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[10-Q] Waystar Holding Corp. Quarterly Earnings Report

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Rhea-AI Filing Summary

Waystar Holding Corp. reported stronger Q3 results. Revenue rose to $268.7 million from $240.1 million a year ago, and income from operations increased to $60.2 million from $27.1 million. Net income improved to $30.6 million (diluted EPS $0.17) from $5.4 million ($0.03).

For the first nine months, revenue reached $795.7 million versus $699.4 million, with net income of $92.1 million compared to a $38.2 million loss last year, helped by lower depreciation/amortization and reduced interest expense. Operating cash flow was $243.0 million. Cash and equivalents were $421.1 million at September 30, 2025, against total debt of $1.23 billion (no revolver borrowings). The company repriced its First Lien Credit Facility on August 12, 2025 to SOFR + 2.00% (effective rate 6.34% at quarter-end) and used short-term investments during the period to help fund the acquisition of Iodine Software Holdings, Inc. Shares outstanding were 191,316,583 as of October 20, 2025.

Waystar Holding Corp. ha comunicato risultati del terzo trimestre migliori. Le entrate sono salite a 268,7 milioni di dollari rispetto a 240,1 milioni di dollari dell'anno precedente, e l'utile operativo è aumentato a 60,2 milioni di dollari da 27,1 milioni. L'utile netto è migliorato a 30,6 milioni di dollari (EPS diluito 0,17 $) da 5,4 milioni (EPS 0,03 $).

Per i primi nove mesi, i ricavi hanno raggiunto 795,7 milioni di dollari rispetto a 699,4 milioni, con un utile netto di 92,1 milioni rispetto a una perdita di 38,2 milioni l'anno scorso, supportato da una minore ammortizzazione e da una ridotta spesa per interessi. Il flusso di cassa operativo è stato di 243,0 milioni. Le disponibilità liquide ed equivalenti erano 421,1 milioni al 30 settembre 2025, contro un debito totale di 1,23 miliardi di dollari (nessun utilizzo della revolver). L'azienda ha rifinanziato la sua First Lien Credit Facility il 12 agosto 2025 a SOFR + 2,00% (tasso effettivo al termine del trimestre 6,34%) e ha utilizzato investimenti a breve termine nel periodo per finanziare l'acquisizione di Iodine Software Holdings, Inc. Le azioni in circolazione erano 191.316.583 al 20 ottobre 2025.

Waystar Holding Corp. informó resultados más fuertes en el tercer trimestre. Los ingresos subieron a $268.7 millones desde $240.1 millones hace un año, y el ingreso operativo aumentó a $60.2 millones desde $27.1 millones. El ingreso neto mejoró a $30.6 millones (EPS diluido $0.17) desde $5.4 millones ($0.03).

Para los primeros nueve meses, los ingresos alcanzaron $795.7 millones frente a $699.4 millones, con un ingreso neto de $92.1 millones en comparación con una pérdida de $38.2 millones el año pasado, ayudado por una menor depreciación/amortización y reducción de gastos por intereses. El flujo de efectivo operativo fue de $243.0 millones. Las disponibilidades de efectivo y equivalentes fueron de $421.1 millones al 30 de septiembre de 2025, frente a una deuda total de $1.23 mil millones (sin revolver utilizado). La empresa repreció su First Lien Credit Facility el 12 de agosto de 2025 a SOFR + 2.00% (tasa efectiva al final del trimestre 6.34%) y utilizó inversiones a corto plazo durante el periodo para ayudar a financiar la adquisición de Iodine Software Holdings, Inc. Las acciones en circulación eran 191,316,583 al 20 de octubre de 2025.

Waystar Holding Corp.은(는) 3분기 실적이 더 좋아졌다고 발표했습니다. 매출은 $268.7백만에서 $240.1백만에서 연간 증가했고 영업이익은 $60.2백만에서 $27.1백만로 상승했습니다. 순이익은 $30.6백만(희석된 EPS $0.17)으로 개선되었고, 전년 대비 $5.4백만($0.03)에서 증가했습니다.

처음 9개월 동안 매출은 $795.7백만으로, 전년 동기의 $699.4백만과 비교되며 순이익은 $92.1백만으로, 작년의 $38.2백만 손실에서 증가했습니다. 이는 더 낮은 감가상각/무형자산상각과 이자비용 감소에 힘입은 것입니다. 영업현금흐름은 $243.0백만이었습니다. 현금 및 현금성자산은 2025년 9월 30일 기준 $421.1백만, 총부채는 $1.23십억 달러였습니다(리볼버 차입 없음). 회사는 2025년 8월 12일 First Lien Credit Facility를 SOFR + 2.00%로 재가격했으며(분기말 실효금리 6.34%), 기간 동안 단기투자 자산을 사용해 Iodine Software Holdings, Inc. 인수를 자금 조달했습니다. 2025년 10월 20일 기준 발행주식수는 191,316,583주였습니다.

Waystar Holding Corp. a publié des résultats du troisième trimestre plus solides. Le chiffre d'affaires est passé à 268,7 millions de dollars contre 240,1 millions de dollars l'année dernière, et le résultat opérationnel est monté à 60,2 millions de dollars contre 27,1 millions. Le résultat net s’est amélioré à 30,6 millions de dollars (BPA dilué 0,17 $) contre 5,4 millions (0,03 $).

Pour les neuf premiers mois, le chiffre d'affaires a atteint 795,7 millions de dollars contre 699,4 millions, avec un résultat net de 92,1 millions de dollars contre une perte de 38,2 millions l'année précédente, aidé par une dépense d'amortissement et de dépréciation moindre et une réduction des intérêts. Le flux de trésorerie opérationnel s’élève à 243,0 millions. Les liquidités et équivalents étaient de 421,1 millions de dollars au 30 septembre 2025, contre une dette totale de 1,23 milliard de dollars (aucun tirage revolver). L'entreprise a reprix sa First Lien Credit Facility le 12 août 2025 à SOFR + 2,00% (taux effectif à la fin du trimestre 6,34%) et a utilisé des investissements à court terme durant la période pour aider au financement de l'acquisition de Iodine Software Holdings, Inc. Le nombre d'actions en circulation était de 191 316 583 au 20 octobre 2025.

Waystar Holding Corp. meldete stärkere Ergebnisse im dritten Quartal. Der Umsatz stieg auf 268,7 Millionen USD von 240,1 Millionen USD vor einem Jahr, und das operative Ergebnis kletterte auf 60,2 Millionen USD von 27,1 Millionen USD. Der Nettogewinn verbesserte sich auf 30,6 Millionen USD (verwässertes EPS 0,17 USD) gegenüber 5,4 Millionen USD (0,03 USD).

Für die ersten neun Monate erreichte der Umsatz 795,7 Millionen USD gegenüber 699,4 Millionen USD, mit einem Nettogewinn von 92,1 Millionen USD im Vergleich zu einem Verlust von 38,2 Millionen USD im Vorjahr, unterstützt durch geringere Abschreibungen und Zinsaufwendungen. Der operative Cashflow betrug 243,0 Millionen USD. Die Barmittel und Pensionen betrugen 421,1 Millionen USD zum Stichtag 30. September 2025, bei einer Gesamtverschuldung von 1,23 Milliarden USD (kein Revolver-Borrowing). Das Unternehmen hat seine First Lien Credit Facility am 12. August 2025 auf SOFR + 2,00% neu bepreist (effektiver Zinssatz zum Quartalsende 6,34%) und im Zeitraum kurzfristige Investitionen genutzt, um die Übernahme von Iodine Software Holdings, Inc. zu finanzieren. Die Anzahl der ausstehenden Aktien betrug 191.316.583 zum 20. Oktober 2025.

Waystar Holding Corp. أبلغت عن نتائج أقوى في الربع الثالث. ارتفع الإيراد إلى $268.7 مليون من $240.1 مليون قبل عام، وزاد الدخل من العمليات إلى $60.2 مليون من $27.1 مليون. تحسن صافي الدخل إلى $30.6 مليون (ربحية السهم المخففة $0.17) من $5.4 مليون ($0.03).

لأول تسعة أشهر، بلغ الإيراد $795.7 مليون مقابل $699.4 مليون، مع صافي دخل قدره $92.1 مليون مقارنة بخسارة قدرها $38.2 مليون في العام الماضي، مدعومًا باعتمادات انخفاض الاستهلاك وزيادة في التكاليف. كان التدفق النقدي من التشغيل $243.0 مليون. بلغت السيولة النقدية وما يعادلها $421.1 مليون في 30 سبتمبر 2025، مقابل ديون إجمالية قدرها $1.23 مليار (لا يوجد سحب من خطوط الائتمان الدائر). قامت الشركة بإعادة تسعير تسهيل الائتمان الأولي في 12 أغسطس 2025 إلى SOFR + 2.00% (المعدل الفعلي عند نهاية الربع 6.34%) واستخدمت استثمارات قصيرة الأجل خلال الفترة للمساعدة في تمويل استحواذ Iodine Software Holdings, Inc. بلغت الأسهم المصدرة 191,316,583 حتى 20 أكتوبر 2025.

Positive
  • Q3 revenue increased to $268.7M and net income to $30.6M, with nine‑month revenue of $795.7M and net income of $92.1M.
  • Operating cash flow reached $243.0M for the nine months, boosting cash to $421.1M.
  • First‑lien facility repriced on Aug 12, 2025 to SOFR + 2.00%, lowering the spread.
Negative
  • None.

Insights

Double-digit growth and a swing to profitability mark solid momentum.

Waystar delivered Q3 revenue of $268.7M and net income of $30.6M, with nine‑month revenue at $795.7M and net income of $92.1M. The move from a prior nine‑month loss indicates operating leverage as depreciation/amortization and interest expense eased.

Liquidity strengthened with cash at $421.1M and operating cash flow of $243.0M. Debt remains significant at $1.23B, but the Aug 12, 2025 first‑lien repricing to SOFR + 2.00% (effective 6.34% at quarter‑end) and active interest rate swaps partially mitigate rate exposure.

The note that short‑term investments were liquidated to help fund the Iodine Software acquisition suggests strategic expansion; actual impact will depend on integration and subsequent disclosures. Key items to track in upcoming periods are revenue mix, interest expense trajectory, and cash conversion.

Waystar Holding Corp. ha comunicato risultati del terzo trimestre migliori. Le entrate sono salite a 268,7 milioni di dollari rispetto a 240,1 milioni di dollari dell'anno precedente, e l'utile operativo è aumentato a 60,2 milioni di dollari da 27,1 milioni. L'utile netto è migliorato a 30,6 milioni di dollari (EPS diluito 0,17 $) da 5,4 milioni (EPS 0,03 $).

Per i primi nove mesi, i ricavi hanno raggiunto 795,7 milioni di dollari rispetto a 699,4 milioni, con un utile netto di 92,1 milioni rispetto a una perdita di 38,2 milioni l'anno scorso, supportato da una minore ammortizzazione e da una ridotta spesa per interessi. Il flusso di cassa operativo è stato di 243,0 milioni. Le disponibilità liquide ed equivalenti erano 421,1 milioni al 30 settembre 2025, contro un debito totale di 1,23 miliardi di dollari (nessun utilizzo della revolver). L'azienda ha rifinanziato la sua First Lien Credit Facility il 12 agosto 2025 a SOFR + 2,00% (tasso effettivo al termine del trimestre 6,34%) e ha utilizzato investimenti a breve termine nel periodo per finanziare l'acquisizione di Iodine Software Holdings, Inc. Le azioni in circolazione erano 191.316.583 al 20 ottobre 2025.

Waystar Holding Corp. informó resultados más fuertes en el tercer trimestre. Los ingresos subieron a $268.7 millones desde $240.1 millones hace un año, y el ingreso operativo aumentó a $60.2 millones desde $27.1 millones. El ingreso neto mejoró a $30.6 millones (EPS diluido $0.17) desde $5.4 millones ($0.03).

Para los primeros nueve meses, los ingresos alcanzaron $795.7 millones frente a $699.4 millones, con un ingreso neto de $92.1 millones en comparación con una pérdida de $38.2 millones el año pasado, ayudado por una menor depreciación/amortización y reducción de gastos por intereses. El flujo de efectivo operativo fue de $243.0 millones. Las disponibilidades de efectivo y equivalentes fueron de $421.1 millones al 30 de septiembre de 2025, frente a una deuda total de $1.23 mil millones (sin revolver utilizado). La empresa repreció su First Lien Credit Facility el 12 de agosto de 2025 a SOFR + 2.00% (tasa efectiva al final del trimestre 6.34%) y utilizó inversiones a corto plazo durante el periodo para ayudar a financiar la adquisición de Iodine Software Holdings, Inc. Las acciones en circulación eran 191,316,583 al 20 de octubre de 2025.

Waystar Holding Corp.은(는) 3분기 실적이 더 좋아졌다고 발표했습니다. 매출은 $268.7백만에서 $240.1백만에서 연간 증가했고 영업이익은 $60.2백만에서 $27.1백만로 상승했습니다. 순이익은 $30.6백만(희석된 EPS $0.17)으로 개선되었고, 전년 대비 $5.4백만($0.03)에서 증가했습니다.

처음 9개월 동안 매출은 $795.7백만으로, 전년 동기의 $699.4백만과 비교되며 순이익은 $92.1백만으로, 작년의 $38.2백만 손실에서 증가했습니다. 이는 더 낮은 감가상각/무형자산상각과 이자비용 감소에 힘입은 것입니다. 영업현금흐름은 $243.0백만이었습니다. 현금 및 현금성자산은 2025년 9월 30일 기준 $421.1백만, 총부채는 $1.23십억 달러였습니다(리볼버 차입 없음). 회사는 2025년 8월 12일 First Lien Credit Facility를 SOFR + 2.00%로 재가격했으며(분기말 실효금리 6.34%), 기간 동안 단기투자 자산을 사용해 Iodine Software Holdings, Inc. 인수를 자금 조달했습니다. 2025년 10월 20일 기준 발행주식수는 191,316,583주였습니다.

Waystar Holding Corp. a publié des résultats du troisième trimestre plus solides. Le chiffre d'affaires est passé à 268,7 millions de dollars contre 240,1 millions de dollars l'année dernière, et le résultat opérationnel est monté à 60,2 millions de dollars contre 27,1 millions. Le résultat net s’est amélioré à 30,6 millions de dollars (BPA dilué 0,17 $) contre 5,4 millions (0,03 $).

Pour les neuf premiers mois, le chiffre d'affaires a atteint 795,7 millions de dollars contre 699,4 millions, avec un résultat net de 92,1 millions de dollars contre une perte de 38,2 millions l'année précédente, aidé par une dépense d'amortissement et de dépréciation moindre et une réduction des intérêts. Le flux de trésorerie opérationnel s’élève à 243,0 millions. Les liquidités et équivalents étaient de 421,1 millions de dollars au 30 septembre 2025, contre une dette totale de 1,23 milliard de dollars (aucun tirage revolver). L'entreprise a reprix sa First Lien Credit Facility le 12 août 2025 à SOFR + 2,00% (taux effectif à la fin du trimestre 6,34%) et a utilisé des investissements à court terme durant la période pour aider au financement de l'acquisition de Iodine Software Holdings, Inc. Le nombre d'actions en circulation était de 191 316 583 au 20 octobre 2025.

Waystar Holding Corp. meldete stärkere Ergebnisse im dritten Quartal. Der Umsatz stieg auf 268,7 Millionen USD von 240,1 Millionen USD vor einem Jahr, und das operative Ergebnis kletterte auf 60,2 Millionen USD von 27,1 Millionen USD. Der Nettogewinn verbesserte sich auf 30,6 Millionen USD (verwässertes EPS 0,17 USD) gegenüber 5,4 Millionen USD (0,03 USD).

Für die ersten neun Monate erreichte der Umsatz 795,7 Millionen USD gegenüber 699,4 Millionen USD, mit einem Nettogewinn von 92,1 Millionen USD im Vergleich zu einem Verlust von 38,2 Millionen USD im Vorjahr, unterstützt durch geringere Abschreibungen und Zinsaufwendungen. Der operative Cashflow betrug 243,0 Millionen USD. Die Barmittel und Pensionen betrugen 421,1 Millionen USD zum Stichtag 30. September 2025, bei einer Gesamtverschuldung von 1,23 Milliarden USD (kein Revolver-Borrowing). Das Unternehmen hat seine First Lien Credit Facility am 12. August 2025 auf SOFR + 2,00% neu bepreist (effektiver Zinssatz zum Quartalsende 6,34%) und im Zeitraum kurzfristige Investitionen genutzt, um die Übernahme von Iodine Software Holdings, Inc. zu finanzieren. Die Anzahl der ausstehenden Aktien betrug 191.316.583 zum 20. Oktober 2025.

Waystar Holding Corp. أبلغت عن نتائج أقوى في الربع الثالث. ارتفع الإيراد إلى $268.7 مليون من $240.1 مليون قبل عام، وزاد الدخل من العمليات إلى $60.2 مليون من $27.1 مليون. تحسن صافي الدخل إلى $30.6 مليون (ربحية السهم المخففة $0.17) من $5.4 مليون ($0.03).

لأول تسعة أشهر، بلغ الإيراد $795.7 مليون مقابل $699.4 مليون، مع صافي دخل قدره $92.1 مليون مقارنة بخسارة قدرها $38.2 مليون في العام الماضي، مدعومًا باعتمادات انخفاض الاستهلاك وزيادة في التكاليف. كان التدفق النقدي من التشغيل $243.0 مليون. بلغت السيولة النقدية وما يعادلها $421.1 مليون في 30 سبتمبر 2025، مقابل ديون إجمالية قدرها $1.23 مليار (لا يوجد سحب من خطوط الائتمان الدائر). قامت الشركة بإعادة تسعير تسهيل الائتمان الأولي في 12 أغسطس 2025 إلى SOFR + 2.00% (المعدل الفعلي عند نهاية الربع 6.34%) واستخدمت استثمارات قصيرة الأجل خلال الفترة للمساعدة في تمويل استحواذ Iodine Software Holdings, Inc. بلغت الأسهم المصدرة 191,316,583 حتى 20 أكتوبر 2025.

Waystar Holding Corp. 报告了第三季度更强劲的业绩。收入从上一年
2.401亿美元上涨至2.687亿美元,经营利润从2,710万美元增至6,020万美元。净利润提升至3,060万美元(摊薄后每股收益 $0.17)/ 与之相比上年为$0.03,净利润从$5.4百万提升至$30.6百万。

在前九个月里,收入达到7.957亿美元,对比上年的6.994亿美元,净利润为9,21千万美元,相较于去年的损失3,82千万美元有明显改善,得益于折旧/摊销下降和利息支出减少。运营现金流为2.430千万美元。截至2025年9月30日,现金及现金等价物为4.211亿美元,总债务为12.3亿美元(无循环信用借款)。公司于2025年8月12日将其First Lien Credit Facility的利率定价重新设为SOFR + 2.00%(季度末实际利率为6.34%),在期内使用短期投资来帮助资助收购。截至2025年10月20日,外流在外股份为191,316,583股。

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Table of Contents
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
x    QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2025
OR
    TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ______ to ______
Commission File Number 001-42125
Waystar Holding Corp.
(Exact name of registrant as specified in its charter)
Delaware
84-2886542
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
1550 Digital Drive, #300
Lehi, Utah 84043
84043
(Address of principal executive offices)(Zip Code)
(844) 492-9782
Registrant’s telephone number, including area code
Not applicable
(Former name, former address and former fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.01 per share
WAY
The Nasdaq Stock Market LLC
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports); and (2) has been subject to such filing requirements for the past 90 days. Yes x No
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes x No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check one):
Large accelerated filerAccelerated filer
Non-accelerated filer
xSmaller reporting company
Emerging growth companyx
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes No x
The registrant had outstanding 191,316,583 shares of common stock as of October 20, 2025.


Table of Contents
Glossary
The following definitions apply to these terms as used in this Quarterly Report on Form 10-Q:
“AI” means artificial intelligence;
“Bain” means those certain investment funds of Bain Capital, LP and its affiliates;
“CPPIB” means Canada Pension Plan Investment Board;
“Credit Facilities” means, collectively, the First Lien Credit Facility, the Revolving Credit Facility, and the Receivables Facility;
“Derby Topco” means Derby TopCo Partnership LP, our direct parent entity prior to the Equity Distribution, in which the Institutional Investors, other equity holders, and certain members of management previously held equity interests;
“EQT” means those certain investment funds of EQT AB and its affiliates;
“Equity Distribution” means the distribution of shares of common stock of the Company held by Derby TopCo to the limited partners of Derby TopCo in accordance with the limited partnership agreement of Derby Topco, which distribution occurred in connection with our initial public offering. Following the Equity Distribution, EQT, CPPIB, Bain, and other equity holders, including members of management, directly hold shares of common stock of the Company;
“Exchange Act” means the U.S. Securities Exchange Act of 1934, as amended;
“First Lien Credit Facility” means the term loan credit facility under the first lien credit agreement, dated as of October 22, 2019, by and among Waystar Technologies, Inc. and the lenders party thereto, as amended from time to time;
“GAAP” means U.S. generally accepted accounting principles;
“Institutional Investors” means EQT, CPPIB, and Bain, and their respective affiliates;
“JOBS Act” means the U.S. Jumpstart Our Business Startups Act of 2012, as amended;
“Net Revenue Retention Rate” means the total amount invoiced to clients in a given twelve-month period divided by the total amount invoiced to those same clients from the prior twelve-month period. See “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Key Performance Metrics and Non-GAAP Financial Measures—Net Revenue Retention Rate”;
“2024 Form 10-K” means the 2024 Form 10-K filed with the SEC by Waystar Holding Corp. on February 18, 2025;
“Receivables Facility” means the receivables facility under the receivables financing agreement, dated as of August 13, 2021, by and among Waystar RC LLC, PNC Bank, National Association, as administrative agent, Waystar Technologies, Inc., as initial servicer, and PNC Capital Markets LLC, as structuring agent, as amended from time to time;
“Revolving Credit Facility” means the revolving credit facility under the first lien credit agreement, dated as of October 22, 2019, by and among Waystar Technologies, Inc. and the lenders party thereto, as amended from time to time;
“SEC” means the U.S. Securities and Exchange Commission;
“Second Lien Credit Facility” means the term loan credit facility under the second lien credit agreement, dated as of October 22, 2019, by and among Waystar Technologies, Inc. and the lenders party thereto, as amended from time to time;
“Securities Act” means the U.S. Securities Act of 1933, as amended;
“SOFR” means the Secured Overnight Financing Rate; and
“Waystar,” the “Company,” “we,” “us,” and “our” mean the business of Waystar Holding Corp. and its subsidiaries.


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Certain numerical figures have been subject to rounding adjustments. Accordingly, numerical figures shown as totals in various tables may not be arithmetic aggregations of the figures that precede them.
Cautionary Statement Regarding Forward-Looking Statements
This report contains forward-looking statements, within the meaning of the Private Securities Litigation Reform Act of 1995, that reflect our current views with respect to, among other things, our operations and financial performance. Forward-looking statements include all statements that are not historical facts. These forward-looking statements are included throughout this report and relate to matters such as our industry, business strategy, goals, and expectations concerning our market position, future operations, margins, profitability, capital expenditures, liquidity, and capital resources and other financial and operating information. We have used the words “anticipate,” “assume,” “believe,” “continue,” “could,” “estimate,” “expect,” “intend,” “may,” “plan,” “potential,” “predict,” “project,” “future,” “will,” “seek,” “foreseeable,” the negative version of these words or similar terms and phrases to identify forward-looking statements in this report.
The forward-looking statements contained in this report are based on management’s current expectations and are not guarantees of future performance. The forward-looking statements are subject to various risks, uncertainties, assumptions, or changes in circumstances that are difficult to predict or quantify. Our expectations, beliefs, and projections are expressed in good faith and we believe there is a reasonable basis for them. However, there can be no assurance that management’s expectations, beliefs, and projections will result or be achieved. Actual results may differ materially from these expectations due to changes in global, regional, or local economic, business, competitive, market, regulatory, and other factors, many of which are beyond our control. We believe that these factors include but are not limited to the following:
our operation in a highly competitive industry;
our ability to retain our existing clients and attract new clients;
our ability to successfully execute on our business strategies in order to grow;
our ability to accurately assess the risks related to acquisitions and successfully integrate acquired businesses, including the acquisition of Iodine Software Holdings, Inc. (“Iodine”);
our ability to establish and maintain strategic relationships;
the growth and success of our clients and overall healthcare transaction volumes;
consolidation in the healthcare industry;
our selling cycle of variable length to secure new client agreements;
our implementation cycle that is dependent on our clients’ timing and resources;
our dependence on our senior management team and certain key employees, and our ability to attract and retain highly skilled employees;
the accuracy of the estimates and assumptions we use to determine the size of our total addressable market;
our ability to develop and market new solutions, or enhance our existing solutions, to respond to technological changes, or evolving industry standards;
the interoperability, connectivity, and integration of our solutions with our clients’ and their vendors’ networks and infrastructures;
the performance and reliability of internet, mobile, and other infrastructure;
the consequences if we cannot obtain, process, use, disclose, or distribute the highly regulated data we require to provide our solutions;
our reliance on certain third-party vendors and providers;
any errors or malfunctions in our products and solutions;
failure by our clients to obtain proper permissions or provide us with accurate and appropriate information;
the potential for embezzlement, identity theft, or other similar illegal behavior by our employees or vendors, and a failure of our employees or vendors to observe quality standards or adhere to environmental, social, and governance standards;


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our compliance with the applicable rules of the National Automated Clearing House Association and the applicable requirements of card networks;
increases in card network fees and other changes to fee arrangements;
the effect of payer and provider conduct which we cannot control;
privacy concerns and security breaches or incidents relating to our platform;
the complex and evolving laws and regulations regarding privacy, data protection, and cybersecurity;
our ability to adequately protect and enforce our intellectual property rights;
our ability to use or license data and integrate third-party technologies;
our use of “open source” software;
legal proceedings initiated by third parties alleging that we are infringing or otherwise violating their intellectual property rights;
claims that our employees, consultants, or independent contractors have wrongfully used or disclosed confidential information of third parties;
the heavily regulated industry in which we conduct business;
the uncertain and evolving healthcare regulatory and political framework;
health care laws and data privacy and security laws and regulations governing our Processing of personal information;
reduced revenues in response to changes to the healthcare regulatory landscape;
legal, regulatory, and other proceedings that could result in adverse outcomes;
consumer protection laws and regulations;
contractual obligations requiring compliance with certain provisions of Bank Secrecy Act/anti-money laundering laws and regulations;
existing laws that regulate our ability to engage in certain marketing activities;
our full compliance with website accessibility standards;
any changes in our tax rates, the adoption of new tax legislation, or exposure to additional tax liabilities;
limitations on our ability to use our net operating losses to offset future taxable income;
losses due to asset impairment charges;
restrictive covenants in the agreements governing our Credit Facilities;
interest rate fluctuations;
unavailability of additional capital on acceptable terms or at all;
the impact of general macroeconomic conditions;
our history of net losses and our ability to achieve or maintain profitability;
the interests of the Institutional Investors may be different than the interests of other holders of our securities;
our status as an “emerging growth company” and whether the reduced disclosure requirements applicable to “emerging growth companies” will make our common stock less attractive to investors; and
the other factors described elsewhere in this report, including under the headings “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” “Quantitative and Qualitative Disclosures About Market Risk” and Part II, Item 1A, “Risk Factors” or as described under the heading “Risk factors” in our 2024 Form 10-K, or as described in the other documents and reports we file with the SEC.
These factors should not be construed as exhaustive and should be read in conjunction with the other cautionary statements that are included in this report. Should one or more of these risks or uncertainties materialize, or should any of our assumptions prove incorrect, our actual results may vary in material respects from those projected in these forward-looking statements.


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Any forward-looking statements made by us in this report speak only as of the date of this report and are expressly qualified in their entirety by the cautionary statements included in this report. Factors or events that could cause our actual results to differ may emerge from time to time, and it is not possible for us to predict all of them. You should not place undue reliance on our forward-looking statements. We undertake no obligation to publicly update or review any forward-looking statement, whether as a result of new information, future developments, or otherwise, except as may be required by any applicable securities laws.
Investors and others should note that we routinely announce financial and other material information using our Investor Relations website (investors.waystar.com), SEC filings, press releases, public conference calls and webcasts. We use these channels of distribution to communicate with our investors and members of the public about our company, our services and other items of interest. Information contained on our website is not part of this report or our other filings with the SEC.


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Page
Part I - Financial Information
Item 1. Financial Statements
1
Unaudited Condensed Consolidated Balance Sheets
1
Unaudited Condensed Consolidated Statements of Operations
2
Unaudited Condensed Consolidated Statements of Comprehensive Income (Loss)
3
Unaudited Condensed Consolidated Statements of Changes in Stockholders’ Equity
4
Unaudited Condensed Consolidated Statements of Cash Flows
6
Notes to Unaudited Condensed Consolidated Financial Statements
7
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
26
Item 3. Quantitative and Qualitative Disclosures About Market Risk
36
Item 4. Controls and Procedures
37
Part II - Other Information
Item 1. Legal Proceedings
38
Item 1A. Risk Factors
38
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
38
Item 3. Defaults Upon Senior Securities
38
Item 4. Mine Safety Disclosures
38
Item 5. Other Information
38
Item 6. Exhibits
38
Signatures
41
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Part I - Financial Information
Item 1. Financial Statements
Waystar Holding Corp.
Unaudited Condensed Consolidated Balance Sheets (in Thousands, Except for Share and Per Share Data)
September 30, 2025December 31, 2024
Assets
Current assets
Cash and cash equivalents$421,056 $182,133 
Restricted cash24,301 22,449 
Accounts receivable, net of allowance of $5,895 at September 30, 2025 and $5,885 at December 31, 2024
145,675 145,235 
Income tax receivable 2,838 
Prepaid expenses20,557 14,414 
Other current assets1,993 3,972 
Total current assets613,582 371,041 
Property, plant and equipment, net48,172 46,731 
Operating lease right-of-use assets, net11,026 10,820 
Intangible assets, net954,967 1,039,049 
Goodwill3,019,999 3,019,999 
Deferred costs90,131 82,815 
Other long-term assets8,479 6,549 
Total assets$4,746,356 $4,577,004 
Liabilities and stockholders’ equity
Current liabilities
Accounts payable$51,401 $47,365 
Accrued compensation28,300 31,589 
Aggregated funds payable23,848 22,059 
Other accrued expenses26,757 15,930 
Deferred revenue9,018 10,527 
Current portion of long-term debt11,099 11,311 
Related party current portion of long-term debt569 357 
Current portion of operating lease liabilities5,687 5,591 
Current portion of finance lease liabilities973 904 
Total current liabilities157,652 145,633 
Long-term liabilities
Deferred tax liability123,034 100,523 
Long-term debt, net, less current portion1,158,411 1,185,411 
Related party long-term debt, net, less current portion55,783 35,211 
Operating lease liabilities, net of current portion11,855 13,133 
Finance lease liabilities, net of current portion10,549 11,290 
Deferred revenue - long-term5,385 5,739 
Other long-term liabilities1,091 278 
Total liabilities1,523,760 1,497,218 
Commitments and contingencies (Note 19)
Stockholders’ equity
Preferred stock $0.01 par value - 100,000,000 and 100,000,000 shares authorized as of September 30, 2025 and December 31, 2024, respectively; zero shares issued or outstanding as of September 30, 2025 and December 31, 2024, respectively
  
Common stock $0.01 par value - 2,500,000,000 and 2,500,000,000 shares authorized at September 30, 2025 and December 31, 2024, respectively; 174,667,840 and 172,108,240 shares issued and outstanding at September 30, 2025 and December 31, 2024, respectively
1,747 1,722 
Additional paid-in capital3,350,190 3,298,083 
Accumulated other comprehensive income (loss)(542)881 
Accumulated deficit(128,799)(220,900)
Total stockholders’ equity3,222,596 3,079,786 
Total liabilities and stockholders’ equity$4,746,356 $4,577,004 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
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Waystar Holding Corp.
Unaudited Condensed Consolidated Statements of Operations (in Thousands, Except for Share and Per Share Data)
Three months ended September 30,Nine months ended September 30,
2025202420252024
Revenue$268,651 $240,112 $795,740 $699,447 
Operating expenses
Cost of revenue (exclusive of depreciation and amortization expenses)85,136 80,545 255,525 236,188 
Sales and marketing45,158 38,450 128,805 117,945 
General and administrative32,422 22,704 84,914 88,794 
Research and development12,403 11,082 36,103 37,303 
Depreciation and amortization33,300 60,185 100,106 148,635 
Total operating expenses208,419 212,966 605,453 628,865 
Income from operations60,232 27,146 190,287 70,582 
Other expense
Interest expense(16,613)(17,752)(52,195)(122,759)
Related party interest expense(902)(707)(2,475)(3,425)
Income/(loss) before income taxes42,717 8,687 135,617 (55,602)
Income tax expense/(benefit)12,069 3,274 43,516 (17,398)
Net income/(loss)$30,648 $5,413 $92,101 $(38,204)
Net income/(loss) per share:
Basic$0.18 $0.03 $0.53 $(0.27)
Diluted$0.17 $0.03 $0.51 $(0.27)
Weighted-average shares outstanding:
Basic174,352,079171,578,311173,388,077142,367,458
Diluted181,240,033176,181,511181,165,738142,367,458
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
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Waystar Holding Corp.
Unaudited Condensed Consolidated Statements of Comprehensive Income (Loss) (in Thousands)
Three months ended September 30,Nine months ended September 30,
2025202420252024
Net income/(loss)$30,648 $5,413 $92,101 $(38,204)
Other comprehensive income (loss), before tax:
Interest rate swaps(179)(14,440)(1,868)(20,624)
Available-for-sale securities32    
Income tax effect:
Interest rate swaps44 3,506 445 5,014 
Available-for-sale securities(8)   
Other comprehensive income/(loss), net of tax(111)(10,934)(1,423)(15,610)
Comprehensive income/(loss), net of tax$30,537 $(5,521)$90,678 $(53,814)

(1)Amounts reclassified out of accumulated other comprehensive income/(loss) into net interest expense included $2,171 and $8,788 for the three months ended September 30, 2025 and 2024, respectively, and included $4,060 and $26,085 for the nine months ended September 30, 2025 and 2024, respectively.
(2)The income tax effects of amounts reclassified out of accumulated other comprehensive income/(loss) were ($534) and ($2,134) for the three months ended September 30, 2025 and 2024, respectively, and $(999) and $(6,334) for the nine months ended September 30, 2025 and 2024, respectively.
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
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Waystar Holding Corp.
Unaudited Condensed Consolidated Statements of Changes in Stockholders’ Equity (in Thousands, Except Share Data)
Three months ended September 30, 2025
Common StockAdditional
Paid-In
Capital
Accumulated
Other
Comprehensive
Income (Loss)
Accumulated
Deficit
Total
SharesAmount
Balances at June 30, 2025174,146,070$1,741 $3,331,277 $(431)$(159,447)$3,173,140 
Share-based compensation— 11,525 — — 11,525 
Issuance of common stock under employee equity plans521,7706 7,388 — — 7,394 
Net income— — — 30,648 30,648 
Other comprehensive income (loss)— — (111)— (111)
Balances at September 30, 2025174,667,840$1,747 $3,350,190 $(542)$(128,799)$3,222,596 
Three months ended September 30, 2024
Common StockAdditional
Paid-In
Capital
Accumulated
Other
Comprehensive
Income (Loss)
Accumulated
Deficit
Total
SharesAmount
Balances at June 30, 2024166,659,634 $1,667 $3,178,697 $11,126 $(245,392)$2,946,098 
Stock-based compensation— — 7,949 — — 7,949 
Issuance of common stock under employee equity plans367,485 4 1,517 — — 1,521 
Issuance of common stock in initial public offering, net of issuance costs5,059,010 50 102,650 — — 102,700 
Net loss— — — — 5,413 5,413 
Other comprehensive income (loss)— — — (10,934)— (10,934)
Balances at September 30, 2024172,086,129 1,721 3,290,813 192 (239,979)3,052,747 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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Waystar Holding Corp.
Unaudited Condensed Consolidated Statements of Changes in Stockholders’ Equity (in Thousands, Except Share Data)
Nine months ended September 30, 2025
Common StockAdditional
Paid-In
Capital
Accumulated
Other
Comprehensive
Income (Loss)
Accumulated
Deficit
Total
SharesAmount
Balances at December 31, 2024172,108,240$1,722 $3,298,083 $881 $(220,900)$3,079,786 
Share-based compensation— 29,693 — — 29,693 
Issuance of common stock under employee equity plans2,559,60025 22,414 — — 22,439 
Net income— — — 92,101 92,101 
Other comprehensive income (loss)— — (1,423)— (1,423)
Balances at September 30, 2025174,667,8401,747 3,350,190 (542)(128,799)3,222,596 
Nine months ended September 30, 2024
Common StockAdditional
Paid-In
Capital
Accumulated
Other
Comprehensive
Income (Loss)
Accumulated
Deficit
Total
SharesAmount
Balances at December 31, 2023121,679,902$1,217 $2,234,688 $15,802 $(201,775)$2,049,932 
Stock-based compensation— 47,867 — — 47,867 
Issuance of common stock under employee equity plans369,9055 1,483 — — 1,488 
Repurchase of shares(22,688)(1)(843)— — (844)
Capital distributions— (99)— — (99)
Issuance of common stock in initial public offering, net of issuance costs50,059,010500 1,007,717 — — 1,008,217 
Net loss— — — (38,204)(38,204)
Other comprehensive income (loss)— — (15,610)— (15,610)
Balances at September 30, 2024172,086,129$1,721 $3,290,813 $192 $(239,979)$3,052,747 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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Waystar Holding Corp.
Unaudited Condensed Consolidated Statements of Cash Flows (in Thousands)
Nine months ended September 30,
20252024
Cash flows from operating activities
Net income/(loss)$92,101 $(38,204)
Adjustments to reconcile net income/(loss) to net cash provided by operating activities
Depreciation and amortization100,106 148,635 
Stock-based compensation29,871 47,400 
Provision for bad debt expense2,605 1,642 
Loss on extinguishment of debt711 20,277 
Deferred income taxes22,959 (57,984)
Amortization of debt discount and issuance costs2,021 3,301 
Other (99)
Changes in:
Accounts receivable(3,045)(13,445)
Income tax refundable2,838 2,227 
Prepaid expenses and other current assets(4,980)(1,714)
Deferred costs(7,116)(14,389)
Other long-term assets(2,362)(515)
Accounts payable and accrued expenses10,580 9,366 
Deferred revenue(1,863)(1,256)
Operating lease right-of-use assets and lease liabilities(1,387)(244)
Net cash provided by operating activities243,039 104,998 
Cash flows from investing activities
Purchase of property and equipment and capitalization of internally developed software costs(17,069)(21,044)
Purchase of investment securities(206,444) 
Proceeds from sale of investment securities206,444  
Net cash used in investing activities(17,069)(21,044)
Cash flows from financing activities
Change in aggregated funds liability1,789 7,433 
Proceeds from equity offering, net of underwriting discounts 1,017,074 
Payments of third-party IPO issuance costs (3,372)
Repurchase of shares (844)
Proceeds from issuance of common stock from employee equity plans22,439 1,488 
Proceeds from issuances of debt, net of creditor fees 545,209 
Payments on debt(8,751)(1,550,002)
Third-party fees paid in connection with issuance of new debt (1,410)
Finance lease liabilities paid(672)(611)
Net cash provided by financing activities14,805 14,965 
Increase in cash and cash equivalents during the period240,775 98,919 
Cash and cash equivalents and restricted cash–beginning of period204,582 45,428 
Cash and cash equivalents and restricted cash–end of period$445,357 $144,347 
Supplemental disclosures of cash flow information
Interest paid$59,303 $101,189 
Cash taxes paid (refunds received), net9,439 38,558 
Non-cash investing and financing activities
Fixed asset purchases in accounts payable539 586 
Unpaid third-party IPO issuance costs 50 
Reconciliation of Balance Sheet Cash Accounts to Cash Flow Statement
Balance sheet
Cash and cash equivalents421,056 127,125 
Restricted cash24,301 17,222 
Total445,357 144,347 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements

1. Business
Waystar Holding Corp. (“Waystar”, “we”, “us” or “our”) is a provider of mission-critical cloud technology to healthcare organizations. Our enterprise-grade platform transforms the complex and disparate processes comprising healthcare payments received by healthcare providers from payers and patients, from pre-service engagement through post-service remittance and reconciliation. Our platform enhances data integrity, eliminates manual tasks, and improves claim and billing accuracy, which results in better transparency, reduced labor costs, and faster, more accurate reimbursement and cash flow. The market for our solutions extends throughout the United States and includes Puerto Rico and other U.S. Territories.
Risks and Uncertainties— We are subject to risks common to companies in similar industries, including, but not limited to, our operation in a highly competitive industry, our ability to retain our existing clients and attract new clients, our ability to establish and maintain strategic relationships, the growth and success of our clients and overall healthcare transaction volumes, consolidation in the healthcare industry, our selling cycle of variable length to secure new client agreements, our implementation cycle that is dependent on our clients’ timing and resources, our ability to develop and market new solutions, or enhance our existing solutions, to respond to technological changes or evolving industry standards, the interoperability, connectivity, and integration of our solutions with our clients’ and their vendors’ networks and infrastructures, the performance and reliability of internet, mobile, and other infrastructure, the consequences if we cannot obtain, process, use, disclose, or distribute the highly regulated data we require to provide our solutions, impact of government regulations on our market, and our reliance on certain third-party vendors and providers.
On occasion, we enter into standard indemnification arrangements in the ordinary course of business. Pursuant to these arrangements, we indemnify, hold harmless, and agree to reimburse the indemnified parties for losses suffered or incurred by the indemnified party, in connection with any trade secret, copyright, patent, or other intellectual property infringement claim by any third-party with respect to its technology. The terms of these indemnification agreements are generally perpetual any time after the execution of the agreement. The maximum potential future payments we could be required to make under these agreements is not determinable because it involves claims that may be made against us in the future but have not yet been made. Historically, we have not incurred costs to defend lawsuits or settle claims related to these indemnification agreements.
We have entered into agreements with our directors or officers that may require us to indemnify them against liabilities that may arise by reason of their status or service as directors or officers, other than liabilities arising from their willful misconduct.
No liability associated with such indemnifications was recorded as of September 30, 2025 and December 31, 2024.
2. Summary of Significant Accounting Policies
Basis of Financial Statement Presentation
The financial statements include the consolidated balance sheets, statements of operations, statements of comprehensive income (loss), statements of changes in stockholders’ equity, and statements of cash flows of Waystar and its subsidiaries and have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”).
The accompanying unaudited consolidated financial statements and notes have been prepared in accordance with GAAP and applicable rules and regulations of the Securities and Exchange Commission (“SEC”) regarding interim financial reporting. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, the interim financial information includes all adjustments of a normal recurring nature necessary for a fair presentation of the Company’s financial position, results of operations, changes in stockholders’ equity and cash flows. The results of operations for the nine months ended September 30, 2025 are not necessarily indicative of the results for the full year or the results for any future periods. These unaudited consolidated financial statements should be read in conjunction with the audited consolidated financial statements and related notes for the year ended December 31, 2024 in the 2024 Annual Report of Form 10-K filed with the SEC on February 18, 2025 (the “2024 Annual Report”).
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
Use of Estimates
The preparation of the consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities, the disclosures of contingent assets and liabilities as of the date of the financial statements, and the reported amounts of revenues and expenses during the reporting periods. Significant estimates and assumptions are used for, but are not limited to: (1) revenue recognition, including estimated expected customer life; (2) recoverability of accounts receivable and taxes receivable; (3) impairment assessment of goodwill and long-lived intangible assets; (4) fair value of intangibles acquired in business combinations; (5) litigation reserves; (6) depreciation and amortization; (7) fair value of stock options issued to employees and assumed as part of business combinations; (8) fair value of interest rate swaps; and (9) leases, including incremental borrowing rate. Future events and their effects cannot be predicted with certainty, and accordingly, accounting estimates require the exercise of judgment. We evaluate and update assumptions and estimates on an ongoing basis and may employ outside experts to assist in evaluations. Actual results could differ from the estimates used.
Revenue Recognition
We derive revenue primarily from providing access to our solutions for use in the healthcare industry and in doing so generate two types of revenue: (i) subscription revenue and (ii) volume-based revenue, which account for 99% of total revenue for all periods presented. We also derive revenue from implementation fees for our software, as well as hardware sales to facilitate patient payments.
We recognize revenue in accordance with ASC Topic 606, Revenue from Contracts with Customers (“ASC 606”), through the following five steps:
identification of the contract, or contracts, with a client;
identification of the performance obligations in the contract;
determination of the transaction price;
allocation of the transaction price to the performance obligations in the contract; and
recognition of revenue when, or as, we satisfy a performance obligation
Our customers, referred to as clients elsewhere in this report, represent healthcare providers across all types of care settings, including physician practices, clinics, surgical centers, and laboratories, as well as large hospitals and health systems.
We account for a contract when it has approval and commitment from both parties, the rights of the parties are identified, payment terms are identified, the contract has commercial substance and collectability of consideration is probable. The length of our contracts vary but are typically two to three years and generally renew automatically for successive one-year terms. Our revenue is reported net of applicable sales and use tax and is recognized as, or when, control of these services or products are transferred to clients, in an amount that reflects the consideration we expect to be entitled to in exchange for the contract’s performance obligations.
Revenue from our subscription services as well as from our volume-based services represents a single promise to provide continuous access (i.e., a stand-ready obligation) to our software solutions in the form of a service. Our software products are made available to our clients via a cloud-based, hosted platform where our clients do not have the right or practical ability to take possession of the software. As each day of providing access to the software solutions is substantially the same and the client simultaneously receives and consumes the benefits as services are provided, these services are viewed as a single performance obligation composed of a series of distinct daily services.
Revenue from our subscription services is recognized over time on a ratable basis over the contract term beginning on the date that the service is made available to the client. Volume-based services are priced based on transaction, dollar volume or provider count in a given period. Given the nature of the promise is based on unknown quantities or outcomes of services to be performed over the contract term, the volume-based fee is determined to be variable consideration. The volume-based transaction fees are recognized each day using a time- elapsed output method based on the volume or transaction count at the time the clients’ transactions are processed.
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
Our other services are generally related to implementation activities across all solutions and hardware sales to facilitate patient payments. Implementation services are not considered performance obligations as they do not provide a distinct service to clients without the use of our software solutions. As such, implementation fees related to our solutions are billed upfront and recognized ratably over the customer's life. Implementation fees and hardware sales represent less than 1% of total revenue for all periods presented.
Our contracts with clients typically include various combinations of our software solutions. Determining whether such software solutions are considered distinct performance obligations that should be accounted for separately versus together requires significant judgment. Specifically, judgment is required to determine whether access to the Company’s SaaS solutions is distinct from other services and solutions included in an arrangement.
We follow the requirements of ASC 606-10-55-36 through -40, Revenue from Contracts with Customers, Principal Agent Considerations, in determining the gross versus net revenue presentations for our performance obligations in the contract with a client. Revenue recorded where we act in the capacity of a principal is reported on a gross basis equal to the full amount of consideration to which we expect in exchange for the good or service transferred. Revenue recorded where we act in the capacity of an agent is reported on a net basis, exclusive of any consideration provided to the principal party in the transaction.
The principal versus agent evaluation is a matter of judgment that depends on the facts and circumstances of the arrangement and is dependent on whether we control the good or service before it is transferred to the client or whether we are acting as an agent of a third party. This evaluation is performed separately for each performance obligation identified. For the majority of our contracts, we are considered the principal in the transaction with the client and recognize revenue gross of any related channel partner fees or costs. We have certain agency arrangements where third parties control the goods or services provided to a client and we recognize revenue net of any fees owed to these third parties.
Payment terms and conditions vary by contract type, although our standard payment terms generally require payment within 30 to 60 days. In instances where the timing of revenue recognition differs from the timing of payment, we have determined our contracts do not generally include a significant financing component. The primary purpose of our invoicing terms is to provide clients with simplified and predictable ways of purchasing our products and services, not to receive financing from our clients or to provide clients with financing.
Contract Costs
Incremental Costs of Obtaining a Contract
Incremental costs of obtaining a contract primarily include commissions paid to our internal sales personnel. We consider all such commissions to be both incremental and recoverable since they are only paid when a contract is secured. These capitalized costs are amortized on a straight-line basis over the expected period of benefit, which is determined based on the average customer life, which includes anticipated renewals of contracts. As of September 30, 2025 and December 31, 2024, the total unamortized costs reported as deferred costs on our balance sheet amounted to $30.8 million and $29.0 million, respectively, for internal sales commissions. For the three months ended September 30, 2025 and 2024, amortization related to the sales commission asset was $3.3 million and $2.8 million, respectively. For the nine months ended September 30, 2025 and 2024, amortization related to the sales commission asset was $9.6 million and $7.8 million, respectively. The aforementioned amortization amounts are included in sales and marketing in our consolidated statements of operations.
Costs to Fulfill a Contract
We capitalize costs incurred to fulfill contracts that i) relate directly to the contract, ii) are expected to generate resources that will be used to satisfy performance obligations under the contract, and iii) are expected to be recovered through revenue generated under the contract. Costs incurred to implement clients on our solutions (e.g., direct labor) are capitalized and amortized on a straight-line basis over the estimated customer life if we expect to recover those costs. As of September 30, 2025 and December 31, 2024, the total unamortized costs reported as deferred costs on our balance sheet amounted to $59.3 million and $53.8 million, respectively, for fulfillment costs. For the three months ended September 30, 2025 and 2024, amortization related to the fulfillment cost asset was $4.2 million and $3.2 million, respectively. For the nine months ended September 30, 2025 and 2024, amortization related to the fulfillment cost asset was $11.8 million and
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Notes to Unaudited Condensed Consolidated Financial Statements
$8.9 million, respectively. The aforementioned amortization amounts are included in the costs of revenue in our consolidated statements of operations.
There were no impairment losses relating to deferred costs during the periods presented.
Channel Partners
We account for fees paid to channel partners within sales and marketing expenses in the accompanying statements of operations. For the three months ended September 30, 2025 and 2024, we recorded fees to all channel partners of $19.8 million and $17.0 million, respectively. For the nine months ended September 30, 2025 and 2024, we recorded fees to all channel partners of $57.1 million and $47.6 million, respectively. As we are primarily responsible for contracting with and fulfilling contracts for the end user, we record revenue gross of related channel partner fees.
Cash and cash equivalents
We consider highly liquid investments with an original maturity of three months or less to be cash equivalents. We maintain our cash in bank deposit accounts, which, at times, may exceed federally insured limits. We have not experienced any credit losses in such accounts.

Investment securities
Our short-term investments, which consist of debt securities, are stated at fair value. These debt securities have been categorized as available-for-sale and classified as current assets given their maturity date is twelve months or less. Unrealized holding gains and losses for debt securities, net of applicable deferred taxes, are included in other comprehensive income or loss as a component of stockholders’ equity until realized from a sale or an expected credit loss is recognized. For the purpose of determining realized gross gains and losses for debt securities sold, that are included as a component of interest income/(expense) in the consolidated statements of income, the cost of investment securities sold is based upon specific identification. We recorded $1.4 million and $2.0 million of interest income on investment securities for the three and nine months ended September 30, 2025, within “Other expense” of our statements of operations. For the period ended September 30, 2025 we had purchases of short-term investments of $206.4 million that were liquidated in the same period to help fund the acquisition of Iodine Software Holdings, Inc. (“Iodine”). No material gain or loss was recognized in the sale of these short-term investments.
Under the current expected credit losses model expected losses on available for sale debt securities are recognized through an allowance for credit losses rather than as reductions in the amortized cost of securities. For debt securities whose fair value is less than their amortized cost which we do not intend to sell or are not required to sell, we evaluate the expected cash flows to be received as compared to amortized cost and determine if an expected credit loss has occurred. In the event of any expected credit loss, only the amount of impairment associated with the expected credit loss is recognized in income with the remainder, if any, of the loss recognized in other comprehensive income. To the extent we have the intent to sell the debt security, or it is more likely than not we will be required to sell the debt security before recovery of our amortized cost basis, we recognize an impairment loss in income in an amount equal to the full difference between the amortized cost basis and the fair value.
There were no impairment losses relating to our investment securities during the periods presented.

Recently Issued Accounting Pronouncements Not Yet Adopted
In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-09, “Improvements to Income Tax Disclosures”, which requires disaggregated information about a reporting entity’s effective tax rate reconciliation as well as information on income taxes paid. The standard is intended to benefit investors by providing more detailed income tax disclosures that would be useful in making capital allocation decisions. For public business entities, the ASU will be effective for annual periods beginning after December 15, 2024. The guidance will be applied on a prospective basis with the option to apply the standard retrospectively. Early adoption is permitted. We are
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Notes to Unaudited Condensed Consolidated Financial Statements
currently evaluating the effect of the adoption of this amendment on our consolidated and condensed consolidated financial statements.
In November 2024, the FASB issued ASU 2024-13, “Expense Disaggregation Disclosures.” The standard is intended to benefit investors by providing more detailed information about expenses that is critically important in understanding an entity’s performance, assessing an entity’s prospects for future cash flows, and comparing an entity’s performance over time and with that of other entities. For public business entities, this ASU will be effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The amendments in this Update should be applied either (1) prospectively to financial statements issued for reporting periods after the effective date of this Update or (2) retrospectively to any or all prior periods presented in the financial statements. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements.
In September 2025, the FASB issued ASU 2025-06, “Targeted Improvements to the Accounting for Internal-Use Software” to modernize the accounting guidance for the costs to develop software for internal use. The new guidance amends the existing standard that refers to various stages of a software development project to align better with current software development methods, such as agile programming. The new guidance will be effective for all entities for annual periods beginning after December 15, 2027. The guidance can be applied on a fully prospective basis, a modified basis for in-process projects, or a full retrospective basis. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements.

3. Revenue Recognition
Disaggregation of Revenue
The following table presents revenues disaggregated by revenue type and the timing of revenue recognition (in thousands):
Three months ended September 30,Nine months ended September 30,
Recognition2025202420252024
Subscription revenueOver time$134,450 $117,993 $390,599 $336,421 
Volume-based revenueOver time132,342 120,678 400,551 358,723 
Implementation services and other revenueVarious1,859 1,441 4,590 4,303 
Total revenues$268,651 $240,112 $795,740 $699,447 
Contract Liabilities
We derive our revenue from contracts with clients primarily through subscription fees and volume-based fees. Our payment terms with the client generally comprise an initial payment for implementation services, which includes client enrollment and the setup of contracted solutions on our platform. These implementation fees are due upon contract execution. Additionally, subscription fees are earned on an ongoing basis, which are invoiced monthly.
Client payments received in advance of fulfilling the corresponding performance obligations are recorded as contract liabilities. Implementation fees are recognized over the customer life, with any unrecognized amounts deferred as contract liabilities. These amounts are reported as deferred revenue on our consolidated balance sheet.
Revenue recognized from amounts included in deferred revenue as of the beginning of the period was $0.8 million and $0.7 million for the three months ended September 30, 2025 and 2024, respectively. Revenue recognized from the amounts included in deferred revenue as of the beginning of the period was $9.1 million and $10.2 million for the nine months ended September 30, 2025 and 2024, respectively.
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Notes to Unaudited Condensed Consolidated Financial Statements
Transaction Price Allocated to Remaining Performance Obligations
At September 30, 2025, the transaction price related to unsatisfied performance obligations that are expected to be recognized for the next 12 months and greater than 12 months was $60.4 million and $15.0 million, respectively.
The transaction price allocated to performance obligations that are unsatisfied (or partially unsatisfied) for executed contracts does not include revenue related to performance obligations that are part of a contract with an original expected duration of one year or less.
Additionally, the balance does not include variable consideration that is allocated entirely to wholly unsatisfied promises that form part of a single performance obligation composed of a series of distinct daily services.
Remaining performance obligation estimates are subject to change and are affected by several factors, including terminations and changes in the timing and scope of contracts, arising from contract modifications.
4. Segments
Operating segments are defined as components of an enterprise about which separate financial information is evaluated regularly by the chief operating decision maker in deciding how to allocate resources and assessing performance. We have one business activity and there are no segment managers who are held accountable for operations, operating results and plans for products or components below the consolidated unit level. The geographical location of our customers has no impact on strategy or products offered. The “chief operating decision maker,” or CODM, assesses performance and allocates resources using a consolidated profitability metric as discussed below. Accordingly, we have determined that we operate in a single reportable operating segment.
Our CODM is our Chief Executive Officer. On a monthly basis, our CODM reviews the following financial information presented on a consolidated basis. The key profitability metric used for purposes of making key personnel staffing decisions, approving operating budgets and forecasts, and making strategy decisions is Net Income as detailed below. See Note 3 for our disaggregated revenue by type.
Three months ended September 30,Nine months ended September 30,
($in thousands)2025202420252024
Total Revenue$268,651 $240,112 $795,740 $699,447 
Less:
Materials & connectivity60,061 57,877 182,784 168,875 
Labor & associated expenses25,075 22,668 72,740 67,313 
Research & development12,403 11,082 36,103 37,303 
Sales & marketing45,158 38,450 128,805 117,945 
General and administrative32,422 22,704 84,914 88,794 
Depreciation5,449 21,105 16,024 31,395 
Amortization27,851 39,080 84,082 117,240 
Interest and non-operating expenses, net17,515 18,459 54,672 126,184 
Income tax expense (benefit)12,069 3,274 43,515 (17,398)
Segment Net income/(loss)$30,648 $5,413 $92,101 $(38,204)
Consolidated Net income/(loss)$30,648 $5,413 $92,101 $(38,204)
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Notes to Unaudited Condensed Consolidated Financial Statements
5. Fair Value Measurements and Disclosures
The following table presents the fair value hierarchy for financial assets and liabilities measured at fair value on a recurring basis (in thousands):
Balance Sheet ClassificationCarrying ValueLevel 1Level 2Level 3
September 30, 2025
Other financial assets:
Interest rate swapsOther current assets$315 $ $315 $ 
Other financial liabilities:
Interest rate swapsOther accrued expenses$217 $ $217 $ 
Interest rate swapsOther long-term liabilities$815 $ $815 $ 
December 31, 2024
Other financial assets:
Interest rate swapsOther current assets$1,127 $ $1,127 $ 
Interest rate swapsOther long-term assets$22 $ $22 $ 
The fair values of our interest rate swaps are based on the sum of all future net present value cash flows. The future cash flows are derived based on the terms of our interest rate swaps, as well as considering published discount factors, and projected SOFR curve. The fair value of long-term debt was determined using the present value of future cash flows based on the borrowing rates currently available for debt with similar terms and maturities. The carrying value of our first lien term loan facility was $1,154.8 million and $1,163.5 million compared to a fair value of $1,151.9 million and $1,169.4 million at September 30, 2025 and December 31, 2024, respectively. There were no transfers in or out of Level 3 during the periods presented.
As of September 30, 2025 and December 31, 2024, the carrying value of cash equivalents, accounts receivable, accounts payable, accrued liabilities, and other current assets and liabilities approximates fair value due to the short maturities of these instruments. Interest rate swaps are Level 2 instruments whose fair value is derived from discounted cash flows adjusted for nonperformance risk. Investment securities are Level 2 instruments whose fair value is observed through market data of similar securities. Money market funds are Level 1 instruments whose fair value is observed through daily quoted prices of similar assets. Money market funds are considered cash equivalents because they have a maturity of less than three months and are highly liquid.
6. Property and Equipment, Net
The balances of the major classes of property and equipment are as follows (in thousands):
September 30, 2025December 31, 2024
Computer hardware$42,799 $39,833 
Capitalized internal-use software50,402 40,281 
Purchased computer software22,938 22,789 
Furniture and fixtures4,010 3,642 
Office equipment266 247 
Leasehold improvements4,236 3,778 
Internal-use software in progress18,745 15,361 
143,396 125,931 
Accumulated depreciation(95,224)(79,200)
Total$48,172 $46,731 
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Notes to Unaudited Condensed Consolidated Financial Statements
Depreciation of fixed assets, including the amortization of capitalized software, for the three months ended September 30, 2025 and 2024 was $5.4 million and $21.1 million, respectively. Depreciation of fixed assets, including the amortization of capitalized software, for the nine months ended September 30, 2025 and 2024 was $16.0 million and $31.4 million, respectively.
We capitalized $4.6 million and $13.5 million in software development costs for the three and nine months ended September 30, 2025, respectively. We capitalized $4.3 million and $12.1 million in software developments costs for the three and nine months ended September 30, 2024, respectively. Amortization of capitalized software was $3.6 million and $2.7 million for the three months ended September 30, 2025 and 2024, respectively, and was $10.3 million and $7.4 million for the nine months ended September 30, 2025 and 2024, respectively. The net book value of capitalized software development costs was $32.8 million and $29.6 million as of September 30, 2025 and December 31, 2024, respectively.
There were no impairments of property and equipment for the three and nine months ended September 30, 2025 and 2024, respectively.
7. Goodwill and Other Intangible Assets
Goodwill has a balance of $3,020.0 million as of both September 30, 2025 and December 31, 2024. There were no additions, disposals or impairments to goodwill during the three and nine months ended September 30, 2025 and 2024.
Amortization for definite-lived intangible assets is as follows (in thousands, except useful life):
Gross Carrying
Amount
Accumulated
Amortization
Net
Carrying
Value
Weighted-
Average
Remaining
Useful Life
As of September 30, 2025
Customer relationships$1,429,400 $(511,890)$917,510 10.4
Purchased developed technology44,100 (22,837)21,263 4.3
Tradenames and trademarks40,300 (24,106)16,194 4.1
Total$1,513,800 $(558,833)$954,967 
As of December 31, 2024
Customer relationships$1,429,400 $(440,729)$988,671 11.1
Purchased developed technology81,800 (50,875)30,925 4.2
Tradenames and trademarks40,700 (21,247)19,453 4.7
Total$1,551,900 $(512,851)$1,039,049 
Amortization expense was $27.9 million and $39.1 million for the three months ended September 30, 2025 and 2024, respectively and was $84.1 million and $117.2 million for the nine months ended September 30, 2025 and 2024, respectively. During the three and nine months ended September 30, 2025, gross carrying amount of definite-lived intangible assets decreased by $38.1 million due to disposals of fully amortized assets.
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Notes to Unaudited Condensed Consolidated Financial Statements
8. Leases
The following table presents components of lease expense for the three and nine months ended September 30, 2025 and 2024, respectively (in thousands):
Three months ended September 30,Nine months ended September 30,
2025202420252024
Finance lease cost
Amortization of right-of-use assets$ $13,442 $ $14,236 
Interest on lease liabilities173 186 530 568 
Operating lease cost1,194 1,978 3,465 3,752 
Variable lease cost149 206 527 357 
Short-term lease227 162 620 526 
Total lease cost$1,743 $15,974 $5,142 $19,439 
Maturities of lease liabilities as of September 30, 2025 are as follows (in thousands):
Operating LeasesFinance Leases
2025$1,722 $401 
20266,198 1,641 
20273,924 1,678 
20283,624 1,714 
20292,182 1,752 
Thereafter1,689 7,557 
Total future minimum lease payments19,339 14,743 
Less: Interest1,797 3,221 
Total$17,542 $11,522 
Supplemental cash flow information related to leases for the three and nine months ended September 30, 2025 and 2024 are as follows (in thousands):
Three months ended September 30,Nine months ended September 30,
2025202420252024
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases$1,622 $1,358 $4,852 $3,995 
Financing cash flows for financing leases401 394 1,095 1,179 
Right-of-use assets obtained in exchange for new lease liabilities:
Operating leases$ $2,411 $ $3,005 
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Notes to Unaudited Condensed Consolidated Financial Statements
Supplemental balance sheet information related to leases as of September 30, 2025 and December 31, 2024 are as follows:
September 30, 2025December 31, 2024
Weighted average remaining lease term (years):
Operating leases3.84.1
Financing leases8.39.1
Weighted average discount rate:
Operating leases4.9 4.7 
Financing leases5.9 5.9 
9. Income Taxes
We recognized income tax expense of $12.1 million and income tax benefit of $3.3 million for the three months ended September 30, 2025 and 2024, respectively, based on the quarter-to-date pre-tax income. We recognized income tax expense of $43.5 million and income tax benefit of $17.4 million for the nine months ended September 30, 2025 and 2024, respectively, based on the year-to-date pre-tax income. The Company’s effective income tax rate was 28.3% and 37.7% for the three months ended September 30, 2025 and 2024, respectively. The Company’s effective income tax rate was 32.1% and 31.3% for the nine months ended September 30, 2025 and 2024, respectively. Differences in the effective tax rate and statutory federal income tax rate of 21% are primarily driven by the impact of certain limitations on the deductibility of stock-based compensation recognized for financial reporting purposes as well as state income taxes and research and development credits claimed.
On July 4, 2025, H.R.1, the budget reconciliation bill known as the “One Big Beautiful Bill Act”, was signed into law in the U.S. This legislation includes significant changes to U.S. tax law impacting corporate tax rates, bonus depreciation, interest limitations under Internal Revenue Code Section 163(j), and the treatment of domestic research and development expenditures. Following the enactment of the OBBBA, the Company recognized the tax effects of the legislation in the interim period that included the enactment date, as required under ASC 740. The Company has evaluated the impact of the OBBBA on deferred tax assets and liabilities, including adjustments to valuation allowances, and has reflected these effects in the consolidated financial statements for the three and nine months ended September 30, 2025. The impacts of adopting the tax law change did not materially impact the net income tax expense or deferred tax balances.
10. Accounts Receivable Securitization
As of September 30, 2025 and December 31, 2024, we had $80.0 million and $80.0 million, respectively, outstanding under a receivables financing agreement with a counterparty as the lender, which provides for a three-year receivables facility with a limit of $80.0 million (the “Receivables Facility”). Pursuant to the Receivables Facility, we sell and/or contribute current and future receivables to Waystar RC, LLC as the Special Purpose Entity (“SPE”). The SPE, in turn, pledges its interests in the receivables to the counterparty, which either makes loans or issues letters of credit on behalf of the SPE. All receivables remain on our balance sheet as they continue to be the property of our consolidated entities under the securitization.
The interest rate under the Receivables Facility is 1.61% per annum above the SOFR rate with a minimum base of 0%. The SOFR is adjusted each thirty-day period to the thirty-day SOFR rate. Interest under the Receivables Facility is paid monthly in arrears. At September 30, 2025, the effective interest rate for the Receivables Facility is 5.74%.
All principal under the Receivables Facility is due on October 31, 2026.
The Receivables Facility contains certain covenants which, among other things, require we maintain certain collection thresholds with respect to our accounts receivable. We were in compliance with all such debt covenants during the periods presented.
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Notes to Unaudited Condensed Consolidated Financial Statements
11. Debt
Debt instruments consist primarily of term notes, revolving lines of credit, and a Receivables Facility as follows (in thousands):
September 30,December 31,
20252024
First lien term loan facility outstanding debt$1,154,795 $1,163,545 
Revolving credit facility  
Receivables facility outstanding debt80,000 80,000 
Total outstanding debt1,234,795 1,243,545 
Unamortized debt issuance costs(8,933)(11,255)
Current portion of long-term debt(11,668)(11,668)
Total long-term debt, net$1,214,194 $1,220,622 
The maturity of long-term principal payments (excluding debt discount) at September 30, 2025 is as follows (in thousands):
2025$2,918 
202691,668 
202711,668 
202811,668 
20291,116,873 
$1,234,795 
As of September 30, 2025 and December 31, 2024, there is no outstanding balance on our revolving credit facility. The interest rate under the revolving credit facility is 1.75% per annum above the SOFR rate with a minimum base of 0.00%. The SOFR is adjusted each thirty-day period to the thirty-day SOFR rate. At September 30, 2025, the effective interest rate for the revolving credit facility is 5.88%.
On August 12, 2025, we executed the eleventh amendment on the First Lien Credit Agreement whereby the outstanding balance was repriced being an interest rate of 2.00% per annum above the SOFR rate with a minimum base of 0.00% ("August 2025 First Lien Repricing"). There was no change in the outstanding loan balance before repricing and after repricing and the maturity date was not impacted by the amendment. As part of the August 2025 First Lien Repricing, we recorded $0.7 million in third-party fees that were expensed immediately, which were recorded in general and administrative expenses in our consolidated statements of operations. We recorded a loss on extinguishment of $0.7 million for the three and nine months ended September 30, 2025 related to the August 2025 First Lien Repricing. The SOFR is adjusted each thirty-day period to the thirty-day SOFR rate. Interest under the First Lien Credit Facility is paid monthly in arrears. At September 30, 2025, the effective interest rate for First Lien Credit Facility is 6.34%.

Principal on the First Lien Credit Facility is payable in 20 equal quarterly installments with the remaining balance to be paid on October 22, 2029. As of September 30, 2025, there are 16 payments remaining. The First Lien Credit Agreement contains certain covenants which, among other things, restrict our ability to incur additional indebtedness. We were in compliance with such debt covenants as of September 30, 2025.
We had unamortized debt issuance costs of $8.9 million and $11.3 million as of September 30, 2025 and December 31, 2024, respectively.
In connection with the Revolving Credit Facility, unamortized debt issuance costs were $1.6 million and $2.1 million as of September 30, 2025 and December 31, 2024, respectively.
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12. Derivative Financial Instruments
To mitigate the risk of a rise in interest rates on the First Lien Credit Facility, we entered into interest rate swaps on January 13, 2023, April 1, 2025 and April 9, 2025. We attempt to minimize our interest risk exposure by fixing our rate through the utilization of interest rate swaps, which are derivative instruments. The interest rate swaps mitigate the exposure on the variable component of interest on our First Lien Credit Facility. The interest rate swaps result in the fixed interest rate shown in the table below on the swapped portion of the First Lien Credit Facility. Our swaps are entered into with financial institutions that participate in the First Lien Credit Facility. By using a derivative instrument to hedge exposures to changes in interest rates, we expose ourselves to credit risk due to the possible failure of the counterparty to perform under the terms of the derivative contract.
As of September 30, 2025 and December 31, 2024, we have the following interest rate swap agreements designated as a hedging instruments:
Effective DatesFloating Rate DebtFixed Rates
January 31, 2023 through January 31, 2026$506.7 million3.87 %
April 1, 2025 through January 30, 202680.0 million3.59 %
January 31, 2026 through March 31, 2027275.0 million3.59 %
January 31, 2026 through March 31, 2027275.0 million3.27 %
The gain or loss on the swaps is recognized in accumulated other comprehensive income/(loss) and reclassified into earnings as adjustments to interest expense in the same period or periods during which the swaps affect earnings. Gains or losses on the swaps representing hedge components excluded from the assessment of effectiveness are recognized in current earnings.
The effect of derivative instruments designated as hedging instruments on the accompanying consolidated financial statements is as follows (in thousands):
Derivatives - Cash Flow Hedging RelationshipsAmount of Gain or
(Loss) Recognized
in AOCI/AOCL on
Derivative
Location of Gain or
(Loss) Reclassified
from AOCI/AOCL
into Income
Amount of Gain or
(Loss) Reclassified
from AOCI/AOCL
into Income
Total Interest
Expense on
Consolidated
Statements of
Operations
Interest rate swaps:
Three months Ended September 30, 2025$(135)Interest expense$736 $(17,515)
Three months Ended September 30, 2024$(10,934)Interest expense$8,788 $(18,459)
Nine Months Ended September 30, 2025$(1,423)Interest expense$2,026 $(54,670)
Nine Months Ended September 30, 2024$(15,610)Interest expense$26,085 $(126,184)
The net amount of accumulated other comprehensive income expected to be reclassified to interest income in the next twelve months is $0.1 million.
13. Related Party Transactions
At September 30, 2025 and December 31, 2024, we had $56.4 million and $35.6 million, respectively, of outstanding debt as part of the First Lien Credit Facility from Bain Affiliated Funds and CPPIB Credit Investments III Inc., affiliates of Bain Capital LP and Canada Pension Plan Investment Board (“Affiliated Debtholders”). Interest expense associated with and
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Notes to Unaudited Condensed Consolidated Financial Statements
paid to Affiliated Debtholders was $0.9 million and $0.7 million for the three months ended September 30, 2025 and 2024, respectively and $2.5 million and $3.4 million for the nine months ended September 30, 2025 and 2024, respectively.
CPPIB has an ownership interest in us and a significant interest in the landlord that leases us office space under an operating lease agreement in Houston, Texas. For the three months ended September 30, 2025 and 2024, we expensed zero and $0.1 million, respectively, and for the nine months ended September 30, 2025 and 2024, we expensed zero and $0.2 million, respectively, for this office space lease in general and administrative expense.
Bain Capital LP has an ownership interest in us and a significant interest in some clients for whom we provide software solutions. For the three months ended September 30, 2025 and 2024, we earned revenue of $0.8 million from five clients and $0.4 million from four clients, respectively. For the nine months ended September 30, 2025 and 2024, we earned revenue of $1.9 million from five clients and $1.2 million from four clients, respectively. They also have an ownership interest in us and a significant interest in two vendors that provide us with software solutions. For the three months ended September 30, 2025 and 2024, we expensed $0.6 million and $0.1 million, respectively, and for the nine months ended September 30, 2025 and 2024, we expensed $1.8 million and $0.3 million for software services from these vendors in cost of revenue expense.
14. Common and Preferred Stock
In connection with our initial public offering ("IPO"), the Company’s amended and restated certificate of incorporation became effective on June 10, 2024, which authorizes the issuance of 2,500,000,000 shares of common stock, par value $0.01 per share, and 100,000,000 shares of preferred stock, par value $0.01 per share. The shares of preferred stock have rights and preferences, including voting rights, designated from time to time by the Board of Directors. In connection with the amendment and restatement of the Company’s certificate of incorporation effective on the IPO date, the Class A common stock shares were automatically reclassified as, and became, one share of common stock. There were 174,667,840 and 172,108,240 common stock shares issued and outstanding as of September 30, 2025 and December 31, 2024, respectively.
15. Retirement Plans
We maintain qualified 401(k) plans which cover substantially all employees meeting certain eligibility requirements. Participants may contribute a portion of their compensation to the plans, up to the maximum amount permitted under Section 401(k) of the Internal Revenue Code. Under these plans, we contribute various percentages of employees’ salaries to the plans. Total expenses included in operating expenses in the accompanying consolidated statement of operations related to the plans were $1.3 million and $1.1 million for the three months ended September 30, 2025 and 2024 and $3.9 million and $3.6 million for the nine months ended September 30, 2025 and 2024, respectively.
16. Stock-based Compensation
Equity incentive plans
On October 22, 2019, the Board of Directors approved the Waystar Holding Corp. 2019 Stock Incentive Plan (“2019 Waystar Holding Plan”). Under this plan, we can issue up to 9.9 million options or other equity awards. The granted awards contain service criteria, performance criteria, market conditions, or a combination thereof for vesting and have a 10-year contractual term. Options with a service condition generally vest over 5 years with 20% vesting in equal vesting installments. Options with a performance condition and a market condition vest based upon a change in control, initial public offering, or a sponsor distribution or deemed return if the investors have achieved specified levels of return on investment. In addition, as part of a change in control in 2019, 2.2 million fully vested rollover options remain outstanding.
The Board of Directors approved the Waystar Holding Corp. 2024 Equity Incentive Plan (the “2024 Equity Incentive Plan”), effective as of June 6, 2024, the date of pricing of our IPO. Under this plan, we can issue non-qualified stock options, incentive stock options, stock appreciation rights, restricted shares of the Company’s Common Stock, restricted stock units, performance based stock units, and other equity-based awards tied to the value of the Company’s shares. Under this plan, we can issue up to 10 million options and other equity awards, subject to annual increases as outlined under the plan. The number of shares available to be issued automatically increases on the first day of each fiscal year beginning in 2025 by a number of shares equal to the lesser of the positive difference, if any, between 5% of the outstanding common
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
stock on the last day of the immediately preceding fiscal year, minus the plan share reserve on the last day of the immediately preceding fiscal year or such lesser number of shares as may be determined by the Board of Directors. Options with a service condition generally vest over 5 years with 20% vesting in equal vesting installments. The restricted stock units (“RSUs”) under the 2024 Equity Incentive Plan generally vest over 4 or 5 years with 25% or 20% vesting, respectively, in equal vesting installments. The performance-based stock units (“PSUs”) under the 2024 Equity Incentive Plan vest between 0% and 200% based on the company's total shareholder return (TSR”) relative to a designated peer group as defined in the respective agreement over a four-year performance period. As of September 30, 2025, 5.4 million shares were available for future grants under this plan.
The Board of Directors approved the Waystar Holding Corp. 2024 Employee Stock Purchase Plan (the “ESPP”), effective as of June 6, 2024, the date of pricing of our IPO. A total of 3,250,000 shares of common stock are initially reserved for the ESPP. The number of shares available to be issued for the ESPP will automatically increase each fiscal year beginning in 2025 by a number of shares equal to the lesser of the positive difference, if any, between 1% of the outstanding common stock on the last day of the immediately preceding fiscal year and the number of shares of common stock available for the issuance of shares pursuant to the plan on the last day of the immediately preceding fiscal year or such lesser number of shares as may be determined by the Board of Directors. The number of shares available to be issued for the ESPP will not exceed 27,000,000 as outlined in the plan agreement. Our employees contribute funds via payroll deductions during the offering periods, which are used to buy Waystar common shares at a discount of up to 15% of the purchase price at the purchase date. Offerings to purchase shares are granted twice annually on or about June 30 and December 31. During the three and nine months ended September 30, 2025, 37,323 of common shares have been issued as part of the ESPP. For the three and nine months ended September 30, 2025, expense of $0.1 million and $0.4 million, respectively, has been recorded which represents the 15% discount given to the employees under the ESPP. During the three and nine months ended September 30, 2024, zero expense was recorded related to the 15% discount given to the employees under the ESPP.

Stock Options
We utilize the Black-Scholes option pricing model to estimate the fair value of the service condition options under all plans and the Monte Carlo pricing model to estimate the fair value of the performance condition options under the 2019 Waystar Holding Corp. Plan. We value both types of options at the grant date using the following assumptions:
Risk-free interest rate—reflects the average rate on the United States Treasury bond with maturity equal to the expected term of the option;
Expected dividend yield—as we do not currently pay dividends or expect to pay dividends in the near future, the expected dividend yield is zero;
Expected term of stock award – under the 2024 Equity Incentive Plan, we utilized the simplified method due to the lack of historical experience activity for Waystar. The simplified method calculates the expected term as the mid-point between the vesting date and the contractual expiration date of the award. Under the 2019 Waystar Holding Corp. Plan, it is based on historical experience that is modified based on expected future changes;
Expected volatility in stock price—reflects the historical volatility of comparable public companies over the expected term of the stock option.
The weighted average grant date fair value of options granted during the nine months ended September 30, 2025 was $18.69 per share. No options were granted during the three months ended September 30, 2025. The weighted average grant date fair value of options granted during the nine months ended September 30, 2024 was $12.89 per share. No options were granted during the three months ended September 30, 2024. As of September 30, 2025, we had 6.8 million fully vested options with a weighted average exercise price of $15.03 per share, an aggregate intrinsic value of $156.3 million and an average remaining contractual term of 4.2 years. The total fair value of options vested for the three months ended September 30, 2025 and 2024 were $2.9 million and $2.9 million, respectively and $16.5 million and $4.8 million for the nine months ended September 30, 2025 and 2024, respectively.
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
Information pertaining to option activity under all plans (including rollover options) during the nine months ended September 30, 2025 and 2024 is as follows:
Number of
options
Weighted average
exercise price per
share
Weighted
average
remaining
contractual life
Outstanding December 31, 202416,511,128$17.57 5.8
Granted132,06536.94 
Exercised(2,061,626)10.14 
Forfeited(121,202)29.75 
Outstanding September 30, 202514,460,365$18.71 5.2
Number of
options
Weighted average
exercise price per
share
Weighted
average
remaining
contractual life
Outstanding December 31, 202313,032,541$15.20 5.7
Granted4,003,70324.20 
Exercised(369,905)4.27 
Forfeited(90,145)20.39 
Outstanding September 30, 202416,576,194$17.59 6.1
The following is a summary of the significant assumptions used in estimating the fair value of options granted the three and nine months ended September 30, 2025 and 2024:
Three months ended September 30,Nine months ended September 30,
2025202420252024
Risk free interest rateN/AN/A3.95 %
3.76%-4.59%
Expected dividend yieldN/AN/A0%0%
Expected term of stock awardN/AN/A6.2
5.0 - 6.5
Expected volatility in stock priceN/AN/A46.24 %
49.62%-51.89%
The aggregate intrinsic value of options exercised (the difference between the fair market value of our stock on the date of exercise and the exercise price) was approximately $12.8 million and $6.7 million for the three months ended September 30, 2025 and 2024, respectively and $61.7 million and $6.7 million for the nine months ended September 30, 2025 and 2024, respectively.
We expect to incur compensation expense of approximately $41.0 million over a weighted average of 3.4 years for all unvested time-based awards outstanding on September 30, 2025.
RSUs
The RSUs granted on June 10, 2024 in conjunction with the IPO were valued at the IPO price. Subsequent RSU grants have been valued using our common stock price as of the grant date based on the publicly traded value per NASDAQ, and are expensed on a straight-line basis over the applicable vesting period. All vesting is contingent on continued service.
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
The following table summarizes RSU activity during the nine months ended September 30, 2025 and 2024.
Number of
shares
Weighted
average grant
date fair value
Outstanding December 31, 20242,089,241$21.91 
Granted2,323,49537.34 
Vested(460,362)21.50 
Forfeited(55,819)27.40 
Outstanding September 30, 20253,896,555$31.08 
Number of
shares
Weighted
average grant
date fair value
Outstanding December 31, 2023$ 
Granted2,011,65121.50 
Vested 
Forfeited(8,259)21.50 
Outstanding September 30, 20242,003,392$21.50 
We expect to incur compensation expense of $110.8 million over a weighted average of 4.5 years for all unvested RSUs outstanding on September 30, 2025.
PSUs
We utilize the Monte Carlo pricing model to estimate the fair value of the market-based condition PSUs at the grant date under the 2024 Equity Incentive Plan. The Monte Carlo model incorporates assumptions regarding expected volatility, correlation between performance of our stock price and that of publicly traded peer companies, expected dividend yields and the risk-free interest rate. The Monte Carlo pricing model simulates potential future stock price paths yielding a grant date fair value that reflects the likelihood of varying outcomes. These awards are expensed on a straight-line basis over the applicable vesting period utilizing the fair value at the grant date.
The following is a summary of the significant assumptions used in estimating the fair value of PSUs granted during the nine months ended September 30, 2025. There were no PSUs granted during the three months ended September 30, 2025 or during the three and nine months ended September 30, 2024.
Three Months Ended September 30, 2025Nine Months Ended September 30, 2025
2025202420252024
Risk free interest rateN/AN/A3.92 %N/A
Expected dividend yieldN/AN/A0%N/A
Expected term of stock awardN/AN/A4.0N/A
Expected volatility in stock priceN/AN/A40.00 %N/A
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
The following table summarizes PSU activity during the nine months ended September 30, 2025.
Number of
shares
Weighted
average grant
date fair value
Outstanding December 31, 2024$ 
Granted396,19761.67 
Vested 
Forfeited 
Outstanding September 30, 2025396,197$61.67 
We expect to incur compensation expense of $21.4 million over a weighted average of 3.5 years for all unvested PSUs outstanding on September 30, 2025.
Stock-based Compensation
We recorded $11.6 million and $7.9 million of stock-based compensation expense for the three months ended September 30, 2025 and 2024, respectively and $29.9 million and $47.4 million for the nine months ended September 30, 2025 and 2024, respectively.
Stock-based compensation expense was recorded in the following cost and expense categories in the consolidated statements of operations:
Three months ended September 30,Nine months ended September 30,
2025202420252024
Cost of revenue$418 $300 $1,064 $2,161 
General and administrative7,218 4,832 18,418 27,043 
Sales and marketing2,392 1,587 6,198 10,958 
Research and development1,569 1,184 4,191 7,238 
Total$11,597 $7,903 $29,871 $47,400 
17. Other Accrued Expenses
Other accrued expenses consist of the following (in thousands):
September 30, 2025December 31, 2024
Accrued income taxes$13,246 $4,111 
Other taxes payable1,214 3,915 
Accrued severance300  
Retirement plan payable25 497 
Accrued self insurance claims1,909 1,064 
Accrued interest272 597 
Accrued rent1,609  
ESPP payable994  
Other7,188 5,746 
Total$26,757 $15,930 
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
18. Income/(Loss) Per Share
A reconciliation of the numerators and the denominators of the basic and diluted per share computations are as follows (in thousands, except for share and per share data):
Three months ended September 30,Nine months ended September 30,
2025202420252024
Basic income/(loss) per share:
Net income/(loss)$30,648 $5,413 $92,101 $(38,204)
Net income/(loss) attributable to common shares$30,648 $5,413 $92,101 $(38,204)
Weighted average common stock outstanding–(voting)174,352,079171,578,311173,388,077142,367,458
Basic weighted average common stock outstanding174,352,079171,578,311173,388,077142,367,458
Basic income/(loss) per share$0.18 $0.03 $0.53 $(0.27)
Diluted income/(loss) per share:
Net income/(loss)$30,648 5,413 $92,101 (38,204)
Net income/(loss) attributable to common shares$30,648 $5,413 $92,101 $(38,204)
Dilutive effect of stock options – (voting)6,048,5794,268,9936,736,352
Dilutive effect of RSUs – (voting)836,036334,2071,040,195
Dilutive effect of ESPP – (voting)3,3391,113
Weighted average common stock outstanding–(voting)181,240,033176,181,511181,165,737142,367,458
Diluted weighted average common stock outstanding181,240,033176,181,511181,165,738142,367,458
Diluted income/(loss) per share$0.17 $0.03 $0.51 $(0.27)
Because of their anti-dilutive effect, 1,652,397 and 5,247,024 common share equivalents comprised of stock options and RSUs have been excluded from the diluted earnings per share calculation for the three months ended September 30, 2025 and 2024, respectively. Additionally because of their anti-dilutive effect, 1,305,855 and 12,148,217 common share equivalents comprised of stock options and RSUs have been excluded from diluted earnings per share calculation for the nine months ended September 30, 2025 and 2024, respectively.
19. Commitments and Contingencies
We may be subject to legal proceedings, claims, asserted or unasserted, and litigation arising in the ordinary course of business. We do not, however, currently expect that the ultimate costs to resolve any pending matter will have a material effect on our consolidated financial position, results of operations, or cash flows.
20. Subsequent Events
We have evaluated subsequent events through the date of issuance.
On October 1, 2025, the Company completed the acquisition of Iodine pursuant to the Agreement and Plan of Merger (the "Merger Agreement") entered into on July 23, 2025 for total cash consideration of approximately $458.6 million and 16,639,920 shares of common stock having a value of $37.31 per share as outlined in the Merger Agreement. Due to the timing of the acquisition, the accounting conclusions related to the transaction have not yet been finalized.
On October 1, 2025, we entered into the Twelfth Amendment to the First Lien Credit Agreement to increase our First Lien Credit Facility by $250.0 million, increase the maximum borrowing capacity under the revolving credit facility from $400.0 million to $500.0 million, and decrease the interest rate under the revolving credit facility from 1.75% per annum above SOFR to 1.50% per annum above SOFR. We drew $30.0 million on the revolving credit facility to help fund the Iodine acquisition.
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Waystar Holding Corp.
Notes to Unaudited Condensed Consolidated Financial Statements
On October 28, 2025, we reached a settlement agreement to terminate the prior lease on one of our office locations that was relocated in the third quarter of 2024. The total settlement was $15.0 million. Due to the timing of the settlement, the accounting conclusions related to the transaction have not yet been finalized.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion and analysis of Waystar Holding Corp. (“Waystar”, the “Company”, “we”, “us”, and “our”) financial condition and results of operations should be read in conjunction with our unaudited consolidated financial statements and the related notes included elsewhere in this Form 10-Q, and the consolidated financial statements and related notes included in the 2024 Form 10-K. In addition to historical information, this discussion and analysis contains forward-looking statements based on current expectations that involve risks, uncertainties, and other factors outside the Company’s control, as well as assumptions, such as our plans, objectives, expectations, and intentions. Our actual results may differ materially from those expressed or implied in the forward-looking statements as a result of various factors, including those described under the sections entitled “Cautionary Statement Concerning Forward-Looking Statements” above and “Risk Factors” in the 2024 Form 10-K and our other filings with the SEC.
Overview
Waystar provides healthcare organizations with mission-critical cloud software that simplifies healthcare payments. Our enterprise-grade platform streamlines the complex and disparate processes our healthcare provider clients must manage to be reimbursed correctly, while improving the payments experience for providers, patients, and payers. We leverage AI as well as proprietary, advanced algorithms to automate payment-related workflow tasks and drive continuous improvement, which enhances claim and billing accuracy, enriches data integrity, and reduces labor costs for providers.
Our software is used daily by providers of all types and sizes across the continuum of care, including physician practices, clinics, surgical centers, and laboratories, as well as large hospitals and health systems. We currently serve over 30,000 clients of various sizes, representing over one million distinct providers practicing across a variety of care sites, including 17 of the top 20 U.S. News Best Hospitals. Our business model is designed such that as our clients grow to serve more patients, their claims and transactional volumes increase, resulting in corresponding growth in our business. In addition, our clients frequently adopt a greater number of our solutions over time and introduce our solutions across new sites of care. In 2024, we facilitated over six billion healthcare payments transactions, including over $1.8 trillion in gross claims volume. As of 2024, we facilitated healthcare payments transactions spanning approximately 50% of patients in the United States.
Our platform benefits from powerful network effects. Our cloud-based software is driven by a sophisticated, automated, and curated rules engine, employing AI to generate and incorporate real-time feedback from millions of network transactions processed through our platform each day. Every transaction we process provides additional data insights across providers, patients, and payers, which are embedded in updates that are deployed efficiently across our client base. This results in cumulative benefits to us over time —as we capture more data from each transaction we process, we leverage that data to continue to improve the Waystar platform through embedded machine learning, advanced algorithms, and other in-house AI technologies to deliver added value to our clients. In turn, the more value we create for our clients, the more likely it is that they will continue to use our products, allowing us to continue to capture more data that results in tangible improvements to our platform. As a result, our clients benefit from faster and more efficient performance from software that is evolving to meet ever-changing regulatory and payer requirements, enabling accurate and timely reimbursement.
We have demonstrated an ability to drive recurring, predictable, and profitable growth. Over 99% of our revenue is either recurring subscription or based on highly predictable volumes. For the twelve months ended September 30, 2025, our Net Revenue Retention Rate was 113.1% and we have 1,306 clients as of September 30, 2025 generating over $100,000 over the same twelve month period. For the nine months ended September 30, 2025, we generated revenue of $795.7 million (reflecting a 13.8% increase compared to revenue of $699.4 million for the same period in the prior year), net income of $92.1 million compared to net loss of $38.2 million for the same period in the prior year, and Adjusted EBITDA of $333.0 million (reflecting a 17.5% increase compared to Adjusted EBITDA of $283.3 million for the same period in the prior year).
Initial Public Offering
In June 2024, we completed an initial public offering (the “IPO”) of 45,000,000 shares of common stock at a price of $21.50 per share. After underwriting discounts and commissions of $53.2 million, we received total proceeds from the offering of $914.3 million. On July 5, 2024, pursuant to the option granted to the underwriters for a period of 30 days from the date of the IPO Prospectus to purchase up to 6,750,000 additional shares of common stock from us at the IPO price less the underwriting discount, the underwriters exercised the right to purchase 5,059,010 additional shares of common stock,
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resulting in additional net proceeds of $102.8 million, after deducting underwriting discounts and commissions of $6.0 million. The remaining option to purchase additional shares expired unexercised at the end of the 30-day period. See Item 1, Financial Statements, Note 1 (Business) in the 2024 Form 10-K for more information.
Secondary Offerings
On February 24, 2025, the Institutional Investors closed an underwritten public offering of 23,000,000 shares of our common stock (inclusive of the underwriters’ option to purchase additional shares) (the “First Secondary Offering”). On May 15, 2025, the Institutional Investors closed another underwritten public offering of 14,375,000 shares of our common stock (inclusive of the underwriters' option to purchase additional shares) (the "Second Secondary Offering"). Additionally on September 10, 2025, the Institutional Investors closed another underwritten public offering of 18,000,000 shares of our common stock (the "Third Secondary Offering"). The Company did not sell any shares in these offerings or receive any proceeds from these offerings. Pursuant to the terms of the Amended and Restated Registration Rights Agreement, dated as of June 10, 2024, by and among the Company, the Institutional Investors, and certain other parties thereto, we paid $1.4 million and $4.6 million in certain expenses on behalf of the selling stockholders related to these offerings for the three and nine months ended September 30, 2025, respectively, while the selling stockholders paid all applicable underwriting discounts and commissions.
Iodine Acquisition
On July 23, 2025, we entered into the Merger Agreement to acquire Iodine through a series of mergers. Iodine is a trusted leader in AI-powered clinical intelligence, enhancing clinical documentation and accuracy, streamlining utilization management, and preventing revenue leakage before billing. This strategic move is expected to bolster our AI leadership, automate manual work, and improve financial performance for providers. The acquisition was completed on October 1, 2025 for a total purchase price of $1.25 billion. The consideration paid was approximately $458.6 million in cash consideration and 16,639,920 shares of common stock having a value of $37.31 per share, and certain adjustments as outlined in the Merger Agreement.
Significant Items Affecting Comparability
We believe that the future growth and profitability of our business, and the comparability of our results from period to period, depend on numerous factors, including the following:
Our Ability to Expand our Relationship with Existing Clients
As our clients grow their businesses and provide more services and see more patients, our volume-based revenues also increase. In addition, our growth in revenues also depends on our ability to sell more products and solutions to existing clients, including through cross-selling as our clients adopt additional Waystar offerings as well as up-selling as our clients leverage our solutions across additional providers and sites of care.
Our Ability to Grow our Client Base
We are focused on continuing to grow our client base, which will depend in part on our ability to continue to maintain our product leadership, invest in our research and development team, and maintain our reputation and brand.
Impacts of the IPO
Debt Repayment. We used proceeds from our IPO to repay an aggregate of $1.0 billion in outstanding principal amount on our First Lien Credit Facility in the second and third quarters of fiscal 2024. This debt repayment has contributed to lower interest expense for the three and nine months ended September 30, 2025 compared to the same periods in the prior year.
Stock-Based Compensation Expenses. We expect to recognize stock-based compensation expense of $17.9 million per year over the applicable vesting periods in connection with equity awards granted in connection with the IPO. Such stock-based compensation expense will be reflected in our results of operations from the closing date of the IPO through the applicable vesting periods of such awards. Additionally, we recognized $33.1 million of stock-based compensation expense during the nine months ended September 30, 2024, as the vesting of our performance
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condition options became probable upon the closing of the IPO as the implicit service period for the awards established at the grant date had elapsed.
Incremental Public Company Expenses. Following the IPO, we have incurred significant expenses on an ongoing basis that we did not incur as a private company. Those costs include additional director and officer liability insurance expenses, as well as third-party and internal resources related to accounting, auditing, Sarbanes-Oxley Act compliance, legal, and investor and public relation expenses. These costs are generally expensed under general and administrative expenses.
Components of Results of Operations
Revenue
We primarily generate two types of revenue: (i) subscription revenue and (ii) volume-based revenue, which account for 99% of total revenue for all periods presented. We believe we have high visibility into our volume-based and subscription revenue from existing clients. We refer to the solutions our clients use to better process and understand their payment workflows from payers as provider solutions, and we refer to the products that assist healthcare providers in collecting payments from patients as patient payment solutions. We expect provider solutions will continue to generate the substantial majority of our total revenue, although the revenue mix attributable to patient payment solutions is expected to increase slightly over time.
Subscription revenue. Reflects recurring monthly provider count fees and minimum amounts owed. The vast majority of subscription revenue is generated by provider solutions, which constituted approximately 70% of total revenue in each of the three and nine months ended September 30, 2025 and 2024.
Volume-based revenue. Represents recurring fees associated with transaction count or dollar volumes in excess of minimums. Generally, approximately half of our volume-based revenue is generated from provider solutions that are based on transaction count, with the other half from patient payments solutions that are based on either dollar volumes or transaction count.
We also derive revenue from implementation fees for our software, as well as hardware sales to facilitate patient payments. Our implementation fees are billed upfront and the revenue is recognized ratably over the customer's life.
Cost of Revenue (Exclusive of Depreciation and Amortization)
Cost of revenue includes salaries, stock-based compensation, and benefits (“personnel costs”) for our team members who are focused on implementation, support, and other client-focused operations, as well as team members focused on enhancing and developing our platform. Cost of revenue also includes costs for third-party technology such as interchange fees and infrastructure related to the operations of our platform, including communicating and processing patient payments, and services to support the delivery of our solutions. Third-party costs for patient payments solutions are approximately 60% of the revenue generated from these solutions, while third-party costs for provider solutions are approximately 6% to 8% of the associated revenue, in each case, for both the three and nine months ended September 30, 2025 and 2024.
Sales and Marketing
Sales and marketing costs consist primarily of personnel costs, internal sales commissions, channel partner fees, travel, and advertising costs.
General and Administrative
General and administrative expenses consist of personnel costs incurred in our corporate service functions such as finance expenses, legal, human resources, and information technology, as well as other professional service costs.
Research and Development
Research and development costs consist primarily of personnel costs for team members engaged in research and development activities as well as third-party fees. All such costs are expensed as incurred, except for capitalized software development costs.
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Depreciation and Amortization
Depreciation and amortization consists of the depreciation of property and equipment and amortization of certain intangible assets, including capitalized software.
Other Expense
Other expense consists primarily of interest expense and related-party interest expense, inclusive of the impact of interest rate swaps and net of interest income.
Income Tax Expense/(Benefit)
Income tax expense/(benefit) includes current income tax and income tax credits from deferred taxes. Income tax expense/benefit is recognized in profit and loss except to the extent that it relates to items recognized in equity or other comprehensive income, in which case the income tax expense/(benefit) is also recognized in equity or other comprehensive income.
Results of Operations for the Three Months Ended September 30, 2025 and 2024
The following table provides consolidated operating results for the periods indicated and percentage of revenue for each line item:
Three months ended September 30,
20252024Change
($ in thousands)($)(%)($)(%)($)(%)
Revenue$268,651 100.0 %$240,112 100.0 %$28,539 11.9 %
Operating expenses
Cost of revenue (exclusive of depreciation and amortization)85,136 31.7 %80,545 33.5 %4,591 5.7 %
Sales and marketing45,158 16.8 %38,450 16.0 %6,708 17.4 %
General and administrative32,422 12.1 %22,704 9.5 %9,718 42.8 %
Research and development12,403 4.6 %11,082 4.6 %1,321 11.9 %
Depreciation and amortization33,300 12.4 %60,185 25.1 %(26,885)(44.7)%
Total operating expenses208,419 77.6 %212,966 88.7 %(4,547)(2.1)%
Income from operations60,232 22.4 %27,146 11.3 %33,086 121.9 %
Other expense
Interest expense(16,613)(6.2)%(17,752)(7.4)%1,139 (6.4)%
Related party interest expense(902)(0.3)%(707)(0.3)%(195)27.6 %
Income/(loss) before income taxes42,717 15.9 %8,687 3.6 %34,030 391.7%
Income tax expense/(benefit)12,069 4.5 %3,274 1.4 %8,795 268.6%
Net income/(loss)$30,648 11.4 %$5,413 2.3 %$25,235 466.2%
Revenue
Three months ended September 30,
20252024Change
($ in thousands)($)(%)($)(%)($)(%)
Revenue
Subscription revenue$134,450 50.0 %$117,993 49.1 %$16,457 13.9 %
Volume-based revenue132,342 49.3 %120,678 50.3 %11,664 9.7 %
Services and other revenue1,859 0.7 %1,441 0.6 %418 29.0 %
Total Revenue$268,651 100.0 %$240,112 100.0 %$28,539 11.9 %
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Revenue was $268.7 million for the three months ended September 30, 2025 as compared to $240.1 million for the three months ended September 30, 2024, an increase of $28.5 million, or 11.9%, of which $16.5 million was attributed to subscription revenue from new and existing clients, almost all of which was generated by provider solutions. Another $11.7 million was attributed to volume-based revenue primarily related to expansion of existing client usage, of which $5.7 million was generated by patient payments solutions and $5.9 million was generated by provider solutions.
Cost of Revenue (Exclusive of Depreciation and Amortization)
Cost of revenue was $85.1 million for the three months ended September 30, 2025 as compared to $80.5 million for the three months ended September 30, 2024, an increase of $4.6 million, or 5.7%. The increase was primarily driven by $2.1 million in increased costs stemming from higher transaction volumes and associated third-party costs, including higher platform usage of which approximately $4.6 million was third-party costs associated with payment solutions offset by a decrease of $2.4 million from third-party costs associated with provider solutions, primarily from timing of prior acquisition synergy attainment. Additionally, there was a $1.8 million of increased personnel costs, net of capitalization expense.
Sales and Marketing
Sales and marketing expense was $45.2 million for the three months ended September 30, 2025 as compared to $38.5 million for the three months ended September 30, 2024, an increase of $6.7 million, or 17.4%. The increase was primarily driven by an increase in channel partner fees and amortization of the internal commission deferred contract costs asset of $3.3 million, increased personnel costs of $1.4 million and increased stock-based compensation costs of $0.8 million.
General and Administrative
General and administrative expense was $32.4 million for the three months ended September 30, 2025 as compared to $22.7 million for the three months ended September 30, 2024, an increase of $9.7 million, or 42.8%. The increase was primarily due to an increase in third party professional fees of $7.1 million from acquisition activity, the August 2025 Debt Repricing and secondary offerings during the quarter. Additionally, there was an increase in stock-based compensation expense of $2.4 million.
Research and Development
Research and development expense was $12.4 million for the three months ended September 30, 2025 as compared to $11.1 million for the three months ended September 30, 2024, an increase of $1.3 million, or 11.9%. The increase was primarily due to an increase in personnel costs of $0.8 million and an increase in stock-based compensation expense of $0.4 million.
Depreciation and Amortization
Depreciation and amortization expense was $33.3 million for the three months ended September 30, 2025, as compared to $60.2 million for the three months ended September 30, 2024, a decrease of $26.9 million, or 44.7%. The decrease was due to several intangible assets becoming fully amortized in the prior year, driving a decrease in intangible amortization.
Interest Expense
Total interest expense was $17.5 million for the three months ended September 30, 2025 as compared to $18.5 million for the three months ended September 30, 2024, a decrease of $0.9 million, or 5.1%. The slight decrease was primarily attributable to debt repricings associated with the First Lien Credit Facility executed in December 2024 and August 2025 partially offset by a favorable interest rate swap that matured in October 2024.
Income Tax Expense/(Benefit)
Income tax expense was $12.1 million for the three months ended September 30, 2025, as compared to an income tax expense of $3.3 million for the three months ended September 30, 2024, an increase of $8.8 million. The increase was primarily driven by the increase in pre-tax income/(loss).
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Results of Operations for the Nine Months Ended September 30, 2025 and 2024
The following table provides consolidated operating results for the periods indicated and percentage of revenue for each line item:
Nine months ended September 30,
20252024Change
($ in thousands)($)(%)($)(%)($)(%)
Revenue$795,740 100.0 %$699,447 100.0 %$96,293 13.8 %
Operating expenses
Cost of revenue (exclusive of depreciation and amortization)255,525 32.1 %236,188 33.8 %19,337 8.2 %
Sales and marketing128,805 16.2 %117,945 16.9 %10,860 9.2 %
General and administrative84,914 10.7 %88,794 12.7 %(3,880)(4.4)%
Research and development36,103 4.5 %37,303 5.3 %(1,200)(3.2)%
Depreciation and amortization100,106 12.6 %148,635 21.3 %(48,529)(32.6)%
Total operating expenses605,453 76.1 % ` 628,865 89.9 %(23,412)(3.7)%
Income from operations190,287 23.9 %70,582 10.1 %119,705 169.6 %
Other expense
Interest expense(52,195)(6.6)%(122,759)(17.6)%70,564 (57.5)%
Related party interest expense(2,475)(0.3)%(3,425)(0.5)%950 (27.7)%
Income/(loss) before income taxes135,617 17.0 %(55,602)(7.9)%191,219 (343.9)%
Income tax expense/(benefit)43,516 5.5 %(17,398)(2.5)%60,914 (350.1)%
Net income/(loss)$92,101 11.6 %$(38,204)(5.5)%$130,305 (341.1)%
Revenue
Nine months ended September 30,
20252024Change
($ in thousands)($)(%)($)(%)($)(%)
Revenue
Subscription revenue$390,599 49.1 %$336,421 48.1 %$54,178 16.1 %
Volume-based revenue400,551 50.3 %358,723 51.3 %41,828 11.7 %
Services and other revenue4,590 0.6 %4,303 0.6 %287 6.7 %
Total Revenue$795,740 100.0 %$699,447 100.0 %$96,293 13.8 %
Revenue was $795.7 million for the nine months ended September 30, 2025 as compared to $699.4 million for the nine months ended September 30, 2024, an increase of $96.3 million, or 13.8%, of which $54.2 million was attributed to subscription revenue from new and existing clients, almost all of which is generated by provider solutions. Another $41.8 million was attributed to volume-based revenue primarily related to expansion of existing client usage, most of which was generated by patient payments solutions.
Cost of Revenue (Exclusive of Depreciation and Amortization)
Cost of revenue was $255.5 million for the nine months ended September 30, 2025 as compared to $236.2 million for the nine months ended September 30, 2024, an increase of $19.3 million, or 8.2%. The increase was primarily driven by $13.9 million in increased costs stemming from higher transaction volume and associated third-party costs, including higher platform usage, of which approximately $20.1 million was third-party costs associated with payment solutions offset by a decrease of $6.2 million from third-party costs associated with provider solutions, primarily from timing of prior acquisition synergy attainment. Additionally, there was an increase in personnel costs, net of capitalization expenses, of $5.8 million.
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Sales and Marketing
Sales and marketing expense was $128.8 million for the nine months ended September 30, 2025 as compared to $117.9 million for the nine months ended September 30, 2024, an increase of $10.9 million, or 9.2%. The increase was primarily driven by an increase in channel partner fees and amortization of the internal commission deferred contract costs asset of $11.3 million associated with revenue growth.
General and Administrative
General and administrative expense was $84.9 million for the nine months ended September 30, 2025 as compared to $88.8 million for the nine months ended September 30, 2024, a decrease of $3.9 million, or 4.4%. The decrease was primarily due to a reduction in stock-based compensation expense of $8.6 million attributable to the recognition of performance condition options that did not recur during the nine months ended September 30, 2025 (see “Impacts of IPO” section above) partially offset by an increase in personnel costs of $3.9 million.
Research and Development
Research and development expense was $36.1 million for the nine months ended September 30, 2025 as compared to $37.3 million for the nine months ended September 30, 2024, a decrease of $1.2 million, or 3.2%. The decrease was primarily driven by a decrease in stock-based compensation expense of $3.0 million attributable to the recognition of performance condition options that did not recur during the nine months ended September 30, 2025 (see “Impacts of IPO” section above) partially offset by an increase in personnel costs, net of capitalization expenses of $1.8 million.
Depreciation and Amortization
Depreciation and amortization expense was $100.1 million for the nine months ended September 30, 2025, as compared to $148.6 million for the nine months ended September 30, 2024, a decrease of $48.5 million, or 32.6%. The decrease was due to several intangible assets becoming fully amortized in the prior year, driving a decrease in intangible amortization.
Interest Expense
Total interest expense was $54.7 million for the nine months ended September 30, 2025 as compared to $126.2 million for the nine months ended September 30, 2024, a decrease of $71.5 million, or 56.7%. The decrease was driven by the paydowns during 2024 totaling $1.0 billion on our First Lien Credit Facility decreasing the corresponding interest expense.
Income Tax Benefit
Income tax expense was $43.5 million for the nine months ended September 30, 2025 as compared to an income tax benefit of $17.4 million for the nine months ended September 30, 2024, an increase of $60.9 million. The increase was primarily driven by the increase in pre-tax income/(loss).
Non-GAAP Financial Measures
We present adjusted EBITDA, adjusted EBITDA margin, non-GAAP net income/(loss), and non-GAAP net income/(loss) per share as supplemental measures of financial performance that are not required by, or presented in accordance with, GAAP. We believe they assist investors and analysts in comparing our operating performance across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our core operating performance. Management believes these non-GAAP financial measures are useful to investors in highlighting trends in our operating performance, while other measures can differ significantly depending on long-term strategic decisions regarding capital structure, the tax jurisdictions in which we operate, and capital investments. Management uses these to supplement GAAP measures of performance in the evaluation of the effectiveness of our business strategies, to make budgeting decisions, to establish discretionary annual incentive compensation, and to compare our performance against that of other peer companies using similar measures. Management supplements GAAP results with non-GAAP financial measures to provide a more complete understanding of the factors and trends affecting the business than GAAP results alone provide.
Adjusted EBITDA, adjusted EBITDA margin, non-GAAP net income/(loss), and non-GAAP net income/(loss) per share are not recognized terms under GAAP and should not be considered as an alternative to net income (loss) or net income (loss) margin as measures of financial performance or cash provided by operating activities as a measure of liquidity, or
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any other performance measure derived in accordance with GAAP. Additionally, these measures are not intended to be a measure of free cash flow available for management’s discretionary use, as they do not consider certain cash requirements such as interest payments, tax payments, and debt service requirements. The presentations of these measures have limitations as analytical tools and should not be considered in isolation, or as a substitute for analysis of our results as reported under GAAP. Because not all companies use identical calculations, the presentations of these measures may not be comparable to other similarly titled measures of other companies and can differ significantly from company to company. A reconciliation is provided below for our non-GAAP financial measures to the most directly comparable financial measure stated in accordance with GAAP. Investors are encouraged to review the related GAAP financial measures and the reconciliation of non-GAAP financial measures to their most directly comparable GAAP financial measures, and not to rely on any single financial measure to evaluate our business.
Adjusted EBITDA and Adjusted EBITDA Margin
We define adjusted EBITDA as net income/(loss) before interest expense, net, income tax expense/(benefit), depreciation and amortization, and as further adjusted for stock-based compensation expense, acquisition and integration costs, asset and lease impairments, costs related to amended debt agreements, and costs related to our IPO and the Secondary Offerings. Adjusted EBITDA margin represents adjusted EBITDA as a percentage of revenue.
The following table presents a reconciliation of net income/(loss) to adjusted EBITDA and net income/(loss) margin to adjusted EBITDA margin for the three and nine months ended September 30, 2025 and 2024:
Three months ended September 30,Nine months ended September 30,
($ in thousands)2025202420252024
Net income/(loss)$30,648 $5,413 $92,101 $(38,204)
Interest expense17,515 18,459 54,670 126,184 
Income tax expense/(benefit)12,069 3,274 43,516 (17,398)
Depreciation and amortization33,300 60,185 100,106 148,635 
Stock-based compensation expense11,597 7,903 29,871 47,400 
Acquisition and integration costs5,313 188 6,197 696 
Costs related to amended debt agreements649 106 649 12,876 
IPO related and Secondary Offering expenses1,372 109 4,571 2,114 
Other (a)240 1,040 1,320 1,040 
Adjusted EBITDA$112,703 $96,677 $333,001 $283,343 
Revenue$268,651 $240,112 $795,740 $699,447 
Net income/(loss) margin11.4 %2.3 %11.6 %(5.5)%
Adjusted EBITDA margin42.0 %40.3 %41.8 %40.5 %
_______________________________________________________________
(a)Adjustments relate to additional lease costs due to the relocation of our Louisville office totaling $0.2 million and $0.7 million, respectively, and executive severance totaling $0.0 million and $0.6 million, respectively, for the three and nine months ended September 30, 2025. For the three and nine months ended September 30, 2024, adjustments relate to additional lease costs due to the relocation of our Louisville office.
Non-GAAP Net Income/(Loss) and Non-GAAP Net Income/(Loss) Per Share
We define non-GAAP net income as GAAP net income/(loss) excluding the impact of stock-based compensation, acquisition and integration costs, asset and lease impairments, costs related to our IPO, and the Secondary Offerings, and costs related to amended debt agreements and amortization of intangibles. The tax effects of the adjustments are calculated using a management estimated annual effective non-GAAP tax rate of 21%, which is based on our statutory federal tax rate and provides consistency across interim reporting periods by eliminating the effects of non-recurring and period specific items. Due to the differences in the tax treatment of items excluded from non-GAAP net income, our estimated tax rate on non-GAAP net income may differ from our GAAP tax rate.
Non-GAAP net income per share is shown on both a basic and diluted basis and is defined as non-GAAP net income divided by the basic or diluted weighted-average shares, respectively.

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The following table presents a reconciliation of net loss to non-GAAP net income/(loss) and non-GAAP net income/(loss) per share for the three and nine months ended September 30, 2025 and 2024:
Three months ended September 30,Nine months ended September 30,
($ in thousands)2025202420252024
Net income/(loss)$30,648 $5,413 $92,101 $(38,204)
Stock based compensation11,597 7,903 29,871 47,400 
Acquisition and integration costs5,313 188 6,197 696 
Costs related to amended debt agreements649 106 649 12,876 
IPO and Secondary Offering expenses1,372 109 4,571 2,114 
Other (a)240 16,816 1,320 16,816 
Intangible amortization27,851 39,080 84,081 117,240 
Tax effect of adjustments(9,875)(13,482)(26,605)(41,400)
Non-GAAP net income/(loss)$67,795 $56,133 $192,185 $117,538 
Non-GAAP net income/(loss) per share:
Basic$0.39 $0.33 $1.11 $0.83 
Diluted$0.37 $0.32 $1.06 $0.80 
Weighted-average shares outstanding:
Basic174,352,079 171,578,311 173,388,077 142,367,458 
Diluted181,240,033 176,181,511 181,165,738 146,843,861 
(a)Adjustments relate to additional lease costs due to the relocation of our Louisville office totaling $0.2 million and $0.7 million, respectively, and executive severance totaling $0.0 million and $0.6 million, respectively, for the three and nine months ended September 30, 2025. For the three and nine months ended September 30, 2024, adjustments relate to additional lease costs due to the relocation of our Louisville office.
Key Performance Metrics
Net Revenue Retention Rate
We also regularly monitor and review our Net Revenue Retention Rate.
The following table presents our Net Revenue Retention Rate for September 30, 2025 and 2024, respectively:
Twelve months ended September 30,
($in thousands)20252024
Net Revenue Retention Rate113.1 %109.4 %
Our Net Revenue Retention Rate compares twelve months of client invoices for our solutions at two period end dates. To calculate our Net Revenue Retention Rate, we first accumulate the total amount invoiced during the twelve months ending with the prior period-end, or Prior Period Invoices. We then calculate the total amount invoiced to those same clients for the twelve months ending with the current period-end, or Current Period Invoices. Current Period Invoices are inclusive of upsell, downsell, pricing changes, clients that cancel or chose not to renew, and discontinued solutions with continuing clients. The Net Revenue Retention Rate is then calculated by dividing the Current Period Invoices by the Prior Period Invoices. Our total invoices included in the analysis are greater than 98% of reported revenue. We use Net Revenue Retention Rate to evaluate our ongoing operations and for internal planning and forecasting purposes. Acquired businesses are included in the last-twelve month Net Revenue Retention Rate in the ninth quarter after acquisition, which is the earliest point that comparable post-acquisition invoices are available for both the current and prior twelve-month period.
Customer Count with >$100,000 Revenue
We also regularly monitor and review our count of clients who generate more than $100,000 of revenue.
The following table sets forth our count of clients who generate more than $100,000 of revenue for the periods presented:
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Twelve months ended September 30,
20252024
Customer Count with > $100,000 Revenue1,306 1,173 
Our count of clients who generate more than $100,000 of revenue is based on an accumulation of the amounts invoiced to clients over the preceding twelve months. The invoices for acquired clients are included starting in the first full calendar quarter after the date of acquisition.
Liquidity and Capital Resources
Overview
We assess our liquidity in terms of our ability to generate adequate amounts of cash to meet current and future needs. Our expected primary uses on a short-term and long-term basis are for working capital, capital expenditures, debt service requirements, and investments in future growth, including acquisitions. We have historically funded our operations and acquisitions through our cash and cash equivalents, cash flows from operations, and debt financings. We believe that our existing unrestricted cash on hand, expected future cash flows from operations, and additional borrowings will provide sufficient resources to fund our operating requirements, as well as future capital expenditures, debt service requirements, and investments in future growth for at least the next 12 months. To the extent additional funds are necessary to meet our long-term liquidity needs as we continue to execute our business strategy, we anticipate that they will be obtained through the incurrence of additional indebtedness, additional equity financings, or a combination of these potential sources of funds. In the event that we need access to additional cash, we may not be able to access the credit markets on commercially acceptable terms or at all. Our ability to fund future operating expenses and capital expenditures and our ability to meet future debt service obligations or refinance our indebtedness will depend on our future operating performance, which will be affected by general economic, financial, and other factors beyond our control, including those described under “Risk factors” in the 2024 Form 10-K.
On September 30, 2025 and December 31, 2024, we had restricted cash of $24.3 million and $22.4 million, respectively, which consists of cash deposited in lockbox accounts owned by us which are contractually required to be disbursed to participating clients on the following day, as well as cash collected on behalf of healthcare providers from patients that have not yet been remitted to providers. These funds payable are not available for our use and liquidity, and are offset on our balance sheet by an aggregated funds payable liability.
On October 1, 2025, we paid approximately $458.6 million in cash in respect of the cash component of the merger consideration for our acquisition of Iodine. On October 1, 2025, we also entered into the Twelfth Amendment to the First Lien Credit Agreement to increase our First Lien Credit Facility by $250.0 million, increase the maximum borrowing capacity under the revolving credit facility from $400.0 million to $500.0 million, and decrease the interest rate under the revolving credit facility from 1.75% per annum above SOFR to 1.50% per annum above SOFR. We drew $30.0 million on the revolving credit facility to help fund the Iodine acquisition.

Our liquidity is influenced by many factors, including timing of revenue and corresponding cash collections, the amount and timing of investments in strategic initiatives, our investments in property, equipment, and software, as well as other factors described under “Risk factors” in the 2024 Form 10-K. Depending on the severity and direct impact of these factors on us, we may not be able to secure additional financing on acceptable terms, or at all.
Cash Flows
Cash flows from operating, investing, and financing activities for the nine months ended September 30, 2025 and September 30, 2024, are summarized in the following table:
Nine months ended September 30,Change
($ in thousands)20252024AmountChange
Net cash provided by operating activities$243,039 $104,998 $138,041 131.5 %
Net cash used in investing activities(17,069)(21,044)3,975 (18.9)%
Net cash provided by financing activities14,805 14,965 (160)(1.1)%
Net increase in cash and restricted cash$240,775 $98,919 $141,856 143.4 %
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Cash Flows Provided by Operating Activities
Cash flows provided by operating activities were $243.0 million for the nine months ended September 30, 2025 as compared to $105.0 million for the nine months ended September 30, 2024, an increase of $138.0 million. This increase is largely driven by changes in working capital, increases in revenue and profits, and decreases in cash paid for interest due to multiple paydowns on our First Lien Credit Facility in 2024.
Cash Flows Used in Investing Activities
Cash flows used in investing activities were $17.1 million for the nine months ended September 30, 2025 as compared to $21.0 million for the nine months ended September 30, 2024 a decrease of cash used of $4.0 million. Cash flows used in investing activities decreased due to less purchases of property and equipment during the nine months ended September 30, 2025 compared to the nine months ended September 30, 2024.
Cash Flows Provided By Financing Activities
Cash flows provided by financing activities were $14.8 million for the nine months ended September 30, 2025 as compared to $15.0 million for the nine months ended September 30, 2024, a decrease of $0.2 million. The net cash provided in 2024 was driven by proceeds from last year's IPO, net of underwriting discounts and the corresponding paydown on debt, as well as proceeds from the issuance of debt, net of creditor fees, during the nine months ended September 30, 2024. The net cash provided in 2025 was from proceeds from the exercise of stock options during the nine months ended September 30, 2025.
Indebtedness
Refer to Item 1, Financial Statements, Notes 11 (Accounts Receivable Securitization) and 12 (Debt), for a description of our Credit Facilities.
Critical Accounting Policies and Estimates
The above discussion and analysis of our financial condition and results of operations is based upon our consolidated financial statements. The preparation of financial statements in conformity with GAAP requires management to make estimates and judgments that affect the reported amounts of assets, liabilities, revenue, and expenses, and disclosures of contingent assets and liabilities. Critical accounting policies are those that we consider to be the most important in portraying our financial condition and results of operations and also require the greatest amount of judgments by management. Judgments or uncertainties regarding the application of these policies may result in materially different amounts being reported under different conditions or using different assumptions.
There have been no material changes to our critical accounting policies and estimates from those disclosed in the 2024 Form 10-K.
Recent Accounting Pronouncements
Refer to Item 1, Financial Statements, Note 2 (Summary of Significant Accounting Policies).
JOBS Act Election
We are currently an “emerging growth company,” as defined in the JOBS Act. Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards until such time as those standards apply to private companies. We have elected to use this extended transition period for complying with new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date we (i) are no longer an emerging growth company or (ii) affirmatively and irrevocably opt out of the extended transition period provided in the JOBS Act.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
We are exposed to certain market risks arising from transactions in the normal course of our business. Such risks are principally associated with credit risk and interest rate risk.
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Credit Risk
Credit risk involves the possibility that a counterparty will not meet its obligations under a financial instrument or client contract, leading to a financial loss. Concentrations of credit risk with respect to our clients are limited due to our diversified client base.
We routinely assess the financial strength of our clients through a combination of third-party financial reports, credit monitoring, publicly available information, and direct communication with those clients. We establish payment terms with clients to mitigate credit risk and monitor its accounts receivable credit risk exposure. However, while we actively seek to ensure credit risk, there can be no assurance that in the future it will be able to obtain credit risk insurance at commercially attractive terms or at all.
Interest Rate Risk
Our exposure to interest rate risk is related to our First Lien Credit Facility, which bears interest at SOFR plus 2.00% as of September 30, 2025. A hypothetical 100 basis point increase or decrease in the current effective rate would have an impact on our interest expense of approximately $3.2 million for the three months ended September 30, 2025 or $9.4 million for the nine months ended September 30, 2025.
In order to limit exposure to risk, we maintain derivative instruments with creditworthy institutions to hedge against changing interest rate fluctuations. We utilize interest rate swap contracts and other non-derivative hedging instruments to manage such risk.
Item 4. Controls and Procedures
Disclosure Controls and Procedures
Under the supervision and with the participation of our management, including the Chief Executive Officer and Chief Financial Officer, we conducted an evaluation of the effectiveness of our disclosure controls and procedures (as such term is defined in Rule 13a-15(e) and 15d-15(e) under the Exchange Act) as of the end of the period covered by this report. Based on this evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective as of such date. Our disclosure controls and procedures are designed to ensure that information required to be disclosed in the reports we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and that such information is accumulated and communicated to management including the Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosures.
Changes in Internal Control Over Financial Reporting
There were no changes to our internal control over financial reporting (as defined in Rule 13a-15(f) under the Exchange Act) that occurred during the quarter ended September 30, 2025 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
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Part II - Other Information
Item 1. Legal Proceedings
The information required with respect to this Part II, Item 1 can be found under Item 1, Financial Statements, Note 19 (Commitments and Contingencies), to the unaudited consolidated financial statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.
Item 1A. Risk Factors
There have been no material changes to the risk factors disclosed in the 2024 Form 10-K.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
None.
Item 3. Defaults Upon Senior Securities
None.
Item 4. Mine Safety Disclosures
Not applicable.
Item 5. Other Information
On August 24, 2025, Eric Lee (Ric) Sinclair III, our Chief Business Officer, adopted a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act. Mr. Sinclair’s plan provides for (i) the exercise of up to 90,750 vested stock options and the associated sale of up 90,750 shares of the Company’s common stock; (ii) the exercise of vested stock options and the associated sale shares of the Company’s common stock with the actual number of such options and associated shares to be determined based on unsold shares from Mr. Sinclair's previously adopted trading plan dated February 19, 2025; and (iii) the exercise of options subject to performance-based vesting conditions and the associated sale of shares of the Company’s common stock, with the actual number of such options and associated shares to be determined based on the level of achievement of the performance criteria associated with the award. Mr. Sinclair’s trading plan will expire December 31, 2026, or upon the earlier sale of all the shares subject to the plan.

On September 9, 2025, Craig Bridge, our Chief Transformation Officer, adopted a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act. Mr. Bridge’s plan provides for (i) the exercise of up to 112,485 vested stock options and the associated sale of up 112,485 shares of the Company’s common stock; (ii) the exercise of vested stock options and the associated sale shares of the Company’s common stock with the actual number of such options and associated shares to be determined based on unsold shares from Mr. Bridge's previously adopted trading plan dated November 27, 2024; and (iii) the exercise of options subject to performance-based vesting conditions and the associated sale of shares of the Company’s common stock, with the actual number of such options and associated shares to be determined based on the level of achievement of the performance criteria associated with the award. . Mr. Bridge’s trading plan will expire December 31, 2026, or upon the earlier sale of all the shares subject to the plan.
On September 11, 2025, Melissa Miller, our Chief Marketing Officer, adopted a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act. Ms. Miller’s plan provides for (i) the exercise of up to 101,470 vested stock options and the associated sale of up 101,470 shares of the Company’s common stock; and (ii) the exercise of options subject to performance-based vesting conditions and the associated sale of shares of the Company’s common stock, with the actual number of such options and associated shares to be determined based on the level of achievement of the performance criteria associated with the award. Ms. Miller’s trading plan will expire December 31, 2026, or upon the earlier sale of all the shares subject to the plan.
On September 11, 2025, Steven Oreskovich, our Chief Financial Officer, adopted a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act. Mr. Oreskovich’s plan provides for (i) the exercise of up to 519,277 vested stock options and the associated sale of up 519,277 shares of the Company’s common stock; and (ii) the exercise of options subject to performance-based vesting conditions and the associated sale of shares of the Company’s common stock, with the actual number of such options and associated shares to be determined based on the
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level of achievement of the performance criteria associated with the award. Mr. Oreskovich’s trading plan will expire December 31, 2026, or upon the earlier sale of all the shares subject to the plan.
On September 11, 2025, Christopher Schremser, our Chief Technology Officer, adopted a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act. Mr. Schremser’s plan provides for (i) the exercise of up to 454,682 vested stock options and the associated sale of up 454,682 shares of the Company’s common stock; and (ii) the exercise of options subject to performance-based vesting conditions and the associated sale of shares of the Company’s common stock, with the actual number of such options and associated shares to be determined based on the level of achievement of the performance criteria associated with the award. Mr. Schremser's trading plan will expire December 31, 2026, or upon the earlier sale of all the shares subject to the plan.
During the nine  months ended September 30, 2025, none of the Company’s other directors or officers adopted, modified, or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement” as each term is defined in Item 408 of Regulation S-K.
Item 6. Exhibits
Exhibit
Number
Exhibit DescriptionFiled
Herewith
2.1
Agreement and Plan of Merger, dated as of July 23, 2025, by and among Waystar Holding Corp., Morton Merger Sub 1, Inc., Isotope Holding, LLC, Iodine Software Holdings, Inc., Iodine Software Parent, LLC and Shareholder Representative Services LLC, as the equityholder representative (incorporated by reference to Exhibit 2.1 to the Company's Current Report on Form 8-K filed on July 23, 2025
3.2
Certificate of Amendment of Amended and Restated Certificate of Incorporation of Waystar Holding Corp. (incorporated by reference to Exhibit 3.1 to the Company’s Current Report on Form 8-K filed on June 5, 2025).
3.3
Amended and Restated Bylaws of Waystar Holding Corp. (incorporated by reference to Exhibit 4.2 to the Company’s Registration Statement on Form S-8 filed on June 10, 2024).
10.1
Amendment No. 2 to the Stockholders Agreement among Waystar Holding Corp. and the other parties named therein, dated as of July 23, 2025 (incorporated by reference to Exhibit 10.2 to the Company’s Current Report on Form 8-K filed on July 23, 2025).
10.2
Stockholder and Lockup Agreement among Waystar Holding Corp., AIO Holdings LP, William Chan and the other parties named therein, dated as of July 23, 2025 (incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed on July 23, 2025).
10.3
Joinder Agreement to Amended and Restated Registration Rights Agreement, dated as of July 23, 2025 (incorporated by reference to Exhibit 10.3 to the Company’s Current Report on Form 8-K filed on July 23, 2025).
10.4
Eleventh Amendment, dated as of August 12, 2025, to the First Lien Credit Agreement, among BNVC Holdings, Inc. (as successor to Derby Parent, Inc.), Waystar Technologies, Inc.(f/k/a Navicure, Inc.) (as successor to Derby Merger Sub, Inc. and BNVC Group Holdings, Inc.), JPMorgan Chase Bank, N.A., as Administrative Agent, Collateral Agent, and Issuing Bank, Barclays Bank PLC as Issuing Bank, Deutsche Bank AG New York Branch, as Issuing Bank, and each lender from time to time party thereto (incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed on August 12, 2025).
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10.5
Twelfth Amendment, dated as of October 1, 2025, to the First Lien Credit Agreement, among BNVC Holdings, Inc. (as successor to Derby Parent, Inc.), Waystar Technologies, Inc.(f/k/a Navicure, Inc.) (as successor to Derby Merger Sub, Inc. and BNVC Group Holdings, Inc.), JPMorgan Chase Bank, N.A., as Administrative Agent, Collateral Agent, and Issuing Bank, Barclays Bank PLC as Issuing Bank, Deutsche Bank AG New York Branch, as Issuing Bank, and each lender from time to time party thereto (incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed on October 1, 2025).
31.1
Certification of Chief Executive Officer, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
X
31.2
Certification of Chief Financial Officer, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
X
32.1 *
Certification of Chief Executive Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
X
32.2 *
Certification of Chief Financial Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
X
101.INSXBRL Instance Document - the instance document does not appear in the interactive data file because its XBRL tags are embedded within the inline XBRL document.X
101.SCHInline XBRL Taxonomy Extension Schema Document.X
101.CALInline XBRL Taxonomy Extension Calculation Linkbase Document.X
101.LABInline XBRL Taxonomy Extension Label Linkbase Document.X
101.PREInline XBRL Taxonomy Extension Presentation Linkbase Document.X
101.DEFInline XBRL Taxonomy Extension Definition Linkbase Document.X
104Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101).X
_______________________________________________________________
XFiled Herewith
† Management contract or compensatory plan or arrangement.
*This exhibit shall not be deemed “filed” for purposes of Section 18 of the Exchange Act or otherwise subject to the liability of that Section. Such exhibit shall not be deemed incorporated into any filing under the Securities Act or the Exchange Act.
The agreements and other documents filed as exhibits to this report are not intended to provide factual information or other disclosure other than the terms of the agreements or other documents themselves, and you should not rely on them for that purpose. In particular, any representations and warranties made by the Company in these agreements or other documents were made solely within the specific context of the relevant agreement or document and may not describe the actual state of affairs as of the date they were made or at any other time.
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Signatures
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized, in the City of Lehi, Utah, on October 29, 2025.
WAYSTAR HOLDING CORP.
By:/s/ Matthew J. Hawkins
Name:Matthew J. Hawkins
Title:Chief Executive Officer
By:/s/ Steven M. Oreskovich
Name:Steven M. Oreskovich
Title:Chief Financial Officer
41

FAQ

How did WAY perform in Q3 2025?

Revenue was $268.7 million and net income was $30.6 million (diluted EPS $0.17).

What are WAY’s year‑to‑date results for 2025?

Nine‑month revenue was $795.7 million with net income of $92.1 million (diluted EPS $0.51).

What is Waystar’s cash and debt position?

Cash and equivalents were $421.1 million; total outstanding debt was $1.23 billion at September 30, 2025.

Did Waystar change its debt terms?

Yes. On August 12, 2025, the first‑lien facility was repriced to SOFR + 2.00% (effective rate 6.34% at quarter‑end).

How strong was operating cash flow?

Operating cash flow for the nine months ended September 30, 2025 was $243.0 million.

How many shares are outstanding for WAY?

There were 191,316,583 shares outstanding as of October 20, 2025.

What did Waystar disclose about the Iodine Software acquisition?

The company liquidated short‑term investments during the period to help fund the acquisition of Iodine Software Holdings, Inc.
Waystar Holding Corp.

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Health Information Services
Services-computer Integrated Systems Design
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United States
LEHI