Revenue growth is positive but decelerating (8% vs 86% in Q4 2025) and gross margin compression signals mix headwinds. Cash burn remains heavy despite OpEx cuts. Maintain full-year guidance provides some stability, but the declining cash balance ($19M) and negative operating cash flow suggest a capital raise may be needed within 2-3 quarters. Watch for Q2 revenue trajectory and any financing announcements.
Price Chart
Executive Summary
Neuronetics reported Q1 2026 revenue of $34.5M (+8% YoY) and a net loss of $(0.16)/share, slightly beating the $(0.17) consensus. Revenue growth was driven by 15% clinic revenue growth, but treatment session revenue declined 5% and gross margin contracted to 46.9% from 49.2%. The company maintained full-year 2026 guidance of $160M-$166M revenue, but cash burn remains significant with $19M total cash on hand. The prior restructuring (CEO transition, debt paydown) provides context but does not offset the mixed operating trends.
Key Financial Metrics
Key Facts
- Q1 2026 revenue $34.5M, up 8% YoY from $32.0M
- Net loss $(10.8)M or $(0.16)/share vs $(12.7)M or $(0.21)/share in Q1 2025
- EPS of $(0.16) beat consensus of $(0.17) by ~5.9%
- Gross margin declined to 46.9% from 49.2% YoY due to mix shift
- U.S. clinic revenue grew 15% to $21.5M; treatment session revenue fell 5% to $9.1M
- Operating expenses decreased 6% to $25.1M from $26.8M
- Total cash dropped to $19.0M from $34.1M at Dec 2025, after $5M debt prepayment
- Full-year 2026 guidance maintained: revenue $160M-$166M, gross margin 47%-49%, operating cash flow $(13)M-$(17)M
- Prior restructuring (CEO change, debt amendment, consulting agreement) filed 29 days ago
Financial Impact
Revenue beat consensus by ~$0.3M; EPS beat by $0.01. Cash burn of $9.4M in Q1 leaves $19M total cash, implying ~2 quarters of runway at current burn rate without additional financing.
Risk Factors
- Cash burn: $9.4M operating cash outflow in Q1, leaving only $19M total cash
- Gross margin compression: 46.9% vs 49.2% YoY, guided 47%-49% for FY2026
- Treatment session revenue declining 5% YoY signals core NeuroStar utilization weakness
- High debt load: $61.3M net long-term debt vs $13.3M equity
- Restructuring context (CEO departure, debt amendment) suggests ongoing operational challenges
Market Snapshot
Investment Themes
Documents Analyzed
This report is based on 7 SEC documents filed with EDGAR.
| Document | Accession Number |
|---|---|
| 8-K Filing (Primary) | 0001193125-26-205117 |
| Document: d139145d8k.htm | 0001193125-26-205117 |
| Document: d139145dex992.htm | 0001193125-26-205117 |
| Document: 0001193125-26-205117-index-headers.html | 0001193125-26-205117 |
| Document: 0001193125-26-205117-index.html | 0001193125-26-205117 |
| Document: 0001193125-26-205117.txt | 0001193125-26-205117 |
| 8-K Data (Synthetic) | 0001193125-26-205117 |
Filters
| Type | Now | ||||
|---|---|---|---|---|---|
Aug 11, 2026 10w ago | 8-K | $3.19 $3.21 | ▲ +0.63% | ▲ +0.38% | $2.24 (−29.78%) |
Aug 11, 2026 10w ago | Press Release | $3.19 $3.21 | ▲ +0.63% | ▲ +0.38% | $2.24 (−29.78%) |
Jun 23, 2026 17w ago | 8-K | $1.26 $1.27 | ▲ +0.79% | ▲ +0.65% | $2.24 (+77.78%) |
May 22, 2026 22w ago | 8-K | $1.20 $1.22 | ▲ +1.67% | ▲ +1.08% | $2.24 (+86.67%) |
May 5, 2026 24w ago | 8-K | $2.17 $1.91 | ▼ −11.98% | ▼ −13.37% | $2.24 (+3.23%) |
May 5, 2026 24w ago | Press Release | $2.17 $1.91 | ▼ −11.98% | ▼ −13.37% | $2.24 (+3.23%) |
Apr 21, 2026 26w ago | Press Release | $1.50 $1.59 | ▲ +6.00% | ▲ +4.98% | $2.24 (+49.33%) |
Apr 13, 2026 28w ago | EFFECT | $1.39 $1.43 | ▼ −2.88% | ▼ −1.67% | $2.24 (−61.15%) |
Mar 19, 2026 31w ago | Insider Cluster | $1.52 $1.45 | ▼ −4.29% | ▼ −2.55% | $2.24 (+47.85%) |
Mar 19, 2026 31w ago | Insider Cluster | $1.52 $1.45 | ▼ −4.29% | ▼ −2.55% | $2.24 (+47.85%) |
US Market Status
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