NeuroPace Q4 Earnings Call Highlights

Core Insights - NeuroPace reported a total revenue of $26.6 million for Q4 2025, reflecting a 24% year-over-year increase, primarily driven by RNS System sales which reached $22.4 million, up 26% from the previous year [3][7] - The company anticipates a long-term growth trajectory of at least 20% in its core RNS business within the current adult focal epilepsy indication [2] - For the full year 2025, total revenue was $100 million, a 25% increase year-over-year, with RNS System sales also up 25% [12] Financial Performance - Gross margin for Q4 was 77.4%, an improvement from 75.4% in the prior year, driven by higher-margin RNS revenue and improved manufacturing efficiency [8] - Adjusted EBITDA was positive at $0.9 million for the second consecutive quarter, with a net loss of $2.7 million, improved from $5.3 million a year earlier [9][13] - Operating expenses for Q4 were $22.3 million, up from $19.8 million a year ago, but growth remained below revenue growth, indicating operational leverage [9] Regulatory and Product Development - The FDA accepted a PMA supplement to expand RNS into idiopathic generalized epilepsy, with a 180-day review period initiated [5][20] - The AI-enabled SeizureID platform is expected to be approved in H1 2026, aimed at enhancing clinician efficiency [5][22] - NeuroPace is also advancing remote care initiatives, allowing physicians to adjust therapy settings during telehealth visits [23] Future Guidance - For 2026, the company reiterated revenue guidance of $98–100 million on a continuing-operations basis, implying underlying RNS growth of 20–22% [6][15] - The company expects adjusted operating expenses of $90–92 million and an adjusted EBITDA loss of $9–10 million for 2026 [19] - For Q1 2026, revenue is expected to be between $21 million and $22 million, with growth rates typically moderating in the first half of the year [16]