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Tempus AI, Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 24 February 2026: press release. Guidance figures: 2 new. The quarter’s numbers.

Key takeaways

  • Fourth-quarter revenue up 83%: Fourth-quarter revenue was $367.2 million, up 83.0% year over year, with organic growth of 33.5% excluding Ambry. Source
  • Fourth-quarter Adjusted EBITDA improved: Fourth-quarter Adjusted EBITDA was $12.9 million, compared with a loss of $7.8 million a year earlier and $1.5 million in the third quarter. Source
  • Fourth-quarter Diagnostics revenue up 122%: Fourth-quarter Diagnostics revenue was $266.9 million, up 121.6%, with Oncology and Hereditary volume growth of 29% and 23%. Source
  • Fourth-quarter data revenue up 25%: Fourth-quarter Data and Applications revenue was $100.4 million, up 25.1%. Insights rose 69.5% excluding the AstraZeneca warrant effect. Source
  • Fourth-quarter net loss from stock pay: Fourth-quarter net loss was $54.2 million, including $48.7 million of stock compensation expense and related employer payroll taxes. Source
  • Cash and marketable securities: Cash and marketable securities totaled $759.7 million at December 31, 2025. Source

“In 2025, Tempus continued to set the standard for what it means to be a technology company operating in the healthcare space,”

Eric Lefkofsky, Founder and CEO

Guidance

AreaPeriodFigureAgainst last quarter
Revenue Sourcefull year 2026approximately $1.59 billion, about 25% annual growthNew
Adjusted EBITDA Sourcefull year 2026approximately $65 millionNew

What changed from last quarter

  • New guidance: 2026 full-year revenue guidance appears in this release. The January preliminary release did not include any 2026 guidance. Source
  • New guidance: 2026 Adjusted EBITDA guidance appears in this release for the first time, per the documents provided. Source
  • New: Paige Predict, a digital pathology suite, was launched and is listed as a recent operational highlight. Source
  • New: A multi-year strategic collaboration with NYU Langone Health was entered into. Source
  • New: Northwestern Medicine selected Tempus to expand its genomic testing across the health system. Source

Fourth quarter and full-year results

  • Fourth-quarter revenue up 83%: Fourth-quarter revenue was $367.2 million, up 83.0% year over year, with organic growth of 33.5% excluding Ambry. Source
  • Full-year revenue up 83.4%: Full-year revenue was $1.3 billion, up 83.4% from 2024. Source
  • Full-year gross profit up 109.4%: Full-year gross profit was $797.9 million, up 109.4% from a year earlier. Source
  • Fourth-quarter Adjusted EBITDA improved: Fourth-quarter Adjusted EBITDA was $12.9 million, compared with a loss of $7.8 million a year earlier and $1.5 million in the third quarter. Source
  • Full-year Adjusted EBITDA loss narrowed: Full-year Adjusted EBITDA was a loss of $7.4 million, a $97.3 million improvement, after the Paige AI and OneOme acquisitions. Source
  • January estimates replaced by final results: The January release gave preliminary, unaudited estimates. The February release reports the complete year-end results.

Diagnostics volumes and growth

  • Fourth-quarter Diagnostics revenue up 122%: Fourth-quarter Diagnostics revenue was $266.9 million, up 121.6%, with Oncology and Hereditary volume growth of 29% and 23%. Source
  • Full-year Diagnostics revenue up 111.5%: Diagnostics revenue for 2025 was $955.4 million, up 111.5%, with Oncology volume up 26% and Hereditary volume up 29%. Source
  • MRD volume grew sequentially: MRD volume was about 4,700 tests in the fourth quarter, up 56% from the third quarter. Source
  • Oncology volume growth accelerated again: Management said Oncology volume growth accelerated for a third consecutive quarter, to the highest unit growth rate in years.

“The strength of our unit growth in diagnostics along with the accelerating growth of our data business is proof that we are unique in this space.”

Eric Lefkofsky, Founder and CEO

Data and Applications

  • Fourth-quarter data revenue up 25%: Fourth-quarter Data and Applications revenue was $100.4 million, up 25.1%. Insights rose 69.5% excluding the AstraZeneca warrant effect. Source
  • Full-year data growth accelerated: Data and Applications revenue for 2025 was $316.4 million, up 30.9%, with Insights growing 38.0% for the year. Source
  • Record quarterly data revenue: The January release called fourth-quarter Data and Applications revenue a record, at about $100 million.

Partners, products and science

  • Paige Predict digital pathology suite: Paige Predict analyzes standard H&E slides to predict biomarkers, helping clinicians decide on testing when tissue samples are limited. Source
  • Immune Profile Score study reported: The study reported the Immune Profile Score predicts immunotherapy outcomes better than conventional biomarkers, identifying 13% of colorectal and 17% of rare cancer patients as potential responders. Source
  • NYU Langone multi-year collaboration: Tempus entered a multi-year collaboration with NYU Langone Health on a prospective study tracking cancer evolution and treatment resistance. Source
  • Northwestern Medicine selection: Northwestern Medicine selected Tempus to expand genomic testing access for oncology patients across its health system. Source

“As the network effects from our investments in AI continue to compound, we expect to not only drive significant growth over the next several years, but to also enhance the lives of millions of patients around the world.”

Eric Lefkofsky, Founder and CEO

Costs, margins and net loss

  • Fourth-quarter net loss from stock pay: Fourth-quarter net loss was $54.2 million, including $48.7 million of stock compensation expense and related employer payroll taxes. Source
  • Full-year net loss and stock pay: Full-year net loss was $245.0 million, including $136.3 million of stock compensation expense and related employer payroll taxes. Source
  • Diagnostics gross margin rose: Diagnostics gross margin was 61.4% in the fourth quarter, up from 48.4% a year earlier. Full-year Diagnostics gross margin was 59.6%. Source
  • Data gross margin declined: Data and Applications gross margin was 73.5% in the fourth quarter, down from 79.5%. Full-year gross margin was 72.3%. Source
  • Non-GAAP operating expenses increased: Non-GAAP operating expenses were $236.5 million in the fourth quarter and $855.0 million for 2025, against $139.8 million and $544.8 million a year earlier. Source

Cash, debt and capital

  • Cash and marketable securities: Cash and marketable securities totaled $759.7 million at December 31, 2025. Source
  • Operating cash use rose: Net cash used in operating activities was $218.1 million for 2025, against $189.0 million in 2024. Source
  • Convertible notes provided funding: Convertible senior notes provided $726.5 million of net proceeds in 2025. Convertible senior notes, net, were $728.1 million at year end. Source
  • At-the-market stock sales: Common stock sold under an at-the-market offering netted $195.5 million in 2025. Source

Acquisitions and intangible assets

  • Business combinations used cash: Business combinations used $376.7 million of cash, net of cash acquired, in 2025, with no comparable amount in 2024. Source
  • Goodwill and intangibles increased: Goodwill rose to $470.2 million and intangible assets, net, to $355.3 million at year end, from $73.3 million and $11.7 million. Source
  • Acquisition amortization expense added: Amortization of intangibles due to acquisition was $61.5 million for 2025, compared with none in 2024. Source

Figures management reported

FigureReported
Net Revenue Retention Source126%
Total Remaining Contract Value Sourceover $1.1 billion

Earlier plans management reported on

  • Ahead: Management said both product lines exceeded its initial expectations for 2025.
  • Not stated: Management planned to report complete fourth-quarter and full-year 2025 results on its February 2026 earnings call.

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.