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BillionToOne, Inc.: Q3 FY2026 earnings call

What management said about Q3 FY2026, from the documents filed with the SEC on 4 November 2026: press release. Guidance figures: 1 raised. The quarter’s numbers.

Key takeaways

  • Revenue up 47% in the quarter: Quarterly revenue was $123.0 million, up 47% from $83.5 million. Nine-month revenue was $340.8 million, up 63% from $209.1 million. Source
  • Oncology revenue rose 96%: Oncology clinical testing revenue was $17.1 million in the quarter, up from $8.7 million. Nine-month oncology revenue was $41.4 million, up 162%. Source
  • Volume and price both contributed: Revenue growth came from a 25% rise in total tests delivered and an 18% rise in Overall ASP, which was $589 against $501. Both prenatal and oncology grew test volume. Source
  • Gross margin reached 71%: Gross profit was $87.1 million, a 71% gross margin against 70% a year earlier. Management attributed the margin improvement to higher Overall ASP. Source
  • Operating expenses rose 56%: Total operating expenses were $76.1 million, against $48.8 million, an increase of 56%. Source
  • Quarterly free cash flow $8.6 million: Free cash flow was $8.6 million in the quarter, defined as operating cash flow less capital expenditures. Source
  • Northstar Clear launch set for December: Northstar Clear, a tissue-free MRD test for all solid tumors with a blood-only design, is set to be commercially available on December 15, 2026. Source

“Our third quarter was another period of strong execution,”

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

Guidance

AreaPeriodFigureAgainst last quarter
Total revenue Sourcefull year 2026$460.0 million to $470.0 millionRaised from $450.0 million to $465.0 million

What changed from last quarter

  • Guidance raised: Full-year 2026 revenue guidance was raised to $460.0 million to $470.0 million, from $450.0 million to $465.0 million. Source
  • Guidance kept: The expectation of profitability similar to current levels, even with continued investment, was repeated from the prior quarter. Source
  • New: Northstar Clear, a tissue-free MRD test for all solid tumors, was announced with commercial availability set for December 15, 2026. Source

Results and growth drivers

  • Revenue up 47% in the quarter: Quarterly revenue was $123.0 million, up 47% from $83.5 million. Nine-month revenue was $340.8 million, up 63% from $209.1 million. Source
  • Operating income rose modestly: Income from operations was $11.0 million, compared with $9.6 million a year earlier. Operating margin was 9% for the quarter. Source
  • Net income and diluted EPS increased: Net income was $17.4 million, or $0.32 per diluted share, compared with $1.5 million, or $0.10 per diluted share, in the third quarter of 2025. Source
  • Adjusted EBITDA reached $22.7 million: Adjusted EBITDA was $22.7 million for the quarter, against $15.8 million a year earlier. Nine-month Adjusted EBITDA was $64.8 million, against $20.5 million. Source

Segments and products

  • Prenatal revenue up 41%: Prenatal revenue was $104.3 million for the quarter, up 41%. Nine-month prenatal revenue was $295.1 million, up 54% from $191.0 million. Source
  • Oncology revenue rose 96%: Oncology clinical testing revenue was $17.1 million in the quarter, up from $8.7 million. Nine-month oncology revenue was $41.4 million, up 162%. Source
  • Clinical trial support grew: Clinical trial support and other services revenue was $1.6 million, up 115% from $0.8 million. Nine-month revenue in this line was $4.3 million, up 92%. Source

“This quarter we also strengthened the clinical evidence behind our platform.”

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

Test volumes and pricing

  • Volume and price both contributed: Revenue growth came from a 25% rise in total tests delivered and an 18% rise in Overall ASP, which was $589 against $501. Both prenatal and oncology grew test volume. Source
  • Tests accessioned rose 27%: Tests accessioned were 207,000 for the quarter, up 27%. Nine-month tests accessioned were 593,000, up 32%. Source
  • Nine-month deliveries rose 34%: Tests delivered for the nine months were 590,000, up 34% from 441,000. Quarterly tests delivered were 206,000, up 25%. Source

Costs and margins

  • Gross margin reached 71%: Gross profit was $87.1 million, a 71% gross margin against 70% a year earlier. Management attributed the margin improvement to higher Overall ASP. Source
  • Cost per test edged up: Overall cost per test rose slightly compared with a year earlier, according to the company. Source
  • Oncology mix drove cost increase: Management attributed the rise to faster growth in oncology, which has higher cost per test, and a slight prenatal cost increase, partly offset by lower cost per test for both oncology products. Source
  • Operating expenses rose 56%: Total operating expenses were $76.1 million, against $48.8 million, an increase of 56%. Source
  • Both research and SG&A increased: Selling, general and administrative expense was $55.9 million, up from $35.8 million. Research and development was $20.2 million, up from $13.0 million. Source

“Overall, we are proud of our performance so far in 2026 and believe we are still in the early chapters of what our platform can achieve.”

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

Cash, balance sheet and capital

  • Quarterly free cash flow $8.6 million: Free cash flow was $8.6 million in the quarter, defined as operating cash flow less capital expenditures. Source
  • Nine-month free cash flow $24.6 million: Nine-month free cash flow was $24.6 million, against $6.5 million a year earlier. Source
  • Cash balance rose to $561.5 million: Cash and cash equivalents were $561.5 million at September 30, 2026, against $496.0 million at December 31, 2025. Source
  • Debt increased on $30.0M issuance: The company recorded $30.0 million of debt proceeds in the nine months. Long-term debt was $89.0 million at September 30, 2026, up from $57.2 million. Source
  • Option exercise proceeds increased: Proceeds from stock option exercises were $12.2 million in the nine months, against $1.2 million a year earlier. Source
  • Receivables rose to $88.3 million: Accounts receivable were $88.3 million at September 30, 2026, up from $41.6 million at December 31, 2025. Source

Clinical evidence and launches

  • Northstar Clear launch set for December: Northstar Clear, a tissue-free MRD test for all solid tumors with a blood-only design, is set to be commercially available on December 15, 2026. Source
  • Northstar Response head-to-head data published: Published data compared Northstar Response with the most widely used tumor-informed assay in patients on active treatment for advanced cancer. The assays agreed on direction of ctDNA change in 94% of pairs. Source
  • Unity Fetal Risk Screen validated in study: Data published in The Green Journal validated Unity Fetal Risk Screen as a first-line prenatal screen, with 94.4% sensitivity and 99.5% specificity. Source

Coming up, as management said on 4 November 2026

  • Colorectal head-to-head data to follow: Initial colorectal cancer data for Northstar Clear will show head-to-head performance against a tumor-informed assay. Source

Figures management reported

FigureReported
Tests delivered (patient volumes) Source206,000 in the quarter, up 25% from 165,000; 590,000 for nine months, up 34% from 441,000

Earlier plans management reported on

  • Not stated: The new revenue range is compared with the company's previous guidance range. Source
  • Not stated: The CEO said the company plans to launch Northstar Clear next month. Source

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.