BillionToOne, Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 4 March 2026: press release. Guidance figures: 2 raised. The quarter’s numbers.

Read the filing

Key takeaways

• Quarterly revenue more than doubled: Fourth-quarter total revenue was $96.1 million, up 113% from $45.1 million. Full-year revenue was $305.1 million, up 100% from $152.6 million. Source
• Volume and pricing both drove growth: Management attributed the revenue increase to a 47% rise in tests delivered and a 47% rise in Overall ASP. For full-year 2025, tests delivered rose 51% and Overall ASP rose 35%. Source
• Operating income positive in quarter: Operating income was $10.3 million for the fourth quarter, against an operating loss of $11.7 million a year earlier. Full-year operating income was $16.0 million, against a $47.1 million loss in 2024. Source
• Prenatal revenue nearly doubled: Prenatal clinical testing revenue was $86.1 million in the fourth quarter, up 99%. Full-year prenatal revenue was $277.1 million, up 90% from $145.9 million. Source
• Oncology revenue rose more than eightfold: Oncology clinical testing revenue was $9.1 million in the fourth quarter, against $1.1 million a year earlier. Full-year oncology revenue was $25.0 million, against $2.9 million in 2024. Source
• Gross margin rose 14 points: Gross margin was 71% in the fourth quarter, against 57% a year earlier, and 68% for 2025, against 53% for 2024. Management cited higher Overall ASP and lower Overall Cost-Per-Test. Source
• Cash balance near $496 million: Cash and cash equivalents were approximately $496.0 million at December 31, 2025, against $191.5 million a year earlier. Source

“2025 demonstrated how the compounding power of a differentiated technology platform, category-defining products, and disciplined execution can produce an extraordinary outcome”

Dr. Oguzhan Atay, Co-Founder and CEO of BillionToOne

Guidance

What changed from last quarter

• Guidance raised: 2026 total revenue guidance raised to $430 million to $445 million from $415 million to $430 million. Source
• Guidance kept: Expectation of positive GAAP operating income for 2026 carried over from the January guidance. Source
• New: Expanded Red Blood Cell Fetal Antigen NIPT and Platelet Fetal Antigen NIPT offerings launched in February. Source
• New: Northstar PGx and Northstar Select CH launched in Q1 2026 in oncology products. Source

Results and growth drivers

• Quarterly revenue more than doubled: Fourth-quarter total revenue was $96.1 million, up 113% from $45.1 million. Full-year revenue was $305.1 million, up 100% from $152.6 million. Source
• Volume and pricing both drove growth: Management attributed the revenue increase to a 47% rise in tests delivered and a 47% rise in Overall ASP. For full-year 2025, tests delivered rose 51% and Overall ASP rose 35%. Source
• Operating income positive in quarter: Operating income was $10.3 million for the fourth quarter, against an operating loss of $11.7 million a year earlier. Full-year operating income was $16.0 million, against a $47.1 million loss in 2024. Source

Segments and products

• Prenatal revenue nearly doubled: Prenatal clinical testing revenue was $86.1 million in the fourth quarter, up 99%. Full-year prenatal revenue was $277.1 million, up 90% from $145.9 million. Source
• Oncology revenue rose more than eightfold: Oncology clinical testing revenue was $9.1 million in the fourth quarter, against $1.1 million a year earlier. Full-year oncology revenue was $25.0 million, against $2.9 million in 2024. Source
• Trial support revenue was small: Clinical Trial Support and Other Services revenue was $0.8 million in each fourth quarter, with the table showing a 6% change. Full-year revenue was $3.1 million, down 18%. Source
• Fetal antigen NIPT tests launched: In February the company launched expanded Red Blood Cell and Platelet Fetal Antigen NIPT offerings, which it describes as the only non-invasive prenatal tests of their kind in the U.S. Source

“Entering 2026, we believe we are still in the earliest chapters of what is possible, and remain confident that our smNGS platform will continue to unlock diagnostic capabilities that transform patient lives one molecule at a time.”

Dr. Oguzhan Atay, Co-Founder and CEO of BillionToOne

Costs, margins and pricing

• Gross margin rose 14 points: Gross margin was 71% in the fourth quarter, against 57% a year earlier, and 68% for 2025, against 53% for 2024. Management cited higher Overall ASP and lower Overall Cost-Per-Test. Source
• Operating expenses rose 56%: Total operating expenses were $58.3 million in the fourth quarter, up 56%. Selling, general and administrative expense was $44.0 million, against $26.4 million, and R&D was $14.3 million, against $11.0 million. Source
• Net income per diluted share: Fourth-quarter net income available to common shareholders was $4.4 million, or $0.11 per diluted share, against a $1.13 per share loss a year earlier. Full-year net income was $2.9 million, or $0.14 per diluted share. Source

Demand and test volumes

• Test accessions rose 46% in quarter: Tests accessioned were 168,000 in the fourth quarter, against 115,000 a year earlier. Full-year accessions were 616,000, against 410,000 in 2024. Source
• Tests delivered slightly above accessions: Tests delivered were 170,000 in the fourth quarter, compared with 168,000 accessioned. Full-year deliveries were 610,000, up 51% from 405,000. Source
• Both product lines grew volume: Management said prenatal and oncology both grew test volume quarter over quarter and year over year. Source

Cash and capital

• Cash balance near $496 million: Cash and cash equivalents were approximately $496.0 million at December 31, 2025, against $191.5 million a year earlier. Source
• Net cash flow excluding IPO proceeds: Net cash flow excluding net IPO proceeds was $8.8 million in the fourth quarter and $12.5 million for full-year 2025. Source
• Warrant liability recorded at year-end: A $9.3 million common stock warrant liability appeared on the balance sheet at December 31, 2025, with none recorded a year earlier. Source
• Preferred stock converted, equity rose: Redeemable convertible preferred shares outstanding fell from 29,084,235 to zero. Total stockholders’ equity was $480.1 million, against a $251.7 million deficit a year earlier. Source

Strategy and platform

• Proprietary counting platform described: The company describes its patented QCT molecular counting platform as the only multiplex technology that can accurately count DNA molecules at the single-molecule level. Source
• Northstar extended beyond genomic profiling: Northstar PGx and Northstar CH are add-on applications for Northstar Select, extending the platform to chemotherapy safety and clonal hematopoiesis. Source
• Payer coverage expansion cited: Management listed expanding payer coverage alongside new product launches and a growing base of providers choosing its tests. Source

Figures management reported

Earlier plans management reported on

• Not stated: In January the company reiterated its 2025 guidance range along with positive GAAP operating income.

Other quarters

• Q3 FY2026 earnings call
• Q2 FY2026 earnings call
• Q1 FY2026 earnings call
• Q3 FY2025 results

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.