Butterfly (BFLY) Q4 2025 Earnings Call Transcript

Image source: The Motley Fool.

Date

Thursday, Feb. 26, 2026 at 8 a.m. ET

Call participants

• Chairman and Chief Executive Officer — Joseph M. DeVivo
• Chief Financial Officer — John Doherty

Takeaways

• Total Revenue -- $31.5 million, representing 41% growth year over year and the highest quarterly result in the company's history.
• Core POCUS Revenue -- Increased 15% year over year, following 35% growth in Q4 of 2024.
• Butterfly Embedded Revenue -- Contributed $6.8 million in the quarter, primarily from the new Midjourney partnership.
• U.S. Revenue -- $26.8 million, growing 55% year over year, with unit sales up 44%.
• International Revenue -- $4.7 million, declining 6% year over year; iQ3 sales rose 42%, while iQ+ sales dropped 79%.
• Product Revenue -- $18.1 million, up 23%, driven by U.S. health systems, e-commerce, and veterinary channels, as well as higher average selling prices in international markets.
• Software and Other Services Revenue -- $13.4 million, a 76% increase year over year, now 43% of revenue compared to 34% the prior year, reflecting Embedded growth.
• Gross Profit -- $21.2 million, rising 55% from the prior year; gross margin improved to 67% from 61%, driven by higher-margin Embedded deals and lower software amortization.
• Adjusted EBITDA Loss -- $3.2 million, a 65% improvement over the prior year's loss of $9.1 million for the same period.
• Cash and Cash Equivalents -- $154.5 million at year-end; positive cash flow of $6.3 million in the quarter and annual cash usage reduced to $19.4 million from $45.9 million in 2024.
• Butterfly Embedded Pipeline -- Eight to nine active partners, with new research share deals signed, and additional partner agreements expected soon.
• Compass AI Launch -- Drove more than 50% growth in the enterprise pipeline since its release, supporting account refreshes and new customer acquisition.
• Guidance for Q1 2026 -- Revenue projected at $24 million–$28 million; adjusted EBITDA loss guidance of $8 million–$10 million.
• Full Year 2026 Guidance -- Revenue expected between $117 million–$121 million, a 20%–24% increase; adjusted EBITDA loss forecasted at $21 million–$25 million.
• Enterprise and Medical School Momentum -- Second large system-wide enterprise deal closed; medical schools are anticipated to be a significant growth contributor in 2026.
• Home Care Business Progress -- Anticipated commercial agreement in the first half of 2026 with initial revenue impact expected late 2026 and into 2027.
• R&D and Product Roadmap -- Fifth-generation P5.1 chip sent to production, with Apollo chip development underway targeting 20x current data rate and compute performance.

Need a quote from a Motley Fool analyst? Email pr@fool.com

Risks

• International revenue decreased 6% due to weak iQ+ sales, which fell 79% in the quarter.
• Doherty said, "we do still expect to have a bit of some downward pressure" from tariffs in 2026.

Summary

Butterfly Network (NYSE:BFLY) delivered record fourth-quarter revenue, primarily driven by substantial contributions from its Butterfly Embedded segment and the execution of the Midjourney contract. Management emphasized explicit strategic clarity with plans for commercial entry into the home care segment and accelerating the enterprise pipeline through Compass AI and expanded medical school partnerships. New technology launches, including the P5.1 and Apollo chips, underpinned the company's commitment to advancing digital ultrasound capabilities and maintaining a distinctive platform positioning.

• Management described the Midjourney partnership as a $74 million contract featuring upfront payments, annual license fees, and milestone deliverables, with potential additional revenue from future commercialization, including chip sales and revenue share.
• DeVivo said, We are not just a medical device company. We are a true disruptor building the ultrasonic backbone of the AI era and one of the most exciting technology growth stories in healthcare and technology today.
• The company achieved GovRAMP and TXRAMP certifications, and expects FedRAMP qualification, broadening access to large-scale government cloud deployments.
• Over 1,000 NGO partners have now adopted Butterfly’s products globally, with expanded opportunities projected in South America, Middle East, and Asia for 2026.
• Butterfly plans to release its proprietary beam steering API, opening digital 3D imaging capabilities to partners for the first time.

Industry glossary

• POCUS: Point-of-care ultrasound; immediate ultrasound imaging at the patient's location, typically for rapid diagnosis or intervention.
• Butterfly Embedded: Centralized strategy and business involving licensing and commercialization of Butterfly’s Ultrasound-on-Chip technology for third-party applications.
• GovRAMP/TXRAMP/FedRAMP: U.S. government certification programs for security authorization of cloud computing products and services.
• Compass AI: Butterfly’s enterprise software platform integrating cloud, AI, and workflow tools for health systems.
• Beam Steering API: Programming interface enabling partners to implement digital 3D imaging previously restricted to Butterfly products.
• iQ3/iQ+: Handheld ultrasound probe series produced by Butterfly Network, with iQ3 representing the latest generation.

Full Conference Call Transcript

John Doherty: Good morning, thanks to all of you for joining our call today. Earlier, Butterfly released financial results for the fourth quarter and full year ending December 31, 2025. We also provided a business update. The release, which includes a reconciliation of management's use of non-GAAP financial measures compared to the most applicable GAAP measures, are currently available on the Investors section of the company's website at ir.butterflynetwork.com. I, John Doherty, Chief Financial Officer of Butterfly, along with Joseph M. DeVivo, Butterfly's Chairman and Chief Executive Officer, will host the call this morning. During the call, we will be making certain forward-looking statements.

These statements may include, among other things, expectations with respect to financial results, future performance, development and commercialization of products and services, potential regulatory approvals, revenue attributable to embedded collaborations through revenue share, chip purchases or otherwise, and the size and potential growth of current or future markets for our products and services. These forward-looking statements are based on current information, assumptions, and expectations that are subject to change and involve a number of known and unknown risks, uncertainties, and other factors that may cause actual results to differ materially from those contained in the forward-looking statements. These and other risks are described in our filings made with the Securities and Exchange Commission.

You are cautioned not to place undue reliance on these forward-looking statements, and the company disclaims any obligation to update such statements. As a reminder, this call is being webcast live and recorded. To access the webcast, please visit the Events section of our investor website. A replay of the event will also be available on this page following the call. I will now turn the call over to Joe.

Joseph M. DeVivo: Thanks, John. Good morning, everyone, and thank you for joining our fourth quarter and full year 2025 conference call. I am pleased to announce that our fourth quarter revenues came in at $31.5 million, growing 41% year-over-year. It is also the first quarter in our history where we realized positive operating cash flow, driven by upfront payments from our Midjourney deal. We are now nearly two years into our strategic growth plan that we introduced in early 2024. The message was clear: execute with focus and financial discipline, strengthen our core franchise, and unlock the full value of our semiconductor ultrasound platform beyond handheld devices.

We are doing just that, and we now have material contribution outside of our core POCUS business. Earlier this month, Jim Cramer was asked a question about Butterfly Network on Mad Money, and he said, I quote, "It is a very competitive market, and I do not want to be in that part of the medical device group. Too hard for this guy, just too hard." You know, I am a big fan of Jim Cramer, and like you, watch CNBC every day, and he is right about one thing: traditional medical devices are a tough sector, but Butterfly is not a traditional medical device company. We were never just a handheld company shaking at the knees of big ultrasound.

We are David, faithful and committed to our cause, not backing down regardless of how large our opponent is. We are the disruptor. We are playing our own game with our own rules and our own playbook. We are digital eating analog's lunch and plan to revolutionize imaging with digital ultrasound everywhere and images taken. Goliath just does not know it yet. We are changing ultrasound imaging with our differentiated chip platform while deploying secure cloud software, AI tools, and mobile applications, and are the only healthcare company in the world over the last seven years to receive an Apple Design Award. We are not a medical device company alone. We are a transformative semiconductor-based ultrasound company.

As you are all aware, the strategy we introduced has three core tenets: accelerate our core POCUS business with an enterprise-ready, cloud-connected imaging solution, execute strategic initiatives to reach new care settings and enable entirely new applications, namely home care and Ultrasound-on-Chip co-development. Lastly, deliver an R&D roadmap that sharpens our technology edge with next-generation chips and new form factors getting more and more powerful and capable. Let me walk you through the progress in each of these. In core POCUS, revenue grew 15% year-over-year on top of a 35% growth in the fourth quarter of last year, which, as you recall, was a record product launch year.

We closed a second large system-wide enterprise deal in the fourth quarter of 2025 and continue to deepen medical school and enterprise relationships. I will let John cover the financials in more detail, but we feel much better about macro trends and the deal cycle than earlier in the year and expect to carry that momentum into 2026. The fourth quarter Compass AI launch is a big tailwind for our enterprise strategy. Enhancing our enterprise solution helps refresh existing accounts, continue attracting new customers and drove more than 50% growth in our enterprise pipeline since launch. At the same time, we have been building what we believe is one of the most secure cloud infrastructures in healthcare.

In the U.S., we most recently achieved GovRAMP and TXRAMP, and FedRAMP is anticipated in the coming months, meaning we will soon be even more qualified for cloud deployments in now the world's largest government market. Internationally, we see meaningful opportunities in 2026 as we open markets in South America and continue expanding across Middle East and Asia, alongside a renewed momentum in global health. We have surpassed 1,000 NGO partners worldwide, and many expect to increase activity in 2026. We also continue to make progress in our Butterfly Garden partners, and as you know, HeartFocus became the first FDA-cleared app in 2025, and we expected additional partners to reach that clinical milestone in 2026.

We announced plans to release our proprietary beam steering API in the first half of this year. The API will open 3D imaging capabilities that have been reserved for Butterfly products only. Because our beam steering is fully digital on a semiconductor chip and not mechanically driven like other legacy systems, we can uniquely extend those capabilities to partners. The goal is to advance what they can build, expand the AI ecosystem, and help accelerate ease of use. We are excited about the new opportunities this welcomes. Moving to the strategic growth engines.

We have built a home business determined to accelerate the use of POCUS devices where the patient is, expanding the reach and empowering nurses and other clinicians to perform scans using AI tools. I believe we will reach a commercial agreement in 2026, allowing home care to enter its commercial phase. This is a powerful new channel that reduces hospital readmissions, lowers costs, and expands Butterfly's reach beyond the hospital. Home care is a reality, we think it can be a real growth driver, starting to add revenue in late 2026 and into 2027.

We also ventured out to develop a new business to make our core Ultrasound-on-Chip available to companies with large new market opportunities that are not competitive with Butterfly's focus business. That was previously known as Octave. Well, to start the new year, we have officially sunset the Octave name and have centralized our semiconductor platform strategy under Butterfly Embedded, reminiscent of the Intel Inside model. What began as an adjacent effort is now emerging as a foundational business, enabling other category-defining innovators to build entirely new application on Butterfly's Ultrasound-on-Chip technology.

The big news for the fourth quarter, though, was signing Midjourney deal in November, and as you can see today, it contributed $6.8 million of revenue in the quarter and was a key driver of our 41% year-over-year growth. Midjourney is an independent research lab pushing the boundaries of generative AI and human imagination. Their scientists have envisioned a breakthrough new application for ultrasound that we believe the world will be learning about very soon. This partnership combines Butterfly's core Ultrasound-on-Chip technology and imaging software with Midjourney's generative AI compute power to do something very special with ultrasound. This deal is more than revenue, it is validation. It is a foundational step towards Butterfly's reinvention into a platform company.

The initial partnership and revenue contribution is pre-commercial. Based on the plan that Midjourney has shared with us, once commercial, we believe there is meaningful additional revenue opportunity for Butterfly in the form of chip sales and revenue share on top of the licensing fees that will continue through the deal. We expect this to happen in the outer years of our 5-year plan, and if it occurs, could represent meaningful progress towards our goal of reaching $500 million in annual revenue by 2030. Beyond Midjourney, we signed an additional Butterfly Embedded research share partner this quarter and expect another one shortly, while managing an active pipeline of some of the largest technology and healthcare companies in the world.

Before I look ahead to our R&D roadmap initiatives, I will turn it over to John to discuss the financials. John?

John Doherty: Thanks, Joe. I am very excited to have joined Joe and the talented team here at Butterfly, which includes Megan Carlson. Megan, who you all know, did a great job in the interim CFO role and has been an awesome partner to work with, along with the rest of the leadership team. With about three months behind me, I want to open with a few comments and my thoughts on Butterfly overall. I joined Butterfly because I was excited by the incredible potential this company has going forward to provide a valuable and meaningful experience to our customers, as well as to create value for our shareholders.

I was also impressed by the strength of the leadership team and the passion and commitment demonstrated by employees across the company. This is a company I am proud to be a part of. Butterfly certainly navigated a few challenges in its early years as a public company. However, the company has made the necessary difficult adjustments, including improving its operating efficiency, choosing the markets it can win in, selecting the best ways to leverage its IP and technology advantage, and allocating its resources towards higher ROI opportunities and markets. No doubt, based on these actions, Butterfly is a stronger, more agile company today.

With continued steady execution, the company has the potential for significant core growth in an incredibly meaningful domain through its focused and related conscious AI software and Butterfly Garden business, and we are well positioned to gain outsized share in the markets that we compete in. We also have a significant opportunity to leverage our core platform of Ultrasound-on-Chip into other nascent and disruptive markets consistent with our strategy through Butterfly Embedded, as the Midjourney partnership demonstrates.

With that, let us move on to a few highlights for the fourth quarter, including a record level of revenue for the quarter and exceeding the high end of our total revenue and adjusted EBITDA guidance ranges, a record level of quarterly probe sales, significant improvement in adjusted EBITDA margin, driven by our revenue performance and continued financial discipline, the lowest annual cash use in the company's history, and we generated positive free cash flow in the quarter, and the execution of the Midjourney contract, which helps to solidify and amplify all of our efforts to drive a new wave of ultrasound-enabled platforms and use cases through Butterfly Embedded. Let me move on to our results.

We had a strong fourth quarter of 2025, with revenue of $31.5 million, the highest quarterly result in the company's history. This represents a 41% increase year-over-year for the quarter. The increase is driven by increased revenue from Butterfly Embedded, as well as a 27% increase in year-over-year volume in our core focused business, with continued penetration of the iQ3 in all markets. The 41% year-over-year growth is significantly higher than the at least 17% year-over-year growth that we put out in January. We did better in the core business and realized more revenue from Butterfly Embedded, given the work we had already performed relative to the Midjourney contract.

This is the primary reason we used the at least language at the time, as we were still finalizing the accounting treatment. Our results and the guidance I will provide later in the call for first quarter and full year 2026 all include updated financial expectations from this contract. Breaking things down between the U.S. and international channels, during the quarter, U.S. revenue was $26.8 million, which was 55% higher year-over-year, driven by revenue from Embedded, as well as strong demand in the core business, with unit sales up 44%. Total international revenue decreased by 6% year-over-year to $4.7 million in the fourth quarter.

While sales of the iQ3 in the quarter were up 42% year-over-year, sales of the iQ+ were down 79%. Breaking our revenue down between product and software and other services, product revenue was $18.1 million, an increase of 23% versus the fourth quarter of 2024. This increase was driven primarily through growth in volume across all channels, with U.S. health systems, e-com, and vet leading the way, as well as higher average selling prices in international markets with the higher mix of iQ3 sales. Software and other services revenue was $13.4 million in the fourth quarter, up 76% year-over-year. Software and other services mix was 43% of revenue, increasing from 34% in Q4 2024.

This increase can be attributed to the significant step-up in revenue contribution from Butterfly Embedded in the quarter, related primarily to the Midjourney partnership. I will talk more about this as well when I come to guidance for the first quarter and full year 2026. When looking at the full year 2025 versus 2024, total revenue increased 19% to $97.6 million. This was driven by two areas. First, growth in our core focused business, with both increased volume and a higher average selling price, driven by an increased mix in the sales of the iQ3 and strong performance by U.S. sales, our vet channel, and international distributor channels.

Second, growth in our emerging Butterfly Embedded business, primarily from the execution of the Midjourney contract in November of last year. Moving on to gross profit. Gross profit was $21.2 million in Q4 2025, a 55% increase as compared to the prior year adjusted gross profit of $13.7 million. Gross profit margin percentage increased to 67% from 61% in the prior year period. Gross margin percentage was positively impacted by the higher-margin Butterfly Embedded revenue and lower software amortization. Moving to EBITDA and cash. For the fourth quarter of 2025, adjusted EBITDA loss was $3.2 million, compared with a loss of $9.1 million for the same period in 2024, an improvement of 65%.

For the full year 2025, adjusted EBITDA loss was $26.5 million, compared to $38.9 million for 2024, an improvement of 32%. The improvement in adjusted EBITDA loss for both the fourth quarter and full year was driven by contribution from higher margin revenue and continued financial discipline reflected in our lower year-over-year payroll costs for the quarter and full year. This improvement in adjusted EBITDA and continued financial discipline has led to a cash and cash equivalent balance, including restricted cash at year-end of $154.5 million, and the use of cash in 2025 of $19.4 million, excluding the funds from our offering last year.

This compares to a use of cash of $45.9 million in 2024, an improvement of $26.4 million. We also had positive cash flow of $6.3 million in the fourth quarter. These results demonstrate that we are very well positioned as we move forward to continue to invest in the business areas where we see significant opportunities for additional growth and disruption, including expanding our core POCUS business and penetration of Compass AI as a core operating system for health systems. Continuing to enable third parties to build tailored ultrasound AI solutions in Butterfly Garden to provide deeper and expanded access to our platform.

Expanding our home care business following the execution of our anticipated first commercial agreement, which we believe could be finalized in the first half of 2026, as Joe mentioned earlier. Enabling a new wave of Ultrasound-on-Chip-enabled technologies through Butterfly Embedded, and continued AI and semiconductor innovation with the development of our 4th-generation chip. Before turning to guidance, I want to update you on the general macroeconomic environment relative to Butterfly. While there were some concerns in 2025 relative to the government shutdown and impact on the FDA's processing of fee-based submissions, regulatory processing delays, and delays in customer purchasing decisions, we have managed through this, and it is very much behind us.

Our fourth quarter results are indicative of that, and we were able to close some of the larger deals in the pipeline and still have a number that are active. I would now like to turn to our outlook for the first quarter of 2026 and for the calendar year ending December 31, 2026. In the first quarter, we expect revenue in the range of $24 million–$28 million, as we ended the fourth quarter somewhat higher than expected, and the first quarter is typically a slower quarter for the company due to seasonality.

As is typical for Q1, adjusted EBITDA is impacted from expenses related to payroll tax and 401(k) reset, as well as our national sales meeting and POCUS Innovators Forum, which took place in January. As a result, we expect slightly higher expenses and higher adjusted EBITDA loss in the first quarter relative to the remainder of the year in the range of $8 million–$10 million. For the full year 2026, we expect revenues to be between $117 million and $121 million, an increase of approximately 20%–24%. We expect our adjusted EBITDA loss to be between $21 million and $25 million.

Our guidance for adjusted EBITDA includes investment in key areas to support continued innovation, as well as our emerging embedded business, as well as the impact from tariffs initiated in 2025. In summary, we had a great quarter, a record quarter. We closed the year out strong, we exceeded expectations for revenue and adjusted EBITDA, and we are very well positioned going forward. As our 2026 full year guidance indicates, we look forward to continued growth this year and beyond, and our overall outlook on the business is brighter with this past quarter reinforcing our view.

In 2025, we believe the company enhanced its position in the core POCUS markets and can continue to gain share in 2026 through deeper penetration of existing customers, new customers, and applications. We also amplify our Ultrasound-on-Chip platform and the potential of Butterfly Embedded with the licensing partnership with Midjourney. We did all of this while continuing our intense focus on driving operating efficiency across the business and ROI. As I said up front, I am excited to have joined Butterfly late last year, and I am excited about what is ahead for the company in 2026 and beyond. Now, let me hand it back to Joe for some closing comments.

Joseph M. DeVivo: Thanks, John. It is an exciting time for Butterfly. We are in a strong position and are delivering on all fronts. The future is even brighter. Before closing, I will touch briefly on R&D. We recently spent two days with 60 leading POCUS thought leaders at our annual POCUS Innovators Forum, and the alignment was unmistakable. The goals, needs, and future state vision shared was directly in line with where we are taking our portfolio. That level of synergy only strengthened our conviction that we have a path to enable every doctor and nurse with powerful, affordable, compact imaging and can meaningfully unlock enterprise adoption.

As I mentioned on the last call, our fifth generation P5.1 chip was moved to production by year-end. We are excited in achieving harmonics and delivering a new level of imaging for handheld ultrasound. This will open additional subspecialties and support our enterprise selling efforts in 2027 and beyond. Next up on our chip roadmap is Apollo. This new chip architecture is now receiving the full attention of our engineers and will deliver 20 times the current data rate and compute performance, ushering in a new era of digital imaging and AI. We are already working with several Butterfly Embedded partners based on the capabilities of this platform.

I would like to close by sharing exactly why I am so excited about Butterfly's current chapter. We are pioneering semiconductor-based digital ultrasound everywhere it is needed. In the traditional ultrasound market, that means continuing to lead in point-of-care solutions that truly meet the demands in and out of the hospital, empowering doctors, nurses, and caregivers, expanding new subspecialties, strengthening our enterprise roadmap, moving imaging to the bedside and beyond it. It is also bigger than that. Ultrasound is being researched and deployed in brain therapy, continuous monitoring, robotics, organ preservation, and the list goes on.

If you do a simple search of ultrasound in the magazine Nature, just this month alone shows applications in neuromodulation, ablation, antiviral therapy, and soft robotics. The real inflection point comes when ultrasound in these use cases move to silicon, when it becomes programmable, power efficient, AI native, scalable. That is the common thread. Whether it is a Butterfly handheld in a clinician's pocket, a new form factor on our roadmap driving enterprise or home adoption, or a partner building something novel with our technology that we can never do ourselves, it is the same core technology, the same architectural advantage. We are not just building devices, we are opening markets.

We are enabling a new age of digital ultrasound imaging and sensing, all in one strategy. This is Butterfly. We are not just a medical device company. We are a true disruptor building the ultrasonic backbone of the AI era and one of the most exciting technology growth stories in healthcare and technology today. With that, operator, please open it up for questions.

Operator: Thank you, Joe. To ask a question, please press star followed by 1 on your telephone keypad now. If you change your mind, please press star followed by 2. When preparing to ask your question, please ensure your device is unmuted locally. Our first question is from Joshua Thomas Jennings from TD Cowen. Your line is now open. Please go ahead.

Joshua Thomas Jennings: Hi, good morning. Thank you. Impressive to see all the progress in so many different channels. Gives us a lot to ask about, challenging to choose one of those lanes, wanted to start with Butterfly Embedded and just, absolutely. Just wanted to better understand, and you may not be able to share, but any details around potential timing of the technology offering that Midjourney is going to put forward, implementing Butterfly's semiconductor and ultrasound chip technology? Any help just thinking about the cadence of revenue contributions from this partnership over the course of 2026 and what is embedded in guidance?

Joseph M. DeVivo: Thanks, Josh. Well, I will let John answer the second part of that in a moment. Let me just get to the first. I think we are probably going to see something, you know, in the relative near term from Midjourney. You know, one of the things about a Butterfly Embedded program is we are enablers for our partners. This is not our business, this is their business, and we do everything we can to amplify their business. I do not want to get out ahead of them, and all I want to do is do everything that we possibly can as a partner to support them.

That said, I think, you know, they probably want to get this out sooner rather than later. The moment they do, you know, we will do the best to show you how it, you know, translates into Butterfly. John, do you want to take the second part of that?

John Doherty: Yeah, sure. Thanks, Joe. Appreciate it. How you doing, Josh?

Joshua Thomas Jennings: Good.

John Doherty: So—

Joshua Thomas Jennings: Thanks a lot.

John Doherty: when you look at Embedded, you know, obviously, yeah, as Joe touched on during the opening remarks, Midjourney kind of lit it on fire, if you will, with the contract we signed at the back end of 2025. We are very excited about that contract. There is also, you know, a number of other partners that we are working with in Embedded. While right now, Embedded and our revenue is, you know, there is a big contribution from Midjourney, we do expect, you know, other contributions from other partners that we have in there, and, you know, we are really excited about what that part of our business can be, as we discussed at the back end of 2025.

You know, relative to Midjourney, it is a $74 million contract, as we mentioned. There are different components of it. You know, there is the upfront payment, there are annual license fees, and then there is milestone work that we do that ultimately, you know, allows us to, you know, do the, you know, take the revenue, ultimately, you know, quarter by quarter, if you, if you will, year by year. You know, we expect to get a good amount of contribution throughout 2026 into 2027 from the contract.

In addition, when they commercialize, ultimately, you know, as Joe mentioned upfront as well, there is an opportunity for chip sales as well as for a revenue share as part of their business. Ultimately, really excited about the overall contribution from Midjourney, but Embedded is not just Midjourney.

Joshua Thomas Jennings: No, I appreciate that answer, and kind of leads into my next follow-up is, I mean, our understanding is that the team was focused on the Midjourney partnership and development work and then locking that in 2025, but there were some other potential partnerships on the periphery that sounds like you guys are engaged and moving forward. Any help thinking about the Butterfly Embedded pipeline that you just referenced?

Joseph M. DeVivo: Yeah. I mean, we are talking to a lot of people. As I mentioned, some, you know, very large organizations and also a lot of startup organizations. Kind of the way it works is, you know, we saw a, you saw a contract in the 8-K with Midjourney, in November of 2025. They had been an embedded partner for over a year prior. So the way it kind of works is, you know, people will buy a license to our software, and then they will start buying chips, and they will do some research. They will do research, you know, as far as how does, you know, does a chip meet their performance that they need?

How does it integrate with their systems? Then, and they do a bunch of work. You know, whenever they are done and ready, you know, if everything worked out well, then it will turn into a commercial agreement. They will come back and say: "Okay, well, we want to now do, you know, X, Y, and Z." That is kind of how Midjourney happened. There is really no formula. It is just, you know, we have, I think, now, eight or nine embedded partners today, and the pipeline is pretty large. It is also, you know, we are not selling off-the-shelf product.

You know, we have to take our product, and we have to do labs and show them how it can fit with their tech and whatnot. It is a bit of a sales process, but, you know, do we have another Midjourney in there? I hope. You know, there are some very big opportunities people are going after, massive opportunities, actually. You know, we are going to continue to add people into the research phase of our relationships and do everything possible to meet their needs and get them, you know, committed to a commercial phase, like Midjourney did.

Joshua Thomas Jennings: Excellent. Maybe one question on the home care franchise, and it sounds like you have made progress in this first commercial partnership. I mean, what steps are left before that commercial effort kicks in? Maybe just remind us of the home POCUS market opportunity or the revenue opportunity for Butterfly in this channel. Thank you, guys, for taking all the questions.

Joseph M. DeVivo: Hey, thank you, Josh. Appreciate them. Yeah, I think, you know, we are pretty confident that this is going to, you know, get to a commercial conclusion. You know, as John said, in his notes, we think it will probably happen before middle of the year, which will give us the second half of the year to start getting it ramped up. It would probably be nominal revenue in 2026, but start contributing in 2027. Once we get it started, and we have a line of sight, and we are able to give a better shape of what the impact is, we will tell you as far as, you know, and incorporate it into our guidance.

You know, in aggregate, I think I have mentioned in the past, you know, if just this one use case we are working on, if it became a national use case, it could be a $40 million–$50 million revenue opportunity if everything went, you know, the way that we saw it. That is. You know, when we think about the amount of chronic care patients are in nursing homes and also the amount of patients that are in the home, who are being cared for by nurses, you know, as they get sicker, they need to be, you know, moved. They need to have an image.

You know, they have to go to the hospital, whether it is by ambulance or by some other transport, be brought up into radiology and then have, for example, a cardiac echo or something else. You know, empowering caregivers to be able to take images where they are is efficient, is low cost, and has high impact on being able to quickly give a diagnosis for a patient so their meds can be modified to make them healthier and keep them into the home, or keep them wherever they are. That is literally every facet of healthcare is about being where the patients are, being where people are, and helping them get healthier faster in the lowest cost environments.

You know, our home care business is basically an extension of our POCUS business. It is not a third business; it is an amplifier of POCUS. You know, ultimately everyone will figure it out, and they will use our stuff to do all of this using the AI apps, etc. Home is kind of a catalyst for us to, you know, take a lot of the workflow, the logistics, and the ramp-up and the learning curve out. I have mentioned before that we think the home business can be bigger than POCUS, and the opportunities are certainly there. We have, you know, we have to prove it, and we have to get some more... Our pilot was excellent.

We need to get, you know, the first few states up. We need to prove what we are doing there. We need to prove we can go to a larger geography. It is a process, but it is a big opportunity, and it will teach, you know, core healthcare providers and payers that point-of-care ultrasound with Butterfly is a significant way to reduce costs at the exact same time of improving quality and care for patients.

Operator: Thank you, Josh. Our next question is from Chase Richard Knickerbocker from Craig-Hallum. Your line is now open. Please go ahead.

Chase Richard Knickerbocker: Good morning, guys. This is Jake on for Chase. I was wondering if you could, maybe, John, if you could give us any more color on the macro environment, if you guys are seeing any of the same trends that affected 2025 and how they are abating now in 2026?

John Doherty: Sure, and I appreciate the question. As I touched on, you know, with the opening comments, I am not going to say everything is behind us, but certainly, you know, we feel, you know, a lot more confident going forward. Irrespective of the Supreme Court's action relative to tariffs, you know, it is still a very mild, say mildly, and an unpredictable area, given what happened post that. You know, we do still expect to have a bit of some downward pressure. Not a lot, but some downward pressure from tariffs. We did sign a number of contracts late in the year, so we see that things have been opening up a bit there.

We still have a number of, you know, good-sized deals in the pipeline. I would say, you know, the timing did move out kind of the back half of last year as the company had touched on when they did third quarter results, but we are seeing some improvement there. We are starting to see some things move. Ultimately, as I mentioned, you know, the company, we are managing through it, and we do not expect it to have except for the, you know, the tariff component, we do not expect it to have a lot of impact on the company.

Chase Richard Knickerbocker: Great. I appreciate that color. Apologies if I missed this, but is there any more color on the opportunity with medical schools going into the year as well for the one-to-one partnerships?

Joseph M. DeVivo: Yeah. Medical schools, I think, should be a pretty, a pretty strong contributor to us this year. You know, the, you know, second quarter of the year is the big medical school quarter when we, when we put them all in. We have a lot of conversations for one-to-one buys, and you know, we did get a bit of a pause last year when the decision to cap student loan debt occurred, and so it caused people to pause. You know, what is so exciting about what we are doing is there is such a strong commitment for new medical students to learn ultrasound.

They are actually now starting to choose where they go and the types of programs they get into based upon the commitment of building that competency. You know, kids that are graduating today, and are going into their residency, completely distinguish themselves when they have this capability. Even, you know, even their, you know, their attendings, who are working with them, you know, are kind of, surprised when they see what can be done by a resident with ultrasound skills. There is not a lot of daylight out there. This is not a new thing. Students want Butterfly. They are trained on Butterfly.

They want that experience, and then when we build the brand equity with these students, they go into their residency and then into practice with that loyalty, with that understanding, and we are looking to grow with them, especially, you know, with our whole, you know, chip platform improving and getting more and more powerful, and then more apps coming in over the years. You know, we are going to grow with them through their career. We start off with medical schools. Medical schools will be a very positive contributor in 2026.

Chase Richard Knickerbocker: Appreciate the answers, guys. Thank you.

Joseph M. DeVivo: Thanks, Jake.

Operator: Thank you. Our next question is from Andrew Frederick Brackmann, from William Blair. Your line is now open. Please go ahead.

Andrew Frederick Brackmann: Hey, guys. Good morning, thanks for taking the questions. I will echo Josh's comments. Certainly a lot of progress here and a lot to dig into. Joe, maybe with that in mind, I would like to start a little bit higher level. I mean, it is sort of hard to miss the underlying transformation going on here, towards Butterfly Embedded. Can you maybe just sort of talk to us about why now for this transition from med devices towards embedded and the semiconductors type of business? Then just as you sort of think about organizational focus, perhaps, are there any sort of changes in terms of your view on focus versus the opportunity with Embedded? Thanks.

Joseph M. DeVivo: That is a great question, Andrew, and I actually, I probably should have emailed that to you and planted that in, because it is, that is a very appropriate question. You know, we are not trying to pivot away from focus. You know, we, you know, we want to have every doctor and every nurse in the world, have a device that allows them to help diagnose their patients sooner, easier, low cost, where they are at. We will never, you know, move away from that vision. You know, in accomplishing that vision, Andrew, we solved the problem. We solved a major problem in technology where we can digitize, we can digitally control the ultrasound image.

We can control it in a way that is much more than what medical ultrasound uses with, you know, multiple planes and depths. Because we control 9,000 sensors in a rectangle, which allow us to send out information, send out sound a certain way, and listen to sound a certain way. You know, what we solve for ourself for point-of-care ultrasound is a major solution for many other people out in the marketplace. You know, there is this whole concept that AI and the human body are going to merge together. You can Google it. There is a whole sci-fi fantasy out there. You know, there.

If you even think of brain-computer interface, you know, Neuralink today is putting wires into the brain. There is this thing in DCI called the butcher factor, which is, you know, how many neurons do I have to kill before I get to the neuron I want to talk to? Well, one of the beautiful things about ultrasound is, and about Butterfly, is we do not have a stagnant beam that sits in a fixed position. You know, normally, ultrasound is like a flashlight. You know, you have to move the beam in order to capture the image. We can actually, in a fixed location, move our beam and scan.

If you implant something in the brain, you are going to be able to communicate and see and listen to 25% of the entire brain or the entire lobe. It is being seen today that ultrasound is potentially a portal between AI and the human body. Just read Nature and you will see all these articles about brain-computer interfaces, and you will hear about ultrasound, you will hear about neuromodulation, you will hear about all different types of, you know, even if it is therapeutic, people are going to be looking at the brain signals through vasculature and how vasculature flows through the brain. It ultimately, you know, you can potentially heat it and put energy.

This is kind of happening. It is not like we just did a prospect, a randomized study, and we are now pushing the market. The market is calling us. They see our 600 patents, they see the excellent technology that we have, and quite frankly, we have been approached prior to me getting here by companies asking to partner with them, but they were turned away because the company was trying to focus on point-of-care ultrasound. What we have said to ourselves is, "No, we have solved the foundational problem." you know, I would hate to compare ourselves to NVIDIA because there is no way there is a scale or anywhere to draw a line.

You know, from 93 to 2005, they were a video game company, and they focused on their core markets of building technologies to be better gamers, that had to be complex. You know, and then with CUDA in 2006, it opened up their platform for developers who could use these incredible chips for other applications. You know, or you look at Amazon, you know, they did not set out to become the leading cloud compute company in the world. They realized that they needed cloud compute. There was not a large enough vendor to take their volume. They built it themselves.

When they were done, they had excess capacity, and they said, "Let us go sell that capacity." Now it is the highest profit-generating part of their business. Sometimes in business, you solve problems for your customers that benefit others, and we are just simply now allowing ourselves to work with those partners. The beautiful part about it is that the roadmap that we have set ourselves, so, you know, our Poseidon platform, our P5.1 platform, our Apollo platform, we are now not going off and developing new things for other people and losing our focus on Point-of-Care Ultrasound.

What we are actually doing is amplifying our current roadmap, and we are exposing our roadmap to those customers and those and to allow them to meet their needs. It actually is going to make our ability to serve point-of-care ultrasound better, and the roadmap that we have for point-of-care ultrasound and what is going to happen, you know, with our next launch of our platform, with Harmonics and P5.1, and what we are going to do with, you know, some new things that we will unveil in 2007, there is so much synergy here, Andrew. It all ties together. We are not putting something on the shelf and then focusing someplace else.

We are pulling our core tech, we are partnering with people who have real interest of building businesses and have technical challenges that we can solve. Instead of having an analog ultrasound device that, you know, yes, you have digital behind the lens, but then once you push the signal through the lens, that lens is cut to do one thing. Our lens can be anything, and developers love the fact that they can see the signal and then change the software, see the signal, change the software. That, you know, kind of infinite iteration cycle is how, you know, we will fit our ultrasound into many different types of devices throughout the world.

Andrew Frederick Brackmann: Okay. That is terrific color. Thank you for all that, Joe. Maybe if I could just sort of switching lanes here. You referenced the Compass AI, and sort of the launch there. Can you maybe just expand on sort of what that does in practical terms for your moat within that focused business? What does it give you that competitors do not have today? As you sort of think about, you know, defending against some of these potential, you know, AI disruptors that are out there, how does this sort of expand the moat there? Thank you.

Joseph M. DeVivo: Thank you so much, Andrew Brackmann. We were, you know, the prior team before I got here, you know, Todd Fruchterman and the team were very visionary on making sure that if Point-of-Care Ultrasound is going to be adopted enterprise-wide, that we need to manage the data. The systems, you know, the EMRs, the DICOMs, all the current hospital systems were not geared and built to operationalize Point-of-Care Ultrasound. Butterfly became the first ultrasound company that invested in an enterprise SaaS-based software that not only allowed it to collect its own data, push it into the record, push the image into DICOM, and set that record up ready to be submitted for reimbursement with the revenue cycle management software.

We have built the most powerful, you know, SaaS-based system out there in order to do this. Now hospitals, when they put our software in place, they now recognize scans that were not getting reimbursed, and they increase their revenue and profitability. It is, it is just good, and good. Now, on the other side, doctors hate new things. They do not like to have to go through new steps. They just want to do everything in their EMR. They do not want to have one software for this, one software for that. Getting to an ease-of-use paradigm is essential, because the doctors are already asked, and nurses, to do so much in their everyday lives.

To now go into another platform to go through a whole other set of workflow is just something that they dread, regardless of how good it is for, you know, the patient or the economics, it is just more work. Getting our system to be easier, faster, simpler, more integrated into the, their daily workflow and to use the power of AI to where so we take their dictation. Every doctor dictates. If we can take their dictation and then pull apart the data in that dictation and populate the forms for them, you know, those two or three or four minutes that they save is massive to them as they and that multiplies with each patient that they see.

We are very committed to making our workflow now. We have solved the major problem of connecting them and aggregating data. Now we are going to be incessant and passionate about making it easier and easier and easier and easier for them to implement, for them to use on a daily basis, for it to be intuitive, and to let the hospitals continue to have the type of ROI they need of capturing all these images. We are never going to stop making it, and we are going to use every new tool available to us in AI to make it easier for our customers.

Andrew Frederick Brackmann: Great. Thanks, guys. Appreciate the questions.

Joseph M. DeVivo: Appreciate it.

Operator: Thank you, Andrew. Our next question is from Benjamin Charles Haynor from Lake Street Capital Markets. Your line is now open. Please go ahead.

Benjamin Charles Haynor: Good morning, folks. Thanks for taking the questions.

Joseph M. DeVivo: Hey, Ben.

Benjamin Charles Haynor: ... for me on the, yeah, how are you? Excellent. Just on your own internal development, pipeline, new P5.1, you know, when should folks expect you to go to the FDA with that? Anything new on kind of the new form factors, whether that is, you know, iQ Station or, you know, in some of the wearable sort of form factors that you showed at the investor day two years back?

Joseph M. DeVivo: Thank you for the question. You know, we are hoping in the beginning of 2027 to have the P5.1 ship into a next program. That is kind of our timing. We think that we just sent it into production. Normally, it would take us some time, you know, late this summer to get them back, and then we start, you know, putting it into the hardware, validating, testing, and then hopefully get our clearance, and then we will be out, you know, sometime early of 2027. That is kind of our schedule.

At the same time, you know, we have a vision to bring one-to-one in hospitals and how, you know, we can make a cart-based experience with Butterfly better. iQ Station is actively on our roadmap, and it is probably a later 2027 timeframe for that. We are actively working on that program, and we think that will really codify the one-to-one model on the enterprise side. You know, we are working on making software easier, we are working to make our devices more powerful, we are working to make the workflow in the hospital easier. It is just a fate of it is just inevitable what will happen, and we are on the right path there.

You know, on the wearable side, you know, if we wanted to launch a wearable tomorrow, we could, or theoretically, we could, we can put that... Wearables is not an R&D thing, it is more of a what is the use case and what is the market and what is the business? Our philosophy right now is the success of home care will determine, you know, what our wearable use case is. The more that we push ultrasound, alt site, and we push it into nursing homes, we push it into the home, and then the more we will be, "Okay, now this is what it is being used for. This really makes sense.

This is sticking, and now let us automate it, and let us make it easier, and let us put a wearable out there." You know, we have there is one of our partners, Forest Neurotech, took our technology and created a wearable. Go on their website, you will actually see it. They put it right there. It is the technology around creating a wearable is not the challenge, it is, hey, what is the business use case? When does it make sense to invest the next several million dollars in hardware to put that out there? Our home care business, in my view, will determine the success and the timing of what is the right use case for wearables.

Benjamin Charles Haynor: Got it. That is very helpful. Any more you can share on that POCUS Innovators Forum that you held? That sounds like, quite the interesting event.

Joseph M. DeVivo: You know, you probably need to come next year. I probably have to invite our analysts. You know, we—

Benjamin Charles Haynor: No problem.

Joseph M. DeVivo: private the first year. The second year, we brought our whole management team and commercial team in to listen, which was a great education session. I think, you know, what is fascinating about that forum is it is not all one specialty. You have a cardiologist sitting next to an anesthesiologist, sitting next to an ER doctor, sitting next to a primary care doctor, sitting next to an intensivist, sitting next to a nurse, and sitting next to an administrator. They all have a tremendous passion for the power of being able to do a diagnosis immediately at the point of care.

We all heard them present their experiences, but we also gave them a forum to tell us what they need. That is where actually Compass AI came from for the, from the last year's forum, was when they said: "It just takes too long to document each one of these records." We went now from four to five minutes down to 30 seconds. You know, we listened to them, and that is why this forum is so important. I think while we had 60 people, we had about 40 people the first year, 60 people the next year, but we will probably open it up to, you know, 100 or more, and even maybe allow you guys to come, too.

We learned a lot, and the biggest thing that we learned is that we are on the right track. If we keep listening to our customers, and being honest with ourselves on what we need to do to improve, we will win. It was a great session, Ben.

Benjamin Charles Haynor: Sounds fantastic. Lastly, for me, just with Midjourney, you know, you phrase it as a revenue share potential rather than a royalty. Should folks read into that in any way? I mean, that strikes me more as a service offering rather than a device offering.

Joseph M. DeVivo: No, I think you just look into this like a partnership. We are all in with them, and we are doing everything we can to make them successful, and we will do everything we can to make them successful. We do not look at them as someone we are going to sell chips to. We look at them as someone that we are going to invest in, and we are going to do everything to amplify their use case.

If all of a sudden we need to do something that was not planned, we are just going to do it because, you know, we both believe in what they are doing, and we are going to be the best partner possible.

Benjamin Charles Haynor: Great. Thanks for taking the questions, guys.

Joseph M. DeVivo: Awesome, Ben. Thank you.

Operator: Thank you, Ben. We currently have no further questions, so I will hand back to Joe for closing remarks.

Joseph M. DeVivo: Well, thank you all for being with us this morning. I know that this time of the season is busy for all our investors and analysts. I hope you can see the excitement. You know, I think the most important thing, you know, for me is, you know, we put a plan together, and we are executing to our plan. Everything that you hear on this call, there is not one surprise. Not one. Everything that we are delivering, we have told you we are going to deliver. Everything that we are focusing on are things that we have mentioned, if not recently, you know, a year or two ago.

We are executing to our plan because there is a massive opportunity in digital ultrasound. We are digital to film, and we are digital that will take over analog. It is just a fait accompli. We have put a plan in place. We are executing to it. We have an awesome team. We are beyond the time where there was doubt about the company, and the only doubt should be in that, you know, for anyone who is in our way. I appreciate your attention, and I look forward to continuing to deliver results. Thank you.

Operator: Thank you, everyone. This concludes today's Butterfly Network, Inc. Q4 and FY 2025 earnings call. Thank you for joining. You may now disconnect your line.

This article is a transcript of this conference call produced for The Motley Fool. While we strive for our Foolish Best, there may be errors, omissions, or inaccuracies in this transcript. Parts of this article were created using Large Language Models (LLMs) based on The Motley Fool's insights and investing approach. It has been reviewed by our AI quality control systems. Since LLMs cannot (currently) own stocks, it has no positions in any of the stocks mentioned. As with all our articles, The Motley Fool does not assume any responsibility for your use of this content, and we strongly encourage you to do your own research, including listening to the call yourself and reading the company's SEC filings. Please see our Terms and Conditions for additional details, including our Obligatory Capitalized Disclaimers of Liability.

The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.