores growing recognition of TMS as an effective, non-drug treatment for depression and reflects Neuronetics’ continued commitment to improving access to advanced mental health therapies through its NeuroStar Advanced Therapy system.
Business Outlook
For the fourth quarter of 2025, the Company expects total worldwide revenue between
For the full year 2025, the Company now expects its total worldwide revenue to be between
For the full year 2025, the Company now expects gross margin to be between
For the full year 2025, the Company continues to expect total operating expenses to be between
We continue to target positive cash flow from operations in the fourth quarter of 2025, with a range of between
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/yxrs8osc. 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 (“NeuroStar 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 (the “NeuroStar System”) and associated treatment sessions to customers, Neuronetics operates Greenbrook treatment centers across the United States, acquired in December 2024, offering NeuroStar Therapy, SPRAVATO®, and other treatment modalities for the treatment of MDD and other mental health disorders.
NeuroStar Therapy is indicated for the treatment of depressive episodes and for decreasing anxiety symptoms for those who may exhibit comorbid anxiety symptoms in adult patients suffering from MDD and who failed to achieve satisfactory improvement from previous antidepressant medication treatment in the current episode. It is also cleared by the U.S. Food and Drug Administration as an adjunct for adults with obsessive-compulsive disorder and for adolescent patients aged 15 to 21 with MDD. Neuronetics is committed to transforming lives by offering an exceptional treatment that produces extraordinary results.
“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 2025, 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 revenue concentration among a small number of customers; 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; our ability to successfully roll-out our Better Me Provider Program on the planned timeline; our self-sustainability and existing cash balances; and our ability to achieve cash flow breakeven in the fourth quarter of 2025. For a discussion of these and other related risks, please refer to the Company’s recent filings with 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, 2024, 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 | Nine months ended | |||||||||||||||
| September 30, | September 30, | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| Revenues | $ | 37,297 | $ | 18,530 | $ | 107,380 | $ | 52,397 | ||||||||
| Cost of revenues | 20,189 | 4,529 | 56,776 | 13,129 | ||||||||||||
| Gross profit | 17,108 | 14,001 | 50,604 | 39,268 | ||||||||||||
| Operating expenses: | ||||||||||||||||
| Sales and marketing | 11,848 | 11,877 | 35,715 | 35,820 | ||||||||||||
| General and administrative | 11,077 | 7,436 | 36,364 | 19,540 | ||||||||||||
| Research and development | 1,504 | 2,416 | 4,918 | 6,999 | ||||||||||||
| Total operating expenses | 24,429 | 21,729 | 76,997 | 62,359 | ||||||||||||
| Loss from operations | (7,321 | ) | (7,728 | ) | (26,393 | ) | (23,091 | ) | ||||||||
| Other (income) expense: | ||||||||||||||||
| Interest expense | 2,206 | 1,725 | 6,097 | 5,529 | ||||||||||||
| Loss on extinguishment of debt | — | 4,427 | — | 4,427 | ||||||||||||
| Other income, net | (126 | ) | (539 | ) | (561 | ) | (2,001 | ) | ||||||||
| Net loss | $ | (9,401 | ) | $ | (13,341 | ) | $ | (31,929 | ) | $ | (31,046 | ) | ||||
| Less: Net loss attributable to non-controlling interest | (356 | ) | — | (89 | ) | — | ||||||||||
| Net loss attributable to Neuronetics stockholders’ | (9,045 | ) | (13,341 | ) | (31,840 | ) | (31,046 | ) | ||||||||
| Net loss per share of common stock outstanding, basic and diluted attributable to Neuronetics stockholders’ | $ | (0.13 | ) | $ | (0.44 | ) | $ | (0.49 | ) | $ | (1.04 | ) | ||||
| Weighted average common shares outstanding, basic and diluted | 67,309 | 30,267 | 65,006 | 29,931 | ||||||||||||
| NEURONETICS, INC. Consolidated Balance Sheets (Unaudited; In thousands, except per share data) | ||||||||
| September 30, | December 31, | |||||||
| 2025 | 2024 | |||||||
| Assets | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 27,971 | $ | 18,459 | ||||
| Restricted cash | 6,500 | 1,000 | ||||||
| Accounts receivable, net of allowance of credit losses for | 18,693 | 23,355 | ||||||
| Inventory | 4,322 | 4,248 | ||||||
| Current portion of net investments in sales-type leases | 175 | 206 | ||||||
| Current portion of prepaid commission expense | 3,118 | 3,078 | ||||||
| Current portion of note receivables | 493 | 930 | ||||||
| Prepaid expenses and other current assets | 3,616 | 6,846 | ||||||
| Total current assets | 64,888 | 58,122 | ||||||
| Property and equipment, net | 4,937 | 6,242 | ||||||
| Goodwill | 22,664 | 18,634 | ||||||
| Intangible assets, net | 18,513 | 19,606 | ||||||
| Operating lease right-of-use assets | 24,234 | 27,093 | ||||||
| Net investments in sales-type leases | 94 | 86 | ||||||
| Prepaid commission expense | 8,021 | 8,902 | ||||||
| Long-term notes receivable | 221 | 295 | ||||||
| Other assets | 1,893 | 1,923 | ||||||
| Total assets | $ | 145,465 | $ | 140,903 | ||||
| Liabilities and Equity | ||||||||
| Current liabilities: | ||||||||
| Accounts payable | $ | 11,573 | $ | 11,077 | ||||
| Accrued expenses | 9,653 | 12,818 | ||||||
| Current portion of deferred revenue | 754 | 974 | ||||||
| Deferred and contingent consideration | 1,000 | 1,000 | ||||||
| Other payables | 376 | 605 | ||||||
| Current portion of operating lease liabilities | 5,584 | 4,791 | ||||||
| Total current liabilities | 28,940 | 31,265 | ||||||
| Long-term debt, net | 65,671 | 55,151 | ||||||
| Deferred revenue | — | 2 | ||||||
| Operating lease liabilities | 19,494 | 22,686 | ||||||
| Total liabilities | 114,105 | 109,104 | ||||||
| Commitments and contingencies | ||||||||
| Equity: | ||||||||
| Preferred stock, | — | — | ||||||
| Common stock, | 685 | 557 | ||||||
| Additional paid-in capital | 478,300 | 446,938 | ||||||
| Accumulated deficit | (451,629 | ) | (419,789 | ) | ||||
| Total Stockholders' equity | 27,356 | 27,706 | ||||||
| Non-controlling interest | 4,004 | 4,093 | ||||||
| Total equity | 31,360 | 31,799 | ||||||
| Total liabilities and equity | $ | 145,465 | $ | 140,903 | ||||
| NEURONETICS, INC. Consolidated Statements of Cash Flows (Unaudited; In thousands) | ||||||||
| Nine months ended September 30, | ||||||||
| 2025 | 2024 | |||||||
| Cash flows from Operating activities: | ||||||||
| Net loss | $ | (31,929 | ) | $ | (31,046 | ) | ||
| Adjustments to reconcile net loss to net cash used in operating activities: | ||||||||
| Depreciation and amortization | 2,698 | 1,627 | ||||||
| Allowance for credit losses | 382 | 1,947 | ||||||
| Inventory impairment | 267 | 346 | ||||||
| Share-based compensation | 4,667 | 4,320 | ||||||
| Non-cash interest expense | 600 | 580 | ||||||
| Loss on extinguishment of debt | — | 4,427 | ||||||
| Loss on disposal of property and equipment | 45 | — | ||||||
| Changes in certain assets and liabilities: | ||||||||
| Accounts receivable, net | 1,384 | (3,834 | ) | |||||
| Inventory | (240 | ) | 2,718 | |||||
| Prepaid commission expense | 840 | (770 | ) | |||||
| Prepaid expenses and other assets | 3,813 | (374 | ) | |||||
| Accounts payable | (77 | ) | (1,524 | ) | ||||
| Accrued expenses | (3,302 | ) | (1,166 | ) | ||||
| Other liabilities | (223 | ) | — | |||||
| Deferred revenue | (229 | ) | (506 | ) | ||||
| Net Cash used in Operating activities | (21,282 | ) | (22,401 | ) | ||||
| Cash flows from Investing activities: | ||||||||
| Purchases of property and equipment and capitalized software | (585 | ) | (1,377 | ) | ||||
| Repayment of notes receivable | — | 1,340 | ||||||
| Net Cash used in Investing activities | (585 | ) | (37 | ) | ||||
| Cash flows from Financing activities: | ||||||||
| Payments of debt issuance costs | (80 | ) | (2,188 | ) | ||||
| Proceeds from issuance of long-term debt | 10,000 | 48,084 | ||||||
| Proceeds from issuance of warrants | — | 1,916 | ||||||
| Repayment of long-term debt | — | (60,000 | ) | |||||
| Payment for debt extinguishment cost | — | (4,185 | ) | |||||
| Proceeds from the issuance of common stock | 20,700 | — | ||||||
| Payments of common stock offering issuance costs | (1,731 | ) | — | |||||
| Proceeds from issuance of common stock under ATM facility | 8,313 | — | ||||||
| Payments of common stock offering issuance costs under ATM Program | (336 | ) | — | |||||
| Proceeds from exercises of stock options | 13 | 1 | ||||||
| Net Cash provided by (used in) Financing activities | 36,879 | (16,372 | ) | |||||
| Net increase (decrease) in Cash, Cash equivalents and Restricted cash | 15,012 | (38,810 | ) | |||||
| Cash, Cash equivalents and Restricted cash, Beginning of Period | 19,459 | 59,677 | ||||||
| Cash, Cash equivalents and Restricted cash, End of Period | $ | 34,471 | $ | 20,867 | ||||
| Reconciliation of cash, cash equivalents and restricted cash to the consolidated balance sheet: | ||||||||
| Cash and cash equivalents | 27,971 | 20,867 | ||||||
| Restricted cash and cash equivalents | 6,500 | — | ||||||
| Total cash, cash equivalents and restricted cash | $ | 34,471 | $ | 20,867 | ||||
Non-GAAP Financial Measures (Unaudited)
Earnings before interest, taxes, depriciation, and amortization (“EBITDA”) is not a measure 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 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:
| Three Months ended | Nine months ended | |||||||||||||||
| September 30, | September 30, | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| (in thousands) | (in thousands) | |||||||||||||||
| Net loss | $ | (9,401 | ) | $ | (13,341 | ) | $ | (31,929 | ) | $ | (31,046 | ) | ||||
| Interest expense, net | 2,080 | 1,186 | 5,536 | 3,528 | ||||||||||||
| Income taxes | — | — | — | — | ||||||||||||
| Depreciation and amortization | 886 | 512 | 2,698 | 1,627 | ||||||||||||
| EBITDA | $ | (6,435 | ) | $ | (11,643 | ) | $ | (23,695 | ) | $ | (25,891 | ) | ||||
Non-GAAP Pro Forma and Adjusted Pro Forma Revenue Information (Unaudited)
The following table presents the Company’s pro forma operating results, giving effect to the acquisition of Greenbrook as if the transaction had occurred on January 1, 2024. These pro forma results are based on assumptions that management believes are reasonable under the circumstances. However, they are not necessarily indicative of the Company’s future performance. The pro forma financial information reflects the historical operating results of both the Company and Greenbrook, with all intercompany transactions eliminated. The adjusted pro forma results further reflect eliminations related to the closure of certain clinics in 2024. The pro forma data does not include the impact of any potential synergies or cost-saving initiatives resulting from the acquisition:
| Three Months ended | ||||
| September 30, 2024 | ||||
| (in thousands) | ||||
| Neuronetics | $ | 18,530 | ||
| Greenbrook | 19,072 | |||
| Intercompany revenue | (2,392 | ) | ||
| Total Pro forma | 35,210 | |||
| Adjusted for clinic closures | (1,652 | ) | ||
| Adjusted Pro forma Revenue | $ | 33,558 | ||
| Three Months ended | ||||
| September 30, 2024 | ||||
| (in thousands) | ||||
| Neuronetics Treatment sessions | $ | 13,326 | ||
| Intercompany Treatment sessions | (2,220 | ) | ||
| Total Pro forma Treatment sessions | 11,106 | |||