Core Insights - iRhythm Technologies reported a "breakout year" for 2025, with significant revenue growth, margin expansion, and its first positive net income quarter [4][6][9] Financial Performance - Fourth-quarter 2025 revenue was $208.9 million, a 27.1% increase year over year, while full-year revenue reached $747.1 million, up 26.2% compared to 2024 [3][6] - Gross margin for Q4 was 70.9%, up 90 basis points year over year, and full-year gross margin was 70.6%, an increase of 170 basis points [1][6] - Operating expenses in Q4 rose to $145.8 million from $119.2 million a year earlier, with full-year operating expenses totaling $584.7 million, up 11.8% [7] - The company achieved its first positive quarterly net income of $5.6 million in Q4, while recording a full-year net loss of $44.6 million [7][9] Market Positioning - iRhythm holds approximately 72% market share in long-term monitoring and over one-third of volume from primary care, with strong EHR integration [5][10] - The company serves around 40,000 primary care physicians, emphasizing a complementary approach to cardiology [11] Product Development - The next-generation mobile cardiac telemetry (MCT) device is under FDA review, expected to launch in H1 2027, featuring a mobile gateway [15][16] - The current MCT offering, Zio AT, has shown unit growth exceeding 50% for the year [14] International Expansion - iRhythm is operational in the U.K., select E.U. markets, and Japan, with plans for growth in these regions expected to outpace overall company growth in 2026 [17][18] 2026 Guidance - Management guided for 2026 revenue of $870 million to $880 million, representing 16% to 18% growth, with an adjusted EBITDA margin of 11.5% to 12.5% [6][20][21] - Pricing is expected to remain flat in 2026, with Medicare rates for long-term monitoring increasing but MCT category rates slightly decreasing [22] Regulatory Considerations - Management addressed concerns regarding heightened scrutiny of chart-derived diagnoses, suggesting that iRhythm's services could reduce audit exposure [23]