EX-99.1 2 d139145dex991.htm EX-99.1 EX-99.1

Exhibit 99.1

 

LOGO

Neuronetics Reports First Quarter 2026 Financial and Operating Results

MALVERN, PA., May 5, 2026 – Neuronetics, Inc. (NASDAQ: STIM) (the “Company” or “Neuronetics”), a vertically integrated, commercial stage, medical technology and healthcare company with a strategic vision of transforming the lives of patients whenever and wherever they need help, with the leading neurohealth therapies in the world, today announced its financial and operating results for the first quarter of 2026.

First Quarter 2026 Highlights

 

   

First quarter 2026 revenue of $34.5 million, up 8% compared to the first quarter 2025

 

   

U.S. clinic revenue of $21.5 million, up 15% compared to the first quarter 2025

 

   

Shipped 34 NeuroStar systems in the US; a 10% increase compared to the first quarter 2025

 

   

Net cash used in operations of $9.4 million, a reduction of $7.6 million compared to $17.0 million in the first quarter 2025

Recent Operational Highlights

 

   

Optum/UHC/UBH expanded its TMS clinical policy to allow nurse practitioners to order, supervise, and administer NeuroStar Advanced Therapy

“I’m encouraged by our first quarter performance, which reflects the team’s continued execution on revenue growth, operational efficiency, and cash management. Our clinic business delivered double-digit growth, we reduced operating expenses, and we meaningfully improved our operating cash flow versus the first quarter of last year,” said Dan Reuvers, President and Chief Executive Officer of Neuronetics. “Looking ahead, I believe there is significant value in this business that has yet to be fully realized. We have the leading technology in TMS, a national clinic platform with real growth runway, and a team that is driving operational execution. Our team is focused on delivering better outcomes for our customers and patients, as well as long term value for our shareholders.”

First Quarter 2026 Financial and Operating Results for the Three Months Ended March 31, 2026

 

     Revenues by Geography
Three Months Ended March 31,
        
     2026      2025         
     Amount      Amount      % Change  
     (Unaudited; in thousands, except percentages)  

U.S.

   $ 34,226      $ 31,483        9

International

     228        492        (54 )% 
  

 

 

    

 

 

    

 

 

 

Total revenues

   $ 34,454      $ 31,975        8
  

 

 

    

 

 

    

 

 

 

Total revenue for the three months ended March 31, 2026 was $34.5 million, an increase of $2.5 million, or 8%, compared to the three months ended March 31, 2025 revenue of $32.0 million. The increase in revenue was primarily driven by higher U.S. clinic revenue, which increased to $21.5 million in the first quarter of 2026 from $18.7 million in the first quarter of 2025, reflecting strong growth since the Greenbrook acquisition and continued expansion of SPRAVATO®, including the buy and bill model.


    

U.S. Revenues by Product Category

Three Months Ended March 31,

        
     2026      2025         
     Amount      Amount      % Change  
     (Unaudited; in thousands, except percentages)  

NeuroStar Advanced Therapy System

   $ 3,203      $ 2,846        13

Treatment sessions

     9,122        9,612        (5 )% 

Clinic revenue

     21,529        18,659        15

Other

     372        366        2
  

 

 

    

 

 

    

 

 

 

Total U.S. revenues

   $ 34,226      $ 31,483        9
  

 

 

    

 

 

    

 

 

 

U.S. NeuroStar Advanced Therapy System revenue for the three months ended March 31, 2026 was $3.2 million, an increase of 13% compared to $2.8 million in the first quarter of 2025. For the three months ended March 31, 2026, the Company shipped 34 systems.

U.S. treatment session revenue was $9.1 million for the three months ended March 31, 2026, a decrease from $9.6 million for the three months ended March 31, 2025.

U.S. clinic revenue was $21.5 million for the three months ended March 31, 2026, compared to $18.7 million for the three months ended March 31, 2025, representing an increase of 15%.

Gross margin for the first quarter of 2026 was 46.9% compared to the first quarter of 2025 gross margin of 49.2%. The decrease in gross margin was primarily a result of mix.

Operating expenses during the first quarter of 2026 were $25.1 million, a decrease of $1.6 million, or 6%, compared to $26.8 million in the first quarter of 2025, mainly attributable to savings in general, administrative, sales and marketing expenses.

Net loss for the first quarter of 2026 was $(10.8) million, or $(0.16) per share, as compared to $(12.7) million, or $(0.21) per share, in the first quarter of 2025. Net loss per share was based on 69,589,144 and 61,464,725 weighted average common shares outstanding for the first quarters of 2026 and 2025, respectively.

As of March 31, 2026, the Company held $19.0 million in total cash, consisting of cash and cash equivalents of $13.2 million and $5.8 million of restricted cash, which is compared to $34.1 million as of December 31, 2025. As previously announced, the Company made a one-time principal payment of $5.0 million in March to reduce its debt obligation and ongoing interest expense.

Optum/UHC/UBH expanded its TMS clinical policy to allow Nurse Practitioners to order, supervise, and administer NeuroStar Advanced Therapy

Optum/United Healthcare/United Behavioral Health (“Optum/UHC/UBH”) has expanded its transcranial magnetic stimulation (“TMS”) clinical policy to allow psychiatric mental health nurse practitioners (“PMHNPs”) to order, supervise, and administer NeuroStar Advanced Therapy, significantly broadening access to this non-drug, non-invasive treatment for major depressive disorder (“MDD”). Previously limited to psychiatrists, the updated policy applies to PMHNPs practicing in states with full practice authority and extends access across 26 states and Washington, D.C., reaching approximately 34.8 million covered lives. This milestone policy change is expected to enhance patient access—particularly in underserved communities—by enabling more qualified providers to deliver NeuroStar TMS Therapy, a clinically proven option for patients who have not achieved adequate relief from antidepressant medications.

Business Outlook

For the second quarter of 2026, the Company expects total revenue growth in the mid-single digits.


For the full year 2026, Neuronetics continues to expect:

 

   

Total revenue between $160 million and $166 million;

 

   

Gross margin between 47% and 49%;

 

   

Operating expenses between $100 million and $105 million, inclusive of approximately $8.5 million of non-cash stock-based compensation;

 

   

Cash flow from operations between negative $13 million and negative $17 million;

Webcast and Conference Call Information

The conference call will be broadcast live in listen-only mode via webcast at https://edge.media-server.com/mmc/p/3pztkve5. To listen to the conference call on your telephone, you may register for the call here. While it is not required, it is recommended you join 10 minutes prior to the event start.

About Neuronetics

Neuronetics, Inc. believes that mental health is as important as physical health. As a global leader in neuroscience, Neuronetics is delivering more treatment options to patients and physicians by offering exceptional in-office treatments that produce extraordinary results. NeuroStar Advanced Therapy is a non-drug, noninvasive treatment that can improve the quality of life for people suffering from neurohealth conditions when traditional medication has not helped. In addition to selling the NeuroStar Advanced Therapy System and associated treatment sessions to customers, Neuronetics operates Greenbrook TMS Inc. (“Greenbrook”) treatment centers across the United States, offering NeuroStar Advanced Therapy for the treatment of MDD and other mental health disorders. NeuroStar Advanced Therapy is the leading TMS treatment for MDD in adults and is backed by what we believe is the largest clinical data set of any TMS treatment system for depression. Greenbrook treatment centers also offer SPRAVATO® (esketamine) Nasal Spray, a prescription medicine indicated for the treatment of treatment-resistant depression (“TRD”) in adults as monotherapy or in conjunction with an oral antidepressant. It is also indicated for depressive symptoms in adults with MDD with acute suicidal ideation or behavior in conjunction with an oral antidepressant.1

The NeuroStar Advanced Therapy System is cleared by the U.S. Food and Drug Administration for adults with MDD, as an adjunct for adults with obsessive-compulsive disorder, to decrease anxiety symptoms in adult patients with MDD that may exhibit comorbid anxiety symptoms (anxious depression), and as a first line adjunct for the treatment of MDD in adolescent patients aged 15-21. For safety information and indications for use, visit NeuroStar.com.


“Safe harbor” statement under the Private Securities Litigation Reform Act of 1995:

Certain statements in this press release, including the documents incorporated by reference herein, include “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), Section 21E of the Securities Exchange Act of 1934, as amended, which are intended to be covered by the safe harbors created by those laws and other applicable laws and “forward-looking information” within the meaning of applicable Canadian securities laws. Statements in this press release that are not historical facts constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements may be identified by terms such as “may,” “will,” “would,” “should,” “expect,” “plan,” “design,” “anticipate,” “could,” “intend,” “target,” “project,” “contemplate,” “believe,” “estimate,” “predict,” “potential,” “outlook” or “continue” as well as the negative of these terms and similar expressions. These statements include those relating to the Company’s business outlook and current expectations for upcoming quarters and fiscal year 2026, including with respect to revenue, expenses, growth, and any statements of assumptions underlying any of the foregoing items. These statements are subject to significant risks and uncertainties and actual results could differ materially from those projected. The Company cautions investors not to place undue reliance on the forward-looking statements contained in this press release. These risks and uncertainties include, without limitation, risks and uncertainties related to: the effect of the transaction with Greenbrook on our business relationships; operating results and business generally; our ability to execute our business strategy; our ability to achieve or sustain profitable operations due to our history of losses; our reliance on the sale and usage of our NeuroStar Advanced Therapy System to generate revenues; the scale and efficacy of our salesforce; our ability to retain talent; availability of coverage and reimbursement from third-party payors for treatments using our products; physician and patient demand for treatments using our products; developments in respect of competing technologies and therapies for the indications that our products treat; product defects; our ability to obtain and maintain intellectual property protection for our technology; developments in clinical trials or regulatory review of the NeuroStar Advanced Therapy System for additional indications; developments in regulation in the U.S. and other applicable jurisdictions; potential effects of evolving and/or extensive government regulation; the terms of our credit facility; our self-sustainability and existing cash balance; and our ability to achieve positive cash flows. For a discussion of these and other related risks, please refer to the Company’s recent filings with the U.S. Securities and Exchange Commission (the “SEC”), which are available on the SEC’s website at www.sec.gov, including, without limitation, the factors described under the heading “Risk Factors” in Neuronetics’ Annual Report on Form 10-K for the fiscal year ended December 31, 2025 and the company’s Quarterly Report on Form 10-Q for the quarter ending March 31, 2026, as may be updated or supplemented by subsequent reports that Neuronetics has filed or files with the SEC. These forward-looking statements are based on the Company’s expectations and assumptions as of the date of this press release. Except as required by law, the Company undertakes no duty or obligation to update any forward-looking statements contained in this press release as a result of new information, future events, or changes in the Company’s expectations.


Investor Contact:

Mike Vallie or Mark Klausner

ICR Healthcare

443-213-0499

ir@neuronetics.com

Media Contact:

EvolveMKD

646-517-4220

NeuroStar@evolvemkd.com


NEURONETICS, INC.

Consolidated Statements of Operations

(Unaudited; In thousands, except per share data)

 

     Three Months ended  
     March 31,  
     2026     2025  

Revenues

    

Products and other

   $ 12,925     $ 13,316  

Services

     21,529       18,659  
  

 

 

   

 

 

 

Total Revenue

     34,454       31,975  
  

 

 

   

 

 

 

Cost of revenues

    

Products and other

     2,858       3,150  

Services

     15,442       13,087  
  

 

 

   

 

 

 

Total Cost of revenues

     18,300       16,237  
  

 

 

   

 

 

 

Gross profit

     16,154       15,738  
  

 

 

   

 

 

 

Operating expenses:

    

Sales and marketing

     10,737       11,999  

General and administrative

     13,048       13,137  

Research and development

     1,364       1,616  
  

 

 

   

 

 

 

Total operating expenses

     25,149       26,752  
  

 

 

   

 

 

 

Loss from operations

     (8,995     (11,014
  

 

 

   

 

 

 

Other (income) expense:

    

Interest expense

     2,266       1,922  

Loss on extinguishment of debt

     539       —   

Other income, net

     (1,020     (247
  

 

 

   

 

 

 

Net loss

   $ (10,780   $ (12,689
  

 

 

   

 

 

 

Less: Net gain (loss) attributable to non-controlling interest

     10       (14
  

 

 

   

 

 

 

Net loss attributable to Neuronetics stockholders’

     (10,790     (12,675
  

 

 

   

 

 

 

Net loss per share of common stock outstanding, basic and diluted attributable to Neuronetics stockholders

   $ (0.16   $ (0.21
  

 

 

   

 

 

 

Weighted average common shares outstanding, basic and diluted

     69,589       61,465  
  

 

 

   

 

 

 


NEURONETICS, INC.

Consolidated Balance Sheets

(Unaudited; In thousands, except per share data)

 

     March 31,     December 31,  
     2026     2025  

Assets

    

Current assets:

    

Cash and cash equivalents

   $ 13,214     $ 28,134  

Restricted cash

     5,750       6,000  

Accounts receivable, net of allowance for credit losses of $780 and $1,043 as of March 31, 2026 and December 31, 2025, respectively

     15,809       16,469  

Inventory

     4,715       4,327  

Current portion of net investments in sales-type leases

     257       225  

Current portion of prepaid commission expense

     2,900       3,050  

Current portion of note receivables

     401       424  

Prepaid expenses and other current assets

     4,129       2,922  
  

 

 

   

 

 

 

Total current assets

     47,175       61,551  
  

 

 

   

 

 

 

Property and equipment, net

     3,874       4,466  

Goodwill

     23,622       23,622  

Intangible assets, net

     17,785       18,149  

Operating lease right-of-use assets

     23,069       23,560  

Net investments in sales-type leases

     108       98  

Prepaid commission expense

     7,464       7,972  

Long-term notes receivable

     92       151  

Other assets

     2,251       1,982  
  

 

 

   

 

 

 

Total assets

   $ 125,440     $ 141,551  
  

 

 

   

 

 

 

Liabilities and Equity

    

Current liabilities:

    

Accounts payable

   $ 11,433     $ 10,739  

Accrued expenses

     9,596       12,316  

Current portion of deferred revenue

     833       753  

Deferred and contingent consideration

     250       500  

Other payables

     751       652  

Current portion of operating lease liabilities

     5,422       5,561  
  

 

 

   

 

 

 

Total current liabilities

     28,285       30,521  
  

 

 

   

 

 

 

Long-term debt, net

     61,297       65,807  

Other long term liabilities

     71       —   

Deferred revenue

     58       48  

Operating lease liabilities

     18,669       18,935  
  

 

 

   

 

 

 

Total liabilities

     108,380       115,311  
  

 

 

   

 

 

 

Commitments and contingencies

    

Equity:

    

Preferred stock, $0.01 par value: 10,000 shares authorized; no shares issued or outstanding on March 31, 2026 and December 31, 2025

     —        —   

Common stock, $0.01 par value: 250,000 shares authorized; 69,583 and 68,994 shares issued and outstanding on March 31, 2026 and December 31, 2025, respectively

     696       690  

Additional paid-in capital

     482,146       480,475  

Accumulated deficit

     (469,577     (458,787
  

 

 

   

 

 

 

Total Stockholders’ equity

     13,265       22,378  

Non-controlling interest

     3,795       3,862  
  

 

 

   

 

 

 

Total equity

     17,060       26,240  
  

 

 

   

 

 

 

Total liabilities and equity

   $ 125,440     $ 141,551  
  

 

 

   

 

 

 


NEURONETICS, INC.

Consolidated Statements of Cash Flows

(Unaudited; In thousands)

 

     Three months ended March 31,  
     2026     2025  

Cash flows from operating activities:

    

Net loss

   $ (10,780   $ (12,689

Adjustments to reconcile net loss to net cash used in operating activities:

    

Depreciation and amortization

     745       911  

Allowance for credit losses

     (267     —   

Inventory impairment

     (30     5  

Share-based compensation

     1,677       1,444  

Non-cash interest expense

     256       189  

Loss on extinguishment of debt

     539       —   

Loss on disposal of property and equipment

     270       —   

Changes in certain assets and liabilities:

    

Accounts receivable, net

     1,008       (2,627

Inventory

     (432     175  

Net investments in sales-type leases

     (43     14  

Prepaid commission expense

     658       401  

Prepaid expenses and other assets

     (1,121     1,785  

Accounts payable

     559       (2,638

Accrued expenses

     (2,720     (3,511

Other liabilities

     170       (193

Deferred revenue

     90       (259
  

 

 

   

 

 

 

Net cash used in operating activities

     (9,421     (16,993
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Purchases of property and equipment and capitalized software

     (197     (219

Proceeds from the sale of property and equipment

     25       —   

Net cash used in investing activities

     (172     (219
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Repayment of deferred and contingent consideration

     (250     —   

Repayment of long-term debt

     (5,000     —   

Payment for debt extinguishment cost

     (250     —   

Proceeds from the issuance of common stock

     —        20,700  

Payments of common stock offering issuance costs

     —        (1,731

Distribution to non-controlling interest

     (77     —   

Proceeds from exercises of stock options

     —        8  
  

 

 

   

 

 

 

Net cash (used in) provided by financing activities

     (5,577     18,977  
  

 

 

   

 

 

 

Net increase (decrease) in Cash, Cash equivalents and Restricted cash

     (15,170     1,765  

Cash and cash equivalents and restricted cash and cash equivalents, beginning of period

     34,134       19,459  
  

 

 

   

 

 

 

Cash and cash equivalents and restricted cash and cash equivalents, end of period

   $ 18,964     $ 21,224  
  

 

 

   

 

 

 

Reconciliation of cash, cash equivalents and restricted cash to the consolidated balance sheet:

    

Cash and cash equivalents

     13,214       20,224  

Restricted cash and cash equivalents

     5,750       1,000  
  

 

 

   

 

 

 

Total cash, cash equivalents and restricted cash

   $ 18,964     $ 21,224  
  

 

 

   

 

 

 


Non-GAAP Financial Measures (Unaudited)

EBITDA and Adjusted EBITDA are not measures of financial performance under generally accepted accounting principles in the U.S. (“GAAP”), and should not be construed as a substitute for, or superior to, GAAP net loss. However, management uses both the GAAP and non-GAAP financial measures internally to evaluate and manage the Company’s operations and to better understand its business. Further, management believes that the addition of the non-GAAP financial measures provides meaningful supplementary information to, and facilitates analysis by, investors in evaluating the Company’s financial performance, results of operations and trends. The Company’s calculation of EBITDA and Adjusted EBITDA may not be comparable to similarly designated measures reported by other companies, because companies and investors may differ as to what type of events warrant adjustment.

The following table reconciles reported net loss to EBITDA and Adjusted EBITDA:

 

     Three Months ended
March 31,
 
     2026      2025  
     (in thousands)  

Net loss attributable to Neuronetics stockholders’

   $ (10,790    $ (12,675

Interest expense, net

     1,246        1,675  

Income taxes

     —         —   

Depreciation and amortization

     745        911  
  

 

 

    

 

 

 

EBITDA

   $ (8,799    $ (10,089
  

 

 

    

 

 

 

Stock based compensation (Note. 1)

     1,677        1,444  

Loss on extinguishment of debt (Note.2)

     539        —   
  

 

 

    

 

 

 

Adjusted EBITDA

   $ (6,583    $ (8,645
  

 

 

    

 

 

 

Footnotes

 

  1.

Stock-based compensation consists of expenses related to restricted stock units. We exclude these expenses from our non-GAAP financial measures because they are non-cash charges that we do not consider reflective of our core ongoing operational performance. While share-based compensation is a recurring expense and a key part of our employee retention strategy, excluding it allows management and investors to compare our operational profitability more consistently against prior periods and industry peers.

 

  2.

In connection with its $5 million repayment of debt in the first quarter of 2026 to Perceptive Advisors, LLC, the Company recorded a total loss on partial debt extinguishment of approximately $0.5 million. This infrequent and non-recurring expense is removed from EBITDA in order to provide a more accurate reflection of the Company’s core operational performance for the period presented.

References

1 The effectiveness of SPRAVATO® in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO® does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after an initial dose of SPRAVATO®. For more important safety information about SPRAVATO®, please visit spravatohcp.com.