Open the filing on EDGARRadNet Reports Fourth Quarter 2025 Results, Including Record Revenue and Adjusted EBITDA and Releases 2026 Financial Guidance
- Total Company Revenue increased 14.8% to a quarterly record of $547.7 million in the fourth quarter of 2025 from $477.1 million in the fourth quarter of 2024; Revenue from the Digital Health reportable segment (inclusive of intersegment revenue) increased 48.2% to $27.9 million in the fourth quarter of 2025 from $18.9 million in the fourth quarter of 2024
- Total Company Adjusted EBITDAwas a quarterly record of $87.7 million in the fourth quarter of 2025 as compared with $75.0 million in the fourth quarter of 2024, an increase of 16.9%; Digital Health reportable segment Adjusted EBITDA increased 8.9% to $4.9 million in the fourth quarter of 2025 from $4.5 million in the fourth quarter of 2024
- Total Company Adjusted EBITDA margins increased by 29 bps to 16.0% in the fourth quarter of 2025 as compared with 15.7% in the fourth quarter of 2024
- Adjusting for unusual or one-time items impacting Net Income in the quarter, Adjusted Earnings Per Sharewas $0.23 for the fourth quarter of 2025; This compares with Adjusted Earnings Per Share of $0.24 for the fourth quarter of 2024
- In the fourth quarter of 2025, aggregate advanced imaging (MRI, CT and PET/CT) procedural volumes increased 14.1% and same-center advanced imaging procedural volumes increased 9.6% as compared with the fourth quarter of 2024
- RadNet releases 2026 guidance levels which anticipate Imaging Center segment Revenue growth of 17%-19%, Adjusted EBITDA growth of 18%-22% and Free Cash Flow growth of 29%-41% from 2025 levels; 2026 guidance levels anticipate Digital Health Revenue growth of 46%-56%
LOS ANGELES, California, March 2, 2026 - RadNet, Inc. (NASDAQ: RDNT), a national leader in providing high-quality, cost-effective, fixed-site outpatient diagnostic imaging services through a network of 418 owned and/or operated outpatient imaging centers, today reported financial results for its fourth quarter and full-year ended December 31, 2025.
Dr. Howard Berger, President and Chief Executive Officer of RadNet, commented, “I am very pleased with the fourth quarter performance. Relative to last year’s fourth quarter, Total Company Revenue increased 14.8% and Adjusted EBITDA increased 16.9%, resulting in margin improvement of 29 basis points. This performance was driven by strong aggregate and same center procedural growth, combined with a continued focus on driving operating and clinical efficiencies within the Imaging Center segment. These factors, amongst others, contributed to RadNet exceeding 2025 Revenue and Adjusted EBTIDA guidance levels in the Imaging Center segment, which had been amended upwards throughout the year.”
Dr. Berger continued, “During the fourth quarter, we continued to experience increasing demand for our services in virtually all core markets, and operations teams were focused on improving patient-throughput and driving capacity at existing centers. In particular, disproportionately higher demand for advanced imaging continues to benefit our procedure mix, evidenced by a 178 basis point increase in MR, CT and PET/CT as a percentage of our overall procedure volume when compared with the fourth quarter of last year. At the same time, during the fourth quarter and throughout 2025, significant investments were made to open new centers and complete tuck-in acquisitions within virtually all core RadNet markets. RadNet centers continue to implement DeepHealth technology solutions to drive efficiencies, lower costs and automate manual processes. This includes the comprehensive roll-out of TechliveTM, See-Mode and other clinical and workflow tools designed to increase productivity, create capacity and decrease exposure to the challenging labor market. In the coming quarters, as we continue to implement many of these solutions internally, we will have the opportunity to demonstrate the power of improved automation and more advanced clinical and operational capabilities, which we believe will lead to more favorable patient care and health outcomes, improved service levels to referring physicians, further alignment with health system partners and closer relationships with insurance plans and other payors.”
“Moving into 2026, RadNet is well-positioned to accelerate growth within Digital Health. With the addition of products resulting from this morning’s acquisition of Gleamer in Paris, France, the Digital Health division now includes what we believe to be the most comprehensive and broad collection of clinical AI solutions of any company worldwide. This will have broad implications for the performance of RadNet’s core Imaging Center business, the businesses of the over 2,700 current Digital Health customers and future customers throughout the diagnostic imaging industry. The diagnostic imaging industry will transform in the coming years as a result of an industry-wide adoption of the kind of AI-powered workflow and clinical tools that RadNet is acquiring, developing, utilizing and commercializing. We intend to continue to develop and bring-to-market solutions that address the critical challenges the industry faces, including labor shortages, capacity constraints and the inability of radiologists to keep pace with growing industry volumes, all in an effort to improve patient care and outcomes,” concluded Dr. Berger.
Financial Results
Fourth Quarter Report:
For the fourth quarter of 2025, RadNet reported Total Company Revenue of $547.7 million and Adjusted EBITDA of $87.7 million. Revenue increased $70.6 million (or 14.8%) and Adjusted EBITDA increased $12.7 million (or 16.9%) as compared with the fourth quarter of 2024.
For the fourth quarter of 2025, RadNet reported Digital Health Revenue of $27.9 million (inclusive of intersegment revenue) and Adjusted EBITDA of $4.9 million. Revenue increased $9.1 million (or 48.2%) and Adjusted EBITDA increased $0.4 million (or 8.9%) as compared with the fourth quarter of 2024.
There were a number of unusual or one-time items impacting the fourth quarter including: $531,000 in severance expense related to cost-savings initiatives; $233,000 impairment loss on lease abandonment; $788,000 expense related to leases for de novo facilities under construction that have yet to open their operations; $2.3 million of acquisition transaction costs; $6.5 million loss on sale and disposal of equipment; $6.3 million of non-capitalized research and development expenses related to the DeepHealth products; $679,000 of non-cash loss from interest rate swaps; and $5.7 million adjustment to the tax provision to normalize nonrecurring and prior year tax adjustments. Adjusting for the above items, Total Company Adjusted Earnings was $18.1 million and diluted Adjusted Earnings Per Share was $0.23 during the fourth quarter of 2025. This compares with Total Company Adjusted Earnings of $18.1 million and diluted Adjusted Earnings Per Share of $0.24 during the fourth quarter of 2024.
Unadjusted for unusual or one-time items impacting the fourth quarter, Total Company Net Loss for the fourth quarter of 2025 was $0.6 million as compared with a Total Company Net Income of $5.3 million for the fourth quarter of 2024. Fully diluted Net Loss Per Share for the fourth quarter of 2025 was $(0.01), compared with a fully diluted Net Income per share of $0.07 in the fourth quarter of 2024, based upon a weighted average number of diluted shares outstanding of 76.6 million shares in 2025 and 75.5 million shares in 2024.
For the fourth quarter of 2025, as compared with the prior year’s fourth quarter, MRI volume increased 15.8%, CT volume increased 10.3% and PET/CT volume increased 28.3%. Overall volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 7.0% over the prior year’s fourth quarter. On a same-center basis, including only those centers which were part of RadNet for both the fourth quarters of 2025 and 2024, MRI volume increased 11.4%, CT volume increased 6.3% and PET/CT volume increased 14.3%. Overall same-center volume, taking into account routine imaging exams, inclusive of x-ray, ultrasound, mammography and other exams, increased 4.5% over the prior year’s same quarter.
Annual Report:
For full-year 2025, RadNet reported Total Company Revenue of $2,040.2 million and Adjusted EBITDA of $300.2 million. Revenue increased $210.5 million (or 11.5%) and Adjusted EBITDA increased $20.8 million (or 7.4%) as compared with full-year 2024.
For full-year 2025, RadNet reported Digital Health Revenue (inclusive of intersegment revenue) of $92.7 million and Adjusted EBITDA of $15.5 million. Revenue increased $27.0 million (or 41.1%) and Adjusted EBITDA increased $0.3 million (or 1.9%) as compared with full-year 2024. At December 31, 2025, Annual Recurring Revenue (ARR) for the Digital Health was $75.4 million, representing 81.3% of 2025 Revenue.
Unadjusted for one-time or unusual items, Total Company Net Loss for 2025 was $18.7 million as compared with a Total Company Net Income of $2.8 million in 2024. Fully diluted Net Loss Per Share for 2025 was $(0.25), compared with a Net Income per share of $0.04 in 2024, based upon a weighted average number of diluted shares outstanding of 75.2 million shares in 2025 and 74.8 million shares in 2024.
Actual 2025 Results vs. 2025 Guidance
Imaging Center Segment
| Original Guidance Range | Revised Guidance Range After Q1 Results | Revised Guidance Range After Q2 Results | Revised Guidance Range After Q3 Results | Actual 2025 Results |
|---|
| Total Net Revenue | $1,825-$1,875mm | $1,835-$1,885mm | $1,850-$1,900mm | $1,900-$1,930mm | $1,988.2mm |
| Adjusted EBITDA | $265 - $273mm | $268 - $276mm | $271 - $279mm | $276 - $284mm | $284.7mm |
| Capital Expenditures | $140 - $150mm | $145 - $155mm | $152 - $162mm | $157 - $167mm | $170.5mm |
| Cash Interest Expense | $35 - $40mm | $35 - $40mm | $35 - $40mm | $31 - $36mm | $32.5mm |
| Free Cash Flow | $70 - $80mm | $70 - $80mm | $70 - $80mm | $70 - $80mm | $81.7mm |
- Includes approximately $16 million of Revenue as a result of the acquisition of Gleamer SAS announced this morning.
- Includes a loss of approximately $5 million of Adjusted EBITDA Before Non-Capitalized R&D as a result of the acquisition of Gleamer SAS announced this morning.
Digital Health Segment
| Original Guidance Range | Revised Guidance Range After Q2 Results | Revised Guidance Range After Q3 Results | Actual 2024 Results |
|---|
| Total Net Revenue (inclusive of intersegment revenue) | $80 - $90mm | $80 - $90mm | $85 - $95mm | $92.7mm |
| Adjusted EBITDA Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | $15 - $17mm | $15 - $17mm | $15 - $17mm | $15.5mm |
| Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | $16 - $18mm | $17 - $19mm | $18 - $20mm | $20.2mm |
| Capital Expenditures | $3 - $5mm | $2 - $4mm | $3 - $5mm | $2.0mm |
| Free Cash Flow Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | $11 - $13mm | $11 - $13mm | $10 - $12mm | $13.5mm |
| Free Cash Flow After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | $(5) - $(8)mm | $(5) - $(8)mm | $(5) - $(9)mm | $(6.7)mm |
- Excludes a $2.6 million purchase of software code and other intellectual property.
2026 Guidance
RadNet reports 2026 guidance ranges as follows:
Imaging Center Segment
| 2026 Guidance Range |
|---|
| Total Net Revenue | $2,325 - $2,375 |
| Adjusted EBITDA | $335 - $348 million |
| Capital Expenditures | $165 - $175 million |
| Cash Interest Expense | $45 - $50 million |
| Free Cash Flow | $105 - $115 million |
- Net of proceeds from the sale of equipment and New Jersey Imaging Network capital expenditures.
- Net of payments from counterparties on interest rate swaps and interest income earned from our cash balance recorded in Other Income.
Dr Berger added, “Within the Imaging Center segment, we expect 2026 performance to benefit from the contribution of continued increases in same-center performance, further tuck-in acquisitions, reimbursement efforts driving more favorable pricing and de novo center openings. As a result, our guidance implies 2026 Revenue to grow 17%-19%, Adjusted EBITDA to grow 18%-22% and Free Cash Flow to grow 29%-41% as compared with 2025 full year performance. We are anticipating this strong growth despite headwinds embedded in the guidance levels from projected increases in same-center labor costs as well as the recent impact of severe winter weather conditions experienced in January and February.”
Digital Health Segment
| 2026 Guidance Range |
|---|
| Total Net Revenue | $135 - $145 million |
| Adjusted EBITDA Before Non-Capitalized R&D | $10 - $12 million |
| Non-Capitalized R&D | $17 - $19 million |
| Capital Expenditures | $9 - $12 million |
| Free Cash Flow Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | $(1) - $3 million |
| Free Cash Flow After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | $(17) - $(19) million |
- Includes approximately $16 million of Revenue as a result of the acquisition of Gleamer SAS announced this morning.
- Includes a loss of approximately $5 million of Adjusted EBITDA Before Non-Capitalized R&D as a result of the acquisition of Gleamer SAS announced this morning.
“Within the Digital Health segment, 2026 growth will be driven by sales of the DeepHealth portfolio of AI-powered workflow and clinical solutions and related products such as TechLiveTM and further contribution from the acquisitions of iCAD, See-Mode, CIMAR and Gleamer. We are anticipating a minimum of four FDA clearances during 2026, further advancing our leadership in radiology clinical AI solutions in the areas of mammography, lung, prostate, thyroid, brain and, with this morning’s announced acquisition of Gleamer, the musculoskeletal system. In 2026, significant infrastructure investments will continue to be made in building sales, marketing and implementation teams to support future growth. Despite the continued focus it takes to invest in building the infrastructure of the business, 2026 Digital Health guidance implies growth of Revenue between 45% and 55% from 2025 full-year performance. We anticipate ARR at December 31, 2026 to approach or exceed $140 million. Furthermore, we expect that the proportion of Digital Health’s Revenue coming from RadNet’s Imaging Center segment will decline from approximately 45% in 2025 to about 33% in 2026,” concluded Dr. Berger.
Conference Call Today
Dr. Howard Berger, President and Chief Executive Officer, and Mark Stolper, Executive Vice President and Chief Financial Officer, will host a conference call today, March 2nd, at 10:30 a.m. Eastern Time. During the call, management will discuss the Company's 2025 fourth quarter and year-end results.
Conference Call Details:
Date: Monday, March 2, 2026
Time: 10:30 a.m. ET
Dial In-Number: 844-826-3035
International Dial-In Number: 412-317-5195
There will also be simultaneous and archived webcasts available at https://viavid.webcasts.com/starthere.jsp?ei=1753363&tp_key=503d78aa96 [viavid.webcasts.com] or http://www.radnet.com under the “About RadNet” menu section and “News & Press Releases” sub-menu of the website. An archived replay of the call will also be available and can be accessed by dialing 844-512-2921 from the U.S., or 412-317-6671 for international callers, and using the passcode 10206844.
About RadNet, Inc.
RadNet, Inc. is a leading national provider of freestanding, fixed-site diagnostic imaging services in the United States based on the number of locations and annual imaging revenue. RadNet has a network of owned and/or operated outpatient imaging centers. RadNet’s markets include Arizona, California, Delaware, Florida, Indiana, Maryland, New Jersey, New York and Texas. In addition, RadNet provides radiology information technology and artificial intelligence solutions marketed under the DeepHealth brand, teleradiology professional services and other related products and services to customers in the diagnostic imaging industry. Together with contracted radiologists, and inclusive of full-time and per diem employees and technologists, RadNet has over 11,000 team members. Learn more at www.radnet.com.
Forward Looking Statements
This press release contains “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements are expressions of our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, and anticipated future conditions, events and trends. Forward-looking statements can generally be identified by words such as: “anticipate,” “intend,” “plan,” “goal,” “seek,” “believe,” “project,” “estimate,” “expect,” “strategy,” “future,” “likely,” “may,” “should,” “will” and similar references to future periods. Forward-looking statements in this press release include statements about our anticipated business results, balance sheet and liquidity and our future liquidity, burn rate and our continuing ability to service or refinance our current indebtedness.
Forward-looking statements are neither historical facts nor assurances of future performance. Because forward-looking statements relate to the future, they are inherently subject to uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Therefore, you should not place undue reliance on any of these forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following:
- changes in general economic conditions nationally and regionally in the markets in which we operate, including their effects on the cost and availability of labor;
- our ability to service our indebtedness, make principal and interest payments as those payments become due and remain in compliance with applicable debt covenants, in addition to our ability to refinance such indebtedness on acceptable terms;
- the availability and terms of capital to fund the expansion of our business and improvements to our existing facilities;
- our ability to maintain our current credit rating and the impact on our funding costs and competitive position if we do not do so;
- volatility in interest and exchange rates, or credit markets;
- the adequacy of our cash flow and earnings to fund our current and future operations;
- changes in service mix, revenue mix and procedure volumes;
- delays in receiving payments for services provided;
- increased bankruptcies among our partner physicians or joint venture partners;
- the impact of the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the future of the Affordable Care Act;
- the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof by federal and state regulators or related litigation result in a reduction in coverage or reimbursement rates for our services, or other material impacts to our business;
- closures or slowdowns and changes in labor costs and labor difficulties, including stoppages affecting either our operations or our suppliers' abilities to deliver supplies needed in our facilities;
- the occurrence of hostilities, political instability or catastrophic events;
- the emergence or reemergence of and effects related to future pandemics, epidemics and infectious diseases; and
- noncompliance by us with any privacy or security laws or any cybersecurity incident or other security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information.
Any forward-looking statement contained in this current report is based on information currently available to us and speaks only as of the date on which it is made. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that we may make from time to time, whether as a result of changed circumstances, new information, future developments or otherwise, except as required by applicable law.
Regulation G: GAAP and Non-GAAP Financial Information
This release contains certain financial information not reported in accordance with GAAP. The Company uses both GAAP and non-GAAP metrics to measure its financial results. The Company believes that, in addition to GAAP metrics, these non-GAAP metrics assist the Company in measuring its cash-based performance. The Company believes this information is useful to investors and other interested parties because it removes unusual and nonrecurring charges that occur in the affected period and provides a basis for measuring the Company's financial condition against other quarters. Such information should not be considered as a substitute for any measures calculated in accordance with GAAP, and may not be comparable to other similarly titled measures of other companies. Non-GAAP financial measures should not be considered in isolation from, or as a substitute for, financial information prepared in accordance with GAAP. Reconciliation of this information to the most comparable GAAP measures is included in this release in the tables which follow.
CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS EXCEPT SHARE AND PER SHARE DATA)
| December 31, 2025 | December 31, 2024 |
|---|
| ASSETS | | |
| CURRENT ASSETS | | |
| Cash and Cash equivalents | $767,215 | $740,020 |
| Accounts receivable | 200,317 | 185,821 |
| Due from affiliates | 12,592 | 41,869 |
| Prepaid expenses and other current assets | 52,003 | 51,542 |
| Total current assets | 1,032,127 | 1,019,252 |
| PROPERTY, EQUIPMENT AND RIGHT-OF-USE ASSETS | | |
| Property and equipment, net | 807,702 | 694,791 |
| Operating lease right-of-use assets | 690,250 | 639,740 |
| Total property, plant, equipment and right-of-use assets | 1,497,952 | 1,334,531 |
| OTHER ASSETS | | |
| Goodwill | 907,663 | 710,663 |
| Other intangible assets | 148,508 | 81,351 |
| Deferred financing costs | 1,684 | 2,265 |
| Investment in joint ventures | 130,340 | 104,057 |
| Deposits and other | 40,289 | 34,571 |
| Total Assets | $3,758,563 | $3,286,690 |
| LIABILITIES AND EQUITY | | |
| CURRENT LIABILITIES | | |
| Accounts payable, accrued expenses and other | $422,029 | $351,464 |
| Due to affiliates | 70,104 | 43,650 |
| Deferred revenue | 7,272 | 3,288 |
| Current operating lease liability | 61,934 | 56,618 |
| Current portion of notes payable | 25,424 | 24,692 |
| Total current liabilities | 586,763 | 479,712 |
| LONG-TERM LIABILITIES | | |
| Long-term operating lease liability | 707,001 | 655,979 |
| Notes payable, net of current portion | 1,064,495 | 991,574 |
| Deferred tax liability, net | 21,903 | 22,230 |
| Other non-current liabilities | 22,515 | 3,785 |
| Total liabilities | 2,402,677 | 2,153,280 |
| EQUITY | | |
| RadNet, Inc. stockholders' equity: | | |
| Common stock - $0.0001 value, 200,000,000 shares authorized; 77,399,615 and 74,036,993 shares issued and outstanding at December 31, 2025 and December 31, 2024, respectively | 8 | 7 |
| Additional paid-in-capital | 1,180,434 | 988,147 |
| Accumulated other comprehensive loss | 4,885 | (9,061) |
| Accumulated deficit | (95,437) | (76,785) |
| Total RadNet, Inc.'s Stockholders' equity: | 1,089,890 | 902,308 |
| Noncontrolling interests | 265,996 | 231,102 |
| Total Equity | 1,355,886 | 1,133,410 |
| Total liabilities and equity | $3,758,563 | $3,286,690 |
CONSOLIDATED STATEMENT OF OPERATIONS
(IN THOUSANDS EXCEPT FOR SHARE AND PER SHARE DATA)
| Years Ended December 31, |
|---|
| 2025 | 2024 | 2023 |
|---|
| REVENUE | | | |
| Service fee revenue | $1,914,673 | $1,693,089 | $1,463,197 |
| Revenue under capitation arrangements | 125,537 | 136,575 | 153,433 |
| Total service revenue | 2,040,210 | 1,829,664 | 1,616,630 |
| OPERATING EXPENSES | | | |
| Cost of operations, excluding depreciation and amortization | 1,804,725 | 1,580,549 | 1,395,239 |
| Lease abandonment charges | 8,563 | 2,478 | 5,146 |
| Depreciation and amortization | 152,127 | 137,838 | 128,391 |
| Loss (gain) on sale and disposal of equipment and other | 9,658 | 2,276 | 2,187 |
| Loss (gain) on contribution of imaging centers into joint venture | - | - | (16,808) |
| Severance costs | 3,145 | 1,902 | 3,778 |
| Total operating expenses | 1,978,218 | 1,725,043 | 1,517,933 |
| INCOME (LOSS) FROM OPERATIONS | 61,992 | 104,621 | 98,697 |
| OTHER INCOME AND EXPENSES | | | |
| Interest expense | 69,913 | 79,849 | 64,483 |
| Equity in earnings of joint ventures | (14,876) | (14,472) | (6,427) |
| Non-cash change in fair value of interest rate hedge | 7,112 | 8,006 | 8,185 |
| Debt restructuring and extinguishment expenses | - | 11,292 | - |
| Other (income) expenses | (32,066) | (24,916) | (6,354) |
| Total other (income) expenses | 30,083 | 59,759 | 59,887 |
| INCOME (LOSS) BEFORE INCOME TAXES | 31,909 | 44,862 | 38,810 |
| Provision for income taxes | (14,862) | (6,026) | (8,473) |
| NET INCOME (LOSS) | 17,047 | 38,836 | 30,337 |
| Net income (loss) attributable to noncontrolling interests | 35,699 | 36,043 | 27,293 |
| NET INCOME (LOSS) ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $(18,652) | $2,793 | $3,044 |
| BASIC NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $(0.25) | $0.04 | $0.05 |
| DILUTED NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $(0.25) | $0.04 | $0.05 |
| WEIGHTED AVERAGE SHARES OUTSTANDING | | | |
| Basic | 75,189,872 | 73,037,237 | 63,580,059 |
| Diluted | 75,189,872 | 74,762,332 | 64,658,299 |
CONSOLIDATED STATEMENTS OF CASHFLOWS
(IN THOUSANDS)
(unaudited)
| Years Ended December 31, |
|---|
| 2025 | 2024 | 2023 |
|---|
| CASH FLOWS FROM OPERATING ACTIVITIES | | | |
| Net income | $17,047 | $38,836 | $30,337 |
| Adjustments to reconcile net income to net cash provided by operating activities: | | | |
| Depreciation and amortization | 152,127 | 137,838 | 128,391 |
| Noncash operating lease expense | 59,867 | 60,552 | 61,102 |
| Equity in earnings of joint ventures, net of dividends | (5,803) | (9,926) | 9,176 |
| Amortization of deferred financing costs and loan discount | 3,014 | 3,093 | 2,987 |
| Loss on sale and disposal of equipment | 9,658 | 2,276 | 2,187 |
| Loss on extinguishment of debt | - | 3,903 | - |
| Gain on contribution of imaging centers into joint venture | - | - | (16,808) |
| Lease abandonment charges | 8,563 | 2,478 | 5,146 |
| Amortization of cash flow hedge | 2,273 | 9,352 | 3,576 |
| Non-cash change in fair value of interest rate swap | 7,112 | 8,006 | 8,185 |
| Stock-based compensation | 54,601 | 29,833 | 26,785 |
| Loss on impairment | - | 1,275 | 3,949 |
| Change in fair value of contingent consideration | 111 | 1,995 | (3,880) |
| Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions: | | | |
| Accounts receivable | (9,560) | (21,767) | 2,650 |
| Other current assets | 2,279 | (32,790) | (8,441) |
| Other assets | (5,710) | 10,723 | (1,484) |
| Deferred taxes | 10,828 | 6,454 | 6,056 |
| Operating leases | (62,816) | (54,866) | (54,763) |
| Deferred revenue | 2,813 | (1,359) | 626 |
| Accounts payable, accrued expenses and other | 52,416 | 37,117 | 15,086 |
| Net cash provided by operating activities | 298,820 | 233,023 | 220,863 |
| CASH FLOWS FROM INVESTING ACTIVITIES | | | |
| Purchase of imaging facilities and other acquisitions, net of cash acquired | (133,422) | (43,661) | (10,918) |
| Purchase of property and equipment and other | (213,251) | (188,070) | (176,600) |
| Proceeds from sale of equipment | 1,288 | 157 | 83 |
| Equity contributions in existing and purchase of interest in joint ventures | (4,147) | (1,496) | (14,035) |
| Collection of notes receivable | 5,667 | - | |
| Net cash used in investing activities | (343,865) | (233,070) | (201,470) |
| CASH FLOWS FROM FINANCING ACTIVITIES | | | |
| Principal payments on notes and leases payable | (7,025) | (5,989) | (2,930) |
| Payments on Term Loan Debt | (20,756) | (692,437) | (41,063) |
| Proceeds from issuance of new debt, net of issuing costs | 99,001 | 863,757 | - |
| Purchase of noncontrolling interests by third party | 2,389 | 22,357 | 5,121 |
| Payments on contingent consideration and holdbacks | (2,249) | (4,268) | (5,495) |
| Distributions paid to noncontrolling interests | (4,602) | (4,522) | (5,972) |
| Proceeds from issuance of common stock | - | 218,385 | 245,832 |
| Proceeds from issuance of common stock upon exercise of options | 5,449 | 667 | 142 |
| Net cash provided by financing activities | 72,207 | 397,950 | 195,635 |
| EFFECT OF EXCHANGE RATE CHANGES ON CASH | 33 | (453) | (292) |
| NET INCREASE IN CASH AND CASH EQUIVALENTS | 27,195 | 397,450 | 214,736 |
| CASH AND CASH EQUIVALENTS, beginning of period | 740,020 | 342,570 | 127,834 |
| CASH AND CASH EQUIVALENTS, end of period | 767,215 | 740,020 | 342,570 |
| SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION | | | |
| Cash paid during the period for interest | $72,266 | $84,601 | $64,695 |
| Cash paid during the period for income taxes | $4,636 | $4,170 | $1,587 |
CONSOLIDATED STATEMENT OF OPERATIONS
(IN THOUSANDS EXCEPT FOR SHARE AND PER SHARE DATA)
| Three Months Ended December 31, |
|---|
| 2025 | 2024 |
|---|
| REVENUE | | |
| Service fee revenue | $515,835 | $445,576 |
| Revenue under capitation arrangements | 31,877 | 31,525 |
| Total service revenue | 547,712 | 477,101 |
| OPERATING EXPENSES | | |
| Cost of operations, excluding depreciation and amortization | 471,781 | 411,436 |
| Lease abandonment charges | 233 | 2,478 |
| Depreciation and amortization | 40,852 | 36,016 |
| Loss (gain) on sale and disposal of equipment and other | 6,490 | 1,541 |
| Loss (gain) on contribution of imaging centers into joint venture | - | - |
| Severance costs | 531 | 1,105 |
| Total operating expenses | 519,887 | 452,576 |
| INCOME (LOSS) FROM OPERATIONS | 27,825 | 24,525 |
| OTHER INCOME AND EXPENSES | | |
| Interest expense | 18,130 | 18,073 |
| Equity in earnings of joint ventures | (4,354) | (3,164) |
| Non-cash change in fair value of interest rate hedge | 679 | 577 |
| Debt restructuring and extinguishment expenses | - | 2,383 |
| Other (income) expenses | (7,546) | (8,668) |
| Total other (income) expenses | 6,909 | 9,201 |
| INCOME (LOSS) BEFORE INCOME TAXES | 20,916 | 15,324 |
| Provision for income taxes | (11,055) | (1,099) |
| NET INCOME (LOSS) | 9,861 | 14,225 |
| Net income (loss) attributable to noncontrolling interests | 10,458 | 8,880 |
| NET INCOME (LOSS) ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $(597) | $5,345 |
| BASIC NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $(0.01) | $0.07 |
| DILUTED NET INCOME (LOSS) PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $(0.01) | $0.07 |
| WEIGHTED AVERAGE SHARES OUTSTANDING | | |
| Basic | 76,632,479 | 73,574,262 |
| Diluted | 76,632,479 | 75,537,595 |
RECONCILIATION OF GAAP NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON SHAREHOLDERS TO ADJUSTED EBITDA
(IN THOUSANDS)
| Three Months Ended December 31, | Years Ended December 31, |
|---|
| 2025 | 2024 | 2025 | 2024 |
|---|
| Net income (loss) attributable to Radnet, Inc. common stockholders | $(597) | $5,345 | $(18,652) | $2,793 |
| Income taxes | 11,055 | 1,099 | 14,862 | 6,026 |
| Interest expense | 18,130 | 18,073 | 69,913 | 79,849 |
| Severance costs | 531 | 1,105 | 3,145 | 1,902 |
| Depreciation and amortization | 40,852 | 36,016 | 152,127 | 137,838 |
| Non-cash employee stock-based compensation | 8,325 | 8,464 | 54,601 | 29,833 |
| Loss (gain) on sale and disposal of equipment and other | 6,490 | 1,541 | 9,658 | 2,276 |
| Non-cash change in fair value of interest rate hedge | 679 | 577 | 7,112 | 8,006 |
| Other expenses (income) | (7,546) | (8,668) | (32,066) | (24,916) |
| Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | 6,320 | 5,018 | 20,155 | 14,995 |
| Lease abandonment charges | 233 | 2,478 | 8,563 | 2,478 |
| Loss (gain) on extinguishment of debt and related expenses | - | 2,383 | - | 11,292 |
| Non-cash change to contingent consideration | 110 | - | 110 | 1,974 |
| Non-operational rent expenses | 788 | 1,114 | 3,247 | 4,233 |
| Acquisition transaction costs | 2,337 | 463 | 7,446 | 880 |
| Adjusted EBITDA - Radnet, Inc. | $87,707 | $75,008 | $300,221 | $279,459 |
| NOTE | | | | |
| Adjusted EBITDA - Imaging Center Segment | 82,762 | 70,468 | 284,710 | 264,901 |
| Adjusted EBITDA - Digital Health Segment | 4,945 | 4,540 | 15,511 | 14,558 |
SCHEDULE OF ADJUSTED EARNINGS AND EARNINGS PER SHARE
(IN THOUSANDS EXCEPT SHARE DATA)
(unaudited)
| Three Months Ended |
|---|
| December 31, |
|---|
| 2025 | 2024 |
|---|
| NET (LOSS) INCOME ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $(597) | $5,345 |
| Add severance costs | 531 | 1,105 |
| Add loss on lease abandonment/impairment | 233 | 2,478 |
| Add non-operational rent expenses (i) | 788 | 1,114 |
| Add acquisition transaction costs | 2,337 | 462 |
| Add loss on sale and disposal of equipment and other | 6,490 | 1,541 |
| Add loss on extinguishment of debt and related expenses | - | 2,383 |
| Add valuation adjustment for contingent consideration | 110 | - |
| Add Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI | 6,320 | 5,018 |
| Add/Subtract non-cash change in fair value of swap valuation (ii) | 679 | 577 |
| Total adjustments - loss (gain) | 17,488 | 14,678 |
| Subtract tax impact of Adjustments (iii) | 4,491 | 1,973 |
| Add Adjustment to Tax Provision (v) | 5,684 | - |
| TOTAL ADJUSTMENT TO NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON SHAREHOLDERS | 18,681 | 12,705 |
| ADJUSTED NET INCOME ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | 18,084 | 18,050 |
| WEIGHTED AVERAGE SHARES OUTSTANDING | | |
| Diluted | 78,185,168 | 75,537,595 |
| ADJUSTED DILUTED NET INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC. COMMON STOCKHOLDERS | $0.23 | $0.24 |
- Represents rent expense associated with de novo sites under construction prior to them becoming operational.
- mpact from the change in fair value of the swaps during the quarter. Excludes the amortization of the accumulation of the changes in fair value out of Other Comprehensive Income that existed prior to the hedges becoming ineffective.
- Tax effected using 25.68% and 13.44% blended federal and state effective tax rate for 2025 and 2024, respectively.
Tax effected using 25.68% and 13.44% blended federal and state effective tax rate for 2025 and 2024, respectively. Effective tax rate of 46.47% adjusted/normalized for nonrecurring and prior year tax return adjustments including nondeductible Executive Compensation as a result of an option exercise, prior year tax return adjustment, nondeductible transaction costs and a state tax valuation adjustment.
- Adjusted from what was reported during last year's fourth quarter for an additional addback of $1,541,000 Loss on the Sale and Disposal of Equipment and Other.
- Addback in Q4 2025 to normalize the tax provision to 25.68% from 52.85% to adjust for items listed in (iii) above.
PAYMENTS BY PAYOR CLASS
| Fourth Quarter |
|---|
| 2025 |
|---|
| Commercial Insurance | 57.1% |
| Medicare | 26.6% |
| Capitation | 5.8% |
| Medicaid | 2.6% |
| Workers Compensation/Personal Injury | 2.2% |
| Other* | 8.6% |
| Total | 100.0% |
* Includes management fee and Digital Health financial reporting unit revenue.
RADNET PAYMENTS BY MODALITY
| Fourth Quarter | Full Year | Full Year | Full Year |
|---|
| 2025 | 2025 | 2024 | 2023 |
|---|
| MRI | 38.2% | 37.7% | 37.1% | 36.8% |
| CT | 15.4% | 15.6% | 15.9% | 16.8% |
| PET/CT | 9.2% | 8.8% | 7.2% | 6.4% |
| X-ray | 5.1% | 5.5% | 6.0% | 6.5% |
| Ultrasound | 13.3% | 13.5% | 13.6% | 12.9% |
| Mammography | 15.5% | 15.6% | 16.4% | 16.0% |
| Nuclear Medicine | 0.8% | 0.9% | 1.0% | 0.8% |
| Other | 2.5% | 2.5% | 2.7% | 3.9% |
| 100.0% | 100.0% | 100.0% | 100.0% |
PROCEDURES BY MODALITY*
| Fourth Quarter | Fourth Quarter |
|---|
| 2025 | 2024 |
|---|
| MRI | 523,405 | 452,063 |
| CT | 299,041 | 271,061 |
| PET/CT | 25,142 | 19,602 |
| Nuclear Medicine | 9,036 | 9,054 |
| Ultrasound | 721,432 | 655,531 |
| Mammography | 526,341 | 517,013 |
| X-ray and Other | 861,254 | 847,429 |
| Total | 2,965,651 | 2,771,753 |
* Volumes include wholly owned and joint venture centers.
Footnotes
The Company defines Adjusted EBITDA as earnings before interest, taxes, depreciation and amortization, each from continuing operations and excludes losses or gains on the disposal of equipment, other income or loss, loss on debt extinguishments, bargain purchase gains and non-cash equity compensation. Adjusted EBITDA includes equity earnings in unconsolidated operations and subtracts allocations of earnings to non-controlling interests in subsidiaries, and is adjusted for non-cash and extraordinary events which took place during the period.
Adjusted EBITDA is reconciled to its nearest comparable GAAP financial measure. Adjusted EBITDA is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance, and is a measure of leverage capacity and ability to service debt. Adjusted EBITDA should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.
As noted above, the Company defines Free Cash Flow as Adjusted EBITDA less total Capital Expenditures (whether completed with cash or financed) and Cash Interest paid. Free Cash Flow is a non-GAAP financial measure. The Company uses Free Cash Flow because the Company believes it provides useful information for investors and management because it measures our capacity to generate cash from our operating activities. Free Cash Flow does not represent total cash flow since it does not include the cash flows generated by or used in financing activities. In addition, our definition of Free Cash Flow may differ from definitions used by other companies.
Free Cash Flow should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted EBITDA should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted EBITDA is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.
The Company defines Adjusted Earnings Per Share as net income or loss attributable to RadNet, Inc. common stockholders and excludes losses or gains on the disposal of equipment, loss on debt extinguishments, bargain purchase gains, severance costs, loss on impairment, loss or gain on swap valuation, gain on extinguishment of debt, unusual or non-recurring entries that impact the Company’s tax provision, pre-tax loss or gain from AI segment and any other non-recurring or unusual transactions recorded during the period.
Adjusted Earnings Per Share is reconciled to its nearest comparable GAAP financial measure (see table on prior page). Adjusted Earnings Per Share is a non-GAAP financial measure used as analytical indicator by RadNet management and the healthcare industry to assess business performance. Adjusted Earnings Per Share should not be considered a measure of financial performance under GAAP, and the items excluded from Adjusted Earnings Per Share should not be considered in isolation or as alternatives to net income, cash flows generated by operating, investing or financing activities or other financial statement data presented in the consolidated financial statements as an indicator of financial performance or liquidity. As Adjusted Earnings Per Share is not a measurement determined in accordance with GAAP and is therefore susceptible to varying methods of calculation, this metric, as presented, may not be comparable to other similarly titled measures of other companies.
The Company defines Annual Recurring Revenue (ARR) as a key subscription economy metric representing the predictable, normalized annualized value of contracted recurring revenue generated from customers from active customer contracts. ARR includes subscription fees, recurring support fees, and contracted usage charges and excludes one-time, non-recurring fees such as, implementation, hardware sales, professional services, consulting and one-off training. ARR is a non-GAAP measure and does not represent GAAP revenue recognized over time.
Contacts
RadNet, Inc.
Mark Stolper, 310-445-2800
Executive Vice President and Chief Financial Officer