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BillionToOne, Inc.: Q2 FY2026 earnings call

What management said about Q2 FY2026, from the documents filed with the SEC on 5 August 2026: press release. Guidance figures: 1 kept. The quarter’s numbers.

Key takeaways

  • Revenue rose 64% year over year: Total revenue was $109.4 million, up 64% from $66.6 million. The company attributed the increase to 35% more tests delivered and a 21% higher Overall ASP. Source
  • Oncology revenue rose 176%: Oncology revenue was $13.7 million, up 176% from $4.9 million a year earlier, against $10.7 million in the first quarter of 2026. Source
  • Gross margin 70%, up 5 points: Gross margin was 70% against 65% a year earlier. The company attributed the improvement to a higher Overall ASP. Source
  • Operating income of $5.5 million: Income from operations was $5.5 million, a 5% operating margin, against a $1.6 million loss a year earlier and $17.8 million in the first quarter of 2026. Source
  • Net income of $8.1 million: Net income was $8.1 million, or $0.15 per diluted share, against a net loss of $0.2 million a year earlier. First-quarter 2026 diluted EPS was $0.34. Source
  • Free cash flow of $5.1 million: Free cash flow was $5.1 million in the quarter, against negative $1.7 million a year earlier. Six-month free cash flow was $16.0 million. Source

“Our second quarter demonstrated the durability of our model, with our differentiated technology platform, category-defining products, and disciplined execution driving continued growth and profitability,”

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

Guidance

AreaPeriodFigureAgainst last quarter
Total revenue SourceFull year 2026$450.0 million to $465.0 millionKept

What changed from last quarter

  • Guidance kept: Full-year revenue guidance was held at the range given in May, after the May raise from $430 million to $445 million. Source
  • New: Unity Fetal Risk Screen expanded with a 130-gene panel, described by the company as the largest single-gene NIPT panel available. Source
  • New: Northstar Origin announced as a planned add-on tissue-of-origin feature for the Northstar Select test. Source

Revenue growth and drivers

  • Revenue rose 64% year over year: Total revenue was $109.4 million, up 64% from $66.6 million. The company attributed the increase to 35% more tests delivered and a 21% higher Overall ASP. Source
  • Tests accessioned rose 33%: Tests accessioned were 197,000 in the quarter, up 33% from 148,000 a year earlier. Source
  • Six-month revenue rose 74%: Revenue for the six months ended June 30, 2026 was $217.8 million, up 74% from $125.5 million a year earlier. Source

Prenatal and oncology segments

  • Prenatal revenue rose 55%: Prenatal revenue was $94.2 million, up 55% from $60.9 million a year earlier, and below the $96.5 million reported for the first quarter of 2026. Source
  • Oncology revenue rose 176%: Oncology revenue was $13.7 million, up 176% from $4.9 million a year earlier, against $10.7 million in the first quarter of 2026. Source
  • Clinical trial support revenue nearly doubled: Clinical trial support and other services revenue was $1.5 million, up 99% from $0.8 million a year earlier. Source

“We believe we are still in the earliest chapters of what our smNGS platform can achieve, and we remain relentlessly focused on transforming molecular diagnostics and healthcare.”

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

Products and clinical data

  • Northstar Response publication: Management announced peer-reviewed data in The Journal of Liquid Biopsy, with Allegheny Health Network, on Northstar Response in advanced solid tumors receiving immunotherapy. Source
  • Unity Confirm cited in roadmap: The CEO cited the Unity Confirm launch, made in May, as part of the product roadmap advanced this quarter, alongside two upcoming launches. Source
  • Expanded panel broadens Unity market: Management said the expanded Unity panel broadens the addressable market and reinforces its position in cfDNA testing for recessive conditions. Source

Costs, margins and pricing

  • Gross margin 70%, up 5 points: Gross margin was 70% against 65% a year earlier. The company attributed the improvement to a higher Overall ASP. Source
  • Cost per test edged up: Overall cost per test rose slightly year over year. Gains in cost per test for both product lines were offset by faster growth of oncology, which has higher costs per test. Source
  • Operating expenses rose 59%: Total operating expenses were $71.6 million, up 59%, including selling, general and administrative expense of $54.3 million and research and development of $17.3 million. Source

Operating and net results

  • Operating income of $5.5 million: Income from operations was $5.5 million, a 5% operating margin, against a $1.6 million loss a year earlier and $17.8 million in the first quarter of 2026. Source
  • Net income of $8.1 million: Net income was $8.1 million, or $0.15 per diluted share, against a net loss of $0.2 million a year earlier. First-quarter 2026 diluted EPS was $0.34. Source
  • Adjusted EBITDA reached $16.1 million: Adjusted EBITDA was $16.1 million, against $2.9 million a year earlier. Unadjusted EBITDA was $4.7 million for the quarter. Source
  • Term loan fair value change in other income: Other income included $4.7 million of interest income and a $3.0 million change in fair value of the term loan, for total other income of $2.0 million. Source

Cash flow and balance sheet

  • Free cash flow of $5.1 million: Free cash flow was $5.1 million in the quarter, against negative $1.7 million a year earlier. Six-month free cash flow was $16.0 million. Source
  • Cash rose, debt at $91.0 million: Cash and cash equivalents were $548.6 million at June 30, 2026, up from $496.0 million at December 31, 2025. Long-term debt was $91.0 million. Source
  • Receivables increased in the half: Accounts receivable rose to $74.9 million from $41.6 million at year-end 2025. Six-month net cash from operating activities was $24.6 million. Source
  • Capital spending and debt proceeds: Six-month purchases of property and equipment were $8.5 million, and debt proceeds of $30.0 million were received in the period. Source

Coming up, as management said on 5 August 2026

  • Expanded Unity panel available: The expanded Unity Fetal Risk Screen with the 130-gene panel becomes commercially available on the stated date. Source
  • Northstar Origin available: The Northstar Origin add-on feature becomes commercially available on the stated date. Source

Figures management reported

FigureReported
Patient volumes Source196,000 tests delivered in Q2 2026, up 35% from 145,000 in Q2 2025

Other quarters

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.