NeoGenomics (NEO) Q1 2026 Earnings Transcript

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DATE

Tuesday, April 28, 2026 at 4:30 p.m. ET

CALL PARTICIPANTS

• Chief Executive Officer — Tony Zook
• Chief Financial Officer — Abhishek Jain
• President and Chief Operating Officer — Warren Stone
• Vice President, Investor Relations — Priya Vedaraman

TAKEAWAYS

• Total Revenue -- $186.7 million, representing 11% growth year over year and surpassing previously issued guidance.
• Clinical Revenue -- $171.2 million, reflecting 14% year-over-year growth driven by demand, 6% higher volumes, and 8% increase in average unit price (AUP).
• NGS (Next-Generation Sequencing) Revenue -- Grew 26% year over year and now constitutes approximately one third of clinical revenue, with growth ahead of NGS market rates.
• Adjusted EBITDA -- $9 million for the quarter, up 27% year over year, with margin expanding by approximately 60 basis points.
• Adjusted Gross Margin -- 46%, decreasing by 80 basis points due to Pathline acquisition dilution and PanTracer Liquid launch prior to MolDX approval, offset partly by higher AUP and lab efficiency gains.
• Non-Clinical Revenue -- $15.5 million, representing a 15% decrease from the prior year, primarily linked to expected softness in pharma, while ODx business posted double-digit growth.
• Operational Expenses -- $99 million, down $2 million or 2% from prior year, with ongoing investments planned for Sales and R&D functions alongside improved G&A leverage.
• Cash Position -- Ended the quarter with $146 million in cash, with operating cash outflows reduced to $8.1 million from $25.3 million last year.
• Product Launches and Pipeline -- Full clinical launch of RADAR ST targeting two approved indications and PanTracer Liquid received MolDX approval in March, both expected to drive additional revenue through the year.
• Guidance Update -- Full-year 2026 revenue guidance increased to $797 million to $803 million, reflecting strong first-quarter results and MolDX approval of PanTracer Liquid.
• Same-Store Revenue (ex-Pathline) -- $167.9 million, showing 12% growth, with 3% test volume increase and 9% higher AUP for the quarter.
• PanTracer Portfolio -- PanTracer Pro accounted for almost 10% of PanTracer volume and attracted 15% of new users since its February introduction; workflow integration reported to accelerate physician decision-making.
• Sales Force Expansion -- Approximately 25 additional sales resources to be added by third quarter to support launch and deeper penetration of new indications; oncology outside sales team currently numbers in the 50s.
• Commercial Payer Contracts -- Over 300 contracts in place, supporting broad access and minimized provider-patient friction.
• Epic Aura Integration -- Go-live achieved for first customer; third-party data indicates potential for a 20%-30% increase in test adoption per site with broader rollout ongoing in therapy selection and MRD segments.

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RISKS

• Abhishek Jain stated, "our non-clinical business, we reported $15.5 million in revenue, a decline of 15% year over year, primarily driven by expected softness in pharma."
• Abhishek Jain highlighted that adjusted gross margin was "down 80 basis points as compared to last year," attributing the deceleration to "the dilutive impact of the Pathline acquisition and the launch of PanTracer Liquid prior to MolDX approval."
• Guidance indicates anticipated headwinds from exiting a high-volume, low-value contract, expected to weigh on volume growth in the second and third quarters.
• Higher freight costs and fuel surcharges negatively impacted margins due to the geopolitical environment, as per management commentary.

SUMMARY

Management announced an 11% year-over-year revenue increase and raised full-year revenue guidance after a strong first quarter, with clinical revenue up 14%, and highlighted sustained double-digit adjusted EBITDA growth. NeoGenomics (NASDAQ:NEO) launched RADAR ST for MRD and secured MolDX approval for PanTracer Liquid, positioning both for incremental market share as additional cancer indications await reimbursement decisions. The company accelerated its mix-shift toward higher-value tests, supported by 26% NGS revenue growth, expanding commercial reach, and new technology integration including Epic Aura, which is expected to drive further adoption in coming quarters.

• Volumes and AUP both contributed materially to clinical revenue, but future quarterly growth is forecast to rely increasingly on AUP following strategic contract rationalization.
• Cash burn improved significantly versus last year, as total cash reached $146 million and operational outflows declined from $25.3 million to $8.1 million for the quarter.
• PanTracer Pro's single-sample solution accelerated therapy selection workflows and shifted ordering behavior, with one-check requisitions leading to more timely, guideline-driven decisions.
• Medicare and direct client payments are expected to anchor early payer mix for new launches, while commercial coverage is in process given the company's 300 contracted payers.
• Management reaffirms intent to complete refinancing of the $342 million convertible debt by the second half of the year, stating "We are confident it will not be a challenge to refinance the convert."
• Epic Aura's initial implementation and ongoing rollout are anticipated to support therapy selection and MRD segment momentum, with upside if activation accelerates or pull-through outpaces expectations.

INDUSTRY GLOSSARY

• NGS (Next-Generation Sequencing): Advanced genomic sequencing technology enabling simultaneous analysis of multiple genes or entire genomes, used for therapy selection, diagnosis, and monitoring in oncology.
• MRD (Molecular Residual Disease): Molecular testing to detect minimal residual cancer cells post-treatment, aiding recurrence monitoring and treatment planning.
• PanTracer: NeoGenomics’ portfolio of integrated solid tumor genomic tests for therapy selection, including tissue and liquid (ctDNA-based) diagnostic solutions.
• MolDX: Molecular Diagnostics program operated by Medicare administrative contractors that determines coverage and reimbursement for molecular diagnostic tests.
• RADAR ST: Circulating tumor DNA assay by NeoGenomics for sensitive detection of molecular residual disease, initially launched for HPV-negative head and neck and a subset of breast cancers.
• ODx: Companion diagnostics business segment focused on diagnostic tests tied to specific drug therapies or targeted treatments in oncology.
• Epic Aura: Integration and interface tool for Epic health record systems, simplifying and accelerating the adoption of laboratory tests within clinical workflows.
• AUP (Average Unit Price): The average revenue recognized per test performed, reflecting pricing discipline and test-mix changes.

Full Conference Call Transcript

Priya Vedaraman: Thank you, Matthew. Good afternoon, everyone. Welcome to the NeoGenomics, Inc. first quarter 2026 financial results call. With me today to discuss the results are Tony Zook, Chief Executive Officer, Abhishek Jain, Chief Financial Officer, and Warren Stone, President and Chief Operating Officer. Additional members of the management team will be available for the Q&A portion of our call. This call is being simultaneously webcast. We will be advancing through a brief slide presentation to accompany today's call. We have also made the presentation available on the Investors tab of our website at ir.neogenomics.com.

During this call, we will make forward-looking statements regarding our future financial and business performance, planned future operations and related expectations with respect to timing and performance, future financial position, future revenue, growth potential and expected growth drivers, projected costs and capital expenditure, prospects and plans, estimated market size and position, and objectives of management and financial guidance. We caution you that the actual events or results could differ materially from those expressed or implied by the forward-looking statements. These forward-looking statements made during the call speak only as of the original date of this call, and we undertake no obligation to update or revise any of these statements.

Please refer to the information disclosed on the safe harbor statement slide in the deck posted on our website as well as the information under the heading Risk Factors in our most recent Forms 10-K, 10-Q, and 8-K that we filed with the SEC, to identify important risks and other factors that may cause our actual results to differ materially from the forward-looking statements. These documents can be found in the Investors section of our website or on the SEC website. During this call, we also refer to certain non-GAAP financial measures that involve adjustments to GAAP results.

The non-GAAP financial measures presented should not be considered an alternative to the financial measures required by GAAP, should not be considered measures of liquidity, and are unlikely to be comparable to non-GAAP financial measures provided by other companies. Any non-GAAP financial measures referenced on this call are reconciled to the most directly comparable GAAP financial measures in a table available in the press release we issued this afternoon and in the slide deck available in the Investors section of our website. I will now turn the call over to Tony Zook.

Tony Zook: Thank you, Priya, and welcome everyone. For those of you who are relatively new to the NeoGenomics, Inc. story, let me review our investment thesis. We are a pure play oncology solutions company, leveraging our strong heritage in hematology, pathologists, and community hospitals, where we enjoy a leading 25% share across diagnostics and therapy selection. We believe we are highly differentiated from large reference labs as well as specialty diagnostic companies in a few regards: the depth and breadth of our portfolio and a relentless focus in the community setting. We believe in the power of our portfolio and see it as a point of competitive distinction and advantage.

We reentered the MRD space with RADAR ST, which we will discuss momentarily, allowing us to address a $20 billion market opportunity where we will continue to leverage our ambition to be a partner of choice among community practices. And importantly, we believe we are well poised to deliver consistent, double-digit revenue growth. As mentioned, it is our desire to be a partner of choice in the community from diagnosis to recurrence monitoring. Our foundation and strength in hematology and diagnostic testing affords us a strong platform for growth.

We have and will continue to be purposeful with our portfolio transformation as evidenced by our product launches enabling our penetration into the $13 billion therapy selection market, and now with RADAR ST, we have reentered the $20 billion MRD market—both of which are enjoying robust growth but are still relatively modest in penetration rates. This portfolio transformation is evident in our selling performance. The five NGS products we launched in 2023 that we have consistently tracked contributed 25% of our clinical revenue in Q1. So with that, let us highlight some of our key performance metrics for Q1. During the first quarter, we again delivered double-digit revenue growth, reflecting our ability to generate consistent and predictable sales.

Total revenue for Q1 was $186.7 million, representing 11% growth year over year and exceeding our guidance. Adjusted EBITDA of $9 million increased 27% over 2025 and the adjusted EBITDA margin increased approximately 60 basis points year over year. Our Clinical business continued its robust growth, with revenue increasing 14% year over year to $171 million. Clinical performance was driven by effective execution of our commercial strategy, enabling volume growth and share gains in all segments of our business. In this quarter, we again saw an improvement in AUP, which reflected 8% year-over-year growth, and volumes growing 6% year over year.

Turning to NGS, revenue grew 26%, well ahead of the NGS market growth rate, driven by strong volume and AUP growth. Our NGS business now represents about a third of our total clinical revenue. Moving forward, we believe the addition of PanTracer liquid biopsy to the PanTracer family, combined with ongoing investments in our field force size and capabilities, will help us to sustain above-market growth for this part of our portfolio. The momentum with which we exited 2025 continued into the first quarter. As we have shared, we continue to see above-market growth with our non-NGS clinical business, which should continue to grow in the mid-single-digit range as we take share across all modalities.

Importantly, and in line with our overall strategy, our NGS business is scaling at a rate that is three to four times faster than our core clinical business. We are often asked how we win in the community setting, and if the growth is sustainable. I am going to ask Warren to step you through our commercial strategy and give you some insight into our early launch experiences with the PanTracer family and RADAR ST.

Warren Stone: Thank you, Tony, and good afternoon, everybody. Our primary focus is the community setting, where approximately 80% of patients seek treatment so they are close to their support structure. Additionally, most patients live an hour or more from the nearest NCI-designated cancer center. To start, we believe that community oncologists prioritize historic patient management and prioritize certainty over possibility. Guidelines drive their decision making and ensure actionability. With large patient volumes and resource constraints, they choose partners that reduce friction and increase confidence in treatment decisions. Secondly, our leadership in hematology, where we hold greater than a 25% market share, provides trusted access and creates a strong foundation to expand adoption of our broader portfolio.

Third, rapid test results directly impact patient outcomes, and our balanced lab network enables industry-leading turnaround times. The Pathline acquisition strengthened our Northeast presence and grew at 1.5 times our national average, demonstrating the power of local scale to drive service and growth. Finally, our portfolio spans over 500 tests across diagnosis, therapy selection, and MRD, positioning us as a true partner in patient management. We have developed over 330 interfaces, including the recently announced Epic Aura, where published third-party research could drive a 20% to 30% increase in test adoption per site. This position is also supported by a broad commercial payer network of more than 300 contracts, minimizing friction for both providers and patients.

In summary, we simplify the complexity of oncology diagnostics so physicians can focus on delivering the best possible patient care. Turning now to RADAR ST, a circulating tumor DNA assay with exceptional sensitivity for early detection of molecular residual disease. In late February, we announced the full clinical launch of RADAR ST, which has detection as low as 1 ppm. The launch targets two approved indications: HPV-negative head and neck cancer, and a subset of breast cancer. In addition, we have submitted to MolDX for reimbursement in two additional cancer indications, which, if granted, would more than double our market opportunity. Early insights from the RADAR ST launch to date are very encouraging.

Approximately 29% of customers who previously used RADAR 1.0 have ordered RADAR ST since launch. Additionally, 34% of RADAR ST orders received include additional NeoGenomics, Inc. tests. All test results to date have been delivered faster than our published turnaround times. RADAR ST represents a very important advancement in MRD testing, and with its clinical launch, we now offer a comprehensive solid tumor solution spanning diagnosis, profiling, therapy selection, and MRD. Looking ahead, we are focused on targeted R&D investments in whole genome sequencing, including our next-generation MRD assay, and a whole genome solution for heme. Strengthening of our pipeline increases durability and positions us effectively to address future market needs.

Our next-generation MRD platform is progressing well, with data generation expected next year and potential launches as early as 2028. In parallel, we are advancing our non-clinical portfolio to meet the evolving needs of pharma. This includes expanding our MRD offering with an off-the-shelf single-tube AML flow panel designed for broader applications across CLL, B-ALL, and multiple myeloma, as well as enhancing our IHC menu with five new CDx-relevant markers. Turning to our PanTracer portfolio, our integrated solution for solid tumor therapy selection is designed to combine tissue and liquid testing to deliver confident, actionable insights for real-time treatment decisions.

PanTracer Liquid is a non-invasive blood-based test that analyzes circulating tumor DNA to identify key genomic alterations that inform treatment in patients with advanced-stage tumors. With MolDX reimbursement received, we are expecting revenue contributions to ramp throughout the year. The expansion of PanTracer with PanTracer Pro turns a very fragmented tumor physician workup into a coordinated and accelerated workflow from a single sample. It fully integrates the therapy selection workflow by combining comprehensive genomic profiling with immunohistochemistry and other auxiliary tests, allowing oncologists to manage the entire cancer diagnostic workflow from a single requisition and sample. This allows for faster test turnaround and more timely clinical decision making. Slide 13 illustrates a typical PanTracer workflow.

After the test requisition is received, the pathology report is reviewed and ovarian cancer diagnosis is confirmed. The OncoTree then identifies the guideline-relevant add-on tests. In this case, five medically necessary assays, including the recent new launch PD-L1 22C3 FDA for ovarian carcinomas, are included. The slides are prepared and the tests performed. The add-on results are reported to the physician by day 4 and the NGS results are reported by day 8. As part of our go-to-market strategy, we have expanded our sales force to increase reach and frequency and accelerate penetration in therapy selection and MRD markets. The commercial expansion, coupled with the only MolDX-approved HPV-negative test currently available, positions us to accelerate adoption.

We plan to add roughly 25 sales resources by the third quarter of this year to support the launch and penetration of RADAR ST and two new indications which we have submitted to MolDX. In summary, we are very pleased with our performance, both financial and strategic, in the first quarter, and we are excited for the business levers that are available for us to drive improved and accelerated financial performance in the future. With that, I will hand over to Abhishek to further discuss our results for the quarter.

Abhishek Jain: Thank you, Warren, and good afternoon, everyone. In my remarks today, I will discuss our first quarter financial results and revised 2026 guidance. We reported total revenue of $186.7 million, up 11% year over year, driven by clinical revenue of $171.2 million, which grew a strong 14%. This performance was driven by healthy underlying demand with volumes up 6% and AUP increasing 8% as compared to the same quarter last year. Same-store revenue, excluding Pathline, was $167.9 million, representing 12% growth versus the prior year period, driven by a 3% increase in test volumes and a 9% increase in AUP.

Importantly, both in-site test volumes and AUP growth performed at the high level of our expectations despite the anticipated impact of strategically exiting a high-volume, low-value contract. Most encouraging is the ongoing mix shift towards high-value testing driven by strong performance in our NGS business that grew 26% year over year and now represents approximately one third of our clinical revenue. Our targeted investments in the sales team are delivering tangible results and supporting this continued momentum in our NGS business. Further, this favorable mix shift towards high-value testing is also contributing meaningfully to drive AUP growth of 8% year over year. AUP increase was also supported by our RCM initiatives including managed care pricing gains and improved pull-through.

Turning to our non-clinical business, we reported $15.5 million in revenue, a decline of 15% year over year, primarily driven by expected softness in pharma. Our ODx business delivered double-digit growth that helped partially offset the declines in pharma. We believe that we are near the bottom for this business and expect to see sequential growth in the back half of the year. Adjusted gross profit improved by [inaudible] million, or 9%, over the prior year and adjusted gross margin was 46%, down 80 basis points as compared to last year.

As expected, the decline in gross margin in the first quarter was primarily driven by the dilutive impact of the Pathline acquisition and the launch of PanTracer Liquid prior to MolDX approval. Together, these factors represented approximately 150 basis points of headwind in Q1 2026. In addition, we were impacted by higher freight costs and fuel charges due to the geopolitical situation. These headwinds were partially offset by gross margin expansion primarily driven by AUP increase and lab efficiency. Looking ahead, we continue to expect gross margin expansion of approximately 100 basis points year over year in 2026 driven by our Lab of the Future initiative which includes strategic sourcing, histopathology, lab automation, and platform upgrade.

We also expect margin progression to benefit from easier compares in the coming quarters. Total operating expenses in the quarter were $99 million, a decrease of $2 million, or 2%, from prior year. We plan to make targeted investments in our Sales and R&D functions to drive clinical test volumes and higher AUP while continuing to improve leverage in G&A, which we expect to continue to decline as a percentage of revenue. Adjusted EBITDA was $9 million, up 27% year over year, and the adjusted EBITDA margin expanded 60 basis points. This margin expansion was driven by operating leverage in our G&A function that more than offset the headwinds from adjusted gross margin reduction.

Cash used in operations was $8.1 million in the quarter, down from approximately $25.3 million in the same quarter last year. We ended the quarter with total cash of $146 million. Our goal continues to be free cash flow positive this year. Turning now to our 2026 guidance. Considering our strong first quarter revenue performance, and earlier than assumed MolDX approval of PanTracer Liquid in March, we are increasing our full-year revenue guidance to a range of $797 million to $803 million, up from $793 million to $801 million previously. The key assumptions underlying the midpoint of our revenue guidance are as follows. First, no change in RADAR ST revenue assumption which remains in the mid-single-digit millions.

Second, we expect PanTracer Liquid revenue to be in the mid-single-digit millions, following MolDX approval in early March. Third, no change in revenue assumptions for our non-clinical business which we expect to be down low- to mid-single digits year over year in 2026. Regarding the quarterly cadence, we now suggest modeling approximately 9% year-over-year growth in the second quarter, up from the 8% to 9% range previously discussed, followed by 9% to 10% growth in the third quarter and above 10% in the fourth quarter of 2026. Turning to gross margin, no change in our guidance, and we expect approximately 100 basis points of gross margin expansion in 2026, driven by a combination of factors we discussed earlier.

We are maintaining and reiterating our full-year 2026 adjusted EBITDA guidance of $55 million to $57 million, representing year-over-year growth of approximately 27% to 31%. As discussed previously, adjusted EBITDA was impacted by higher freight costs and fuel surcharges due to the geopolitical environment. We have taken actions to offset these pressures while remaining committed to our previously communicated adjusted EBITDA guidance. With that, let me turn the call back to Tony.

Tony Zook: Reviewing the significant catalysts for the year, I am very pleased with our progress to date. We launched RADAR ST in head and neck and in a subset of breast cancers, and received MolDX reimbursement for PanTracer Liquid biopsy. We continue to drive NGS growth well ahead of market growth rates. Looking out to the remainder of the year, we anticipate MolDX reimbursement decisions for two additional RADAR ST indications which, if granted, would double the population of patients eligible for this advanced MRD test. We are also advancing plans to expand our sales force by the third quarter to capture these additional opportunities that are emerging in advanced cancer testing.

Taken together, I believe these catalysts form a solid foundation from which to drive future growth. I will close by outlining how we are driving accelerated financial performance through execution across our key business levers. The launch of RADAR ST and MolDX approval for liquid biopsy have opened up large addressable markets, and we are focused on driving adoption alongside continued expansion into new indications and advancement of our next-generation MRD programs. Commercial initiatives across sales, pricing, and payer coverage are improving access and monetization, while ongoing investments in automation, platform upgrades, and lab optimization are enhancing efficiency and scalability. Together, these efforts position us well for sustained growth in 2026 and beyond.

Thank you for your continued interest in NeoGenomics, Inc. Operator, this concludes our prepared remarks. Please open up the line for questions.

Operator: We will now open the call for questions. Certainly. Everyone at this time will be conducting a question-and-answer session. If you have any questions or comments, please press 1 on your phone at this time. We do ask that while posing your question, please pick up your handset if you are listening on speakerphone to provide optimum sound quality. Once again, if you have any questions or comments, please press 1 on your phone. Your first question is coming from David Westenberg from Piper Sandler. Your line is live.

David Westenberg: Hi. Thanks for taking the question, and congrats on all the growth. I want to focus on the positive here. The NGS growth has been robust. You have been tracking in the mid-twenties for a long time, but you are facing difficult comps. As we model the durability of the growth algorithm, can you talk about NGS growth predicated on PanTracer Liquid versus tissue? How should we see that mix growth? Can that help you sustain kind of that 20% range? And then secondly, how do we think about the AUP over the next couple of years as this starts to ramp? And I will ask one small follow-up.

Tony Zook: Okay, Dave. Thanks for the question. I will kick us off, then Warren can fill in some color as well. First, on the sustainability of NGS, I appreciate the question. We are showing really good growth in NGS. As we said, 26% revenue growth, and that was driven by 16% volume growth. If you turn back the hands of time, we closed last year at 23% in Q4, and we did 22% for the year. At that time, we said we thought we would be able to sustain that at a minimum, if not beat it, with the addition of PanTracer Liquid. Looking at where we sit right now, we feel very good.

The early products that we mentioned before were up to 25% of our clinical revenue in the quarter. Early days of PanTracer are showing really good signs for us. Warren can go into a bit more detail on PanTracer Liquid, but even PanTracer Pro, which was introduced in February, is now almost 10% of PanTracer volume, which is exciting because it has captured 15% of new users. So we absolutely think that it is sustainable, and with the addition of liquid biopsy to the family, we think it can go even further. On AUP, again, very strong performance there. We were up 8% year over year, and I would say that is indicative of the strategy.

We have been very purposeful in saying that we are going to drive growth with that NGS portfolio of ours. Increasing NGS as a percentage of our business—which is now up to a third—and growing it is going to have a big contributing factor to AUP. I would say as well, about half of it is driven by the great work that the team does behind the scenes on the RCM initiatives. We talk about the 300 contracts, and we look at those contracts all the time. Every opportunity we have to increase price, to do direct price increases, all of those initiatives add up. So we believe the AUP is also sustainable this year.

About half of that is driven by mix and the increased volume in NGS, and about half is the good work behind the scenes. And maybe one final point with AUP: while NGS is the big driver there, we are seeing AUP increase contributions across all modalities. It is not just NGS that is contributing; it is the portfolio.

David Westenberg: Got it. That was a really long answer, so I will just hop off. Thanks so much.

Tony Zook: Thank you, Dave.

Operator: Your next question is coming from Tycho Peterson from Jefferies. Your line is live.

Tycho Peterson: Hey. Thanks. Maybe one for Abhishek. Just on the guidance raise. In the past, you have gotten over your skis with raising guidance, to cut later. Why not bank the beat and de-risk the remainder of the year? Or conversely, can you point to what is trending more positive? Was it April data points, the new launches you have talked to? Maybe get us comfortable that guidance is still conservative and beatable here?

Tony Zook: Sure, happy to, and then I will let Abhishek jump in on the details. Relative to the guidance, Tycho, you are right—we want to maintain the philosophy that we shared with you. When we issue our guide, you asked us to only speak with a high degree of confidence, not just with the center point of that guide—making sure we could get to the upper end of that guide at a minimum. We have taken those factors into consideration with this guide. What are the positives? Again, 11% revenue growth, but it was driven by 14% clinical revenue growth. That is certainly a driver, and NGS is a driver for us to be certain.

Based on the middle of that guide, where do we see potential opportunity and where is there some risk? I would say the opportunity is certainly with the NGS portfolio, with emphasis on PanTracer Liquid. Getting another quarter of opportunity to drive revenue and getting out in front with commercial payers—if we can plow that field well, we think there is opportunity associated with the guide relative to PanTracer Liquid. We think there is potential opportunity as well in our non-clinical business. It is way too early despite the football there, which is why we still want to be relatively conservative.

But we are seeing early signs that we are hitting what we said, which would be low single-digit erosion on the non-clinical side. So there is some risk there, but we think that it is taken into account at this point. The other area of opportunity would be even better uptake with RADAR ST. We are playing this one right down the middle, with single-digit millions in the middle of the guide. If the additional indications were to come on board sooner than we thought, that could represent some upside.

We do see some potential risk on the non-clinical side—that is not a new story to you—but we see the rate of decline of that business beginning to slow, and activity beginning to pick up. On balance, we would say there is probably more opportunity than downside against what we have shared with you today. Does that help?

Tycho Peterson: That does. Another question is you lap Pathline next quarter. How do we think about volume growth as you lap that? You grew volumes 2.8% ex-Pathline. Is that kind of the right run rate for the business? You are rolling off big lab contracts. How do we think about just lapping Pathline?

Tony Zook: The most important element—and I will ask Abhishek to get into your specific question on volumes—I look less at the actual volumes associated with just pure Pathline and more at the Northeast, because that was the strategic purpose of having it. Our growth in the Northeast region was 1.5 times faster than the other regions, and that is a first for us. We see the strategic benefit of serving those customers coming through. Our total value associated with Pathline in the Northeast region is absolutely increasing on plan, albeit the actual volumes might be down a little bit because of the non-oncology business we exited. Abhishek?

Abhishek Jain: Let me talk to the overall volume picture, Tycho. We guided low single-digit volume growth for the full year. We came in at about 6% growth for the first quarter. As per the guidance, the second quarter is going to be flattish from a year-over-year growth standpoint. We will start to see sequential growth in our volume from Q2 onwards. That is the good part. A lot of the revenue growth is going to come from AUP in our remaining quarters for the year. We are exiting a high-volume, low-value contract as we look into Q2 and Q3.

Q3 2025 was the peak quarter for this particular one contract, and that is the reason we will have those headwinds in Q2 and Q3. But overall, from the clinical revenue standpoint, we are growing a strong 14% in the current quarter, and our guide keeps us at about 11% growth for our clinical business for the rest of the year.

Tycho Peterson: My last quick one—on the convert. You burned $14 million in cash. You have $146 million in cash and a $342 million convert due January 2028. Can you quickly touch on plans for that?

Abhishek Jain: We are discussing with many of the leading banks on the convert refinancing, and everybody has told me that this has been a good market in 2025 and what we have seen in 2026. We are confident it will not be a challenge to refinance the convert. We are trying to make sure that we are able to get the currency of our stock, which we believe is highly underappreciated, back to a level where we feel it is the right time to do the refinancing. In any case, our plan is to get the refinancing done in the second half of the year. We do not want to leave this open for fairly late in the game.

Tony Zook: Thank you.

Operator: Your next question is coming from Puneet Souda from Leerink. Your line is live.

Puneet Souda: Hi, thanks for the questions. First, was there any weather impact in the quarter, and are you expecting anything in 2Q as a result? Also on the NGS side, how should we think about the ceiling? It is a third of your business and growing rapidly in the community setting. What is the ceiling there? And can you clarify what is included in NGS and what is not?

Tony Zook: On the weather, when we issued the guide for the first quarter, we had already indicated what we anticipated to be the weather impact, and it came in pretty much as we expected. We do not see any issues moving forward through Q2. On the NGS question, Warren?

Warren Stone: How we are defining NGS is simply NGS for our heme cancers and NGS for our solid tumors, largely within the therapy selection vertical. Even though MRD runs on an NGS backbone, we call that out separately; the 26% growth you see excludes any MRD. In terms of the outlook, we would be disappointed if, in the midterm, NGS is not more at the 40% mix of clinical revenue; that is how you should think about it. This is definitely the growth engine of the business. You can see the trajectory since 2022. The portfolio that we added in 2023 and have continued to add is going to continue to fuel that growth at around the 20%+ mark.

Puneet Souda: Follow-up: there is a lot of discussion about repeat use of CGP liquid. When do you think you can start to see some benefit from that in the setting you are serving?

Warren Stone: We have already seen some repeat testing on liquid biopsy, which is encouraging. As the scale continues to grow in the second half of the year, we expect to see more repeat testing. We also anticipate that as we put more patient programs into place to support RADAR ST, we can layer some of those workflows and applications into liquid biopsy as well. This is part of the growth assumption that will help continue the momentum.

Operator: Your next question is coming from William Bonello from Craig-Hallum. Your line is live.

William Bonello: Thanks a lot. I wanted to ask about the PanTracer Pro program—how it works and what you are seeing. Am I understanding this right that somebody checks that box and then, based on what you see in an algorithm along with pathologist experience, you make a decision about the complete set of follow-on tests that should be ordered? Can you give us a sense of comparison in value when physicians are ordering that option versus when they are selecting a straight-up panel?

Warren Stone: Bill, you outlined the workflow pretty well. We try to take friction out of the system and make the ordering experience as easy as possible, whether through a bidirectional interface, a portal, or paper. It is a one-check requisition. Typically, a diagnosis has taken place already at the anatomic pathology core. That gets read, and the algorithm then determines—based on guidelines and what is medically necessary—what additional add-on testing should be performed based on that specific diagnosis. The add-on testing will vary based on the diagnosis. In the ovarian example I shared, we added five additional tests, including the new PD-L1 for ovarian carcinomas. The system does that automatically.

We then cut the slides appropriately, perform the testing, and report out the add-on testing results as soon as they are available, typically before NGS. That is valuable because you can get an early indication around what therapies you may want to put somebody on. Once the NGS is available—typically three or four days thereafter—we submit the NGS results so the physician has a complete package to make a more holistic treatment decision. In the past, a physician could have done that themselves, but in the community setting, with many different patients and indications, they often do not.

They would typically send PanTracer in and then send a second requisition later to do add-on testing, which takes longer and exhausts more sample. This approach has a lot of efficiencies and typically results in additional add-on testing, which has a revenue component, but I want to stress it is only what is driven by guidelines and medically necessary.

Operator: Your next question is coming from Analyst from Stephens. Your line is live.

Analyst: Hey, good afternoon. This is Ben on for Mason. Could you help us bridge Q1 reported AUP to the underlying core AUP after adjusting for that low-value contract? I believe some remaining volumes of that contract were expected to flow through in the first quarter here.

Abhishek Jain: We grew our AUP by 8% year over year. Excluding Pathline, the number was 9%. If you exclude the impact of the high-volume, low-value contract, it did not impact the AUP change much because the number of tests became a smaller portion and there was a little bit of growth in the AUP we saw as we progressed in 2025 from Q1 onwards. The impact from the high-volume, low-value test was about a point or so in the overall AUP growth. The AUP growth was primarily driven by the higher mix of high-value testing—our NGS growth—as well as the impact of the RCM work we have done.

Analyst: That makes sense. And then on the two additional RADAR MolDX submissions, has anything changed in your confidence or the expected timing of when you could get those decisions? Is prior to year-end the right way to think about those?

Tony Zook: It is. That has been a consistent assumption we have shared. We submitted at the close of last year. We anticipate those can be available to us by the close of this year, which is why we are gearing up the sales force in anticipation of addressing those in the second half of the year.

Operator: Your next question is coming from Analyst from Guggenheim. Your line is live.

Analyst: Thank you for taking my questions. What percentage of liquid biopsy orders today are Medicare versus commercial? And what is the realistic timeline to getting meaningful private payer rates? The rate is $3,289—fully loaded cost to deliver—how much is it accretive to gross margins from day one, or is there a scale threshold you need to hit first? And I have the same question for RADAR ST as well—the impact on gross margin from day one to when it ramps.

Abhishek Jain: For liquid, because we have not seen all the volumes since our soft launch in the second half of last year, we are going to push on all cylinders now to increase volume. I will use PanTracer tissue as a proxy to provide the fair mix. Between Medicare and client bill, the direct client is about 40% that we would get paid, then about 10 points of Medicare Advantage, and the other 50% are commercial payers. We believe we will start to get paid on the 40%—client bill and Medicare. With commercial, as you know, there will be time needed to build coverage and policy.

Given we already have contracts with 300 payers, that gives us a seat at the table, and we should be able to progress relatively faster, but it will take time. For RADAR ST, the mix is slightly different. Medicare is about 20% to 25%, Medicare Advantage 10% to 15%, and the rest commercial and some Medicaid tail. Payment will start with Medicare, and then we will build commercial coverage. On gross margin accretion, liquid biopsy becomes more accretive as scale builds and payer mix improves; early periods are less accretive due to start-up and reimbursement ramp dynamics. The same general dynamic applies to RADAR ST.

Analyst: And just to put all the numbers together, the low-value contract you rationalized—were those largely Pathline volumes or unrelated?

Abhishek Jain: Not Pathline volumes. Overall volumes in 2025 were roughly 1.35 million. We said that this high-volume, low-value contract was about 3% to 4% of overall volume. Pathline is much smaller. This was a different contract.

Operator: Your next question is coming from Daniel Gregory Brennan from TD Cowen. Your line is live.

Daniel Gregory Brennan: Thanks for the questions. First, on the guide for Q2 and for the year—you kind of spoke to it, but for NGS and ex-NGS, what are we expecting for Q2, and how does it look for the full year?

Abhishek Jain: We are guiding to $800 million at the midpoint for the full year. For Q2, revenue growth is going to be 9% year over year, compared to the 8% to 9% we guided last time. We are adding more dollars in Q2 because of the MolDX approval for liquid. For NGS, excluding liquid, we expect to be in line with 2025—about 22%. This is a prudent guide that gives us a high degree of confidence to hit the midpoint, but we believe we should be able to do better than mid-single-digit millions on liquid. We would be disappointed internally if we do not.

If we see similar growth in NGS to the 25% to 26% we have been delivering, that could be another upside.

Daniel Gregory Brennan: You called out Epic Aura and the upside others have seen. Where are you, what are you seeing so far, what is baked in, and what would get you to that uplift?

Warren Stone: We went live with our first customer earlier this month. Epic Aura allows for significantly faster implementation with customers. We are targeting Epic Aura implementations for therapy selection and MRD. We have a robust pipeline of accounts to activate in Q2 through the year. We are expecting to see that uptick as the year progresses. This is one of the key levers in sustaining the high NGS growth rate and will help drive demand for RADAR ST due to the simplified workflow.

Daniel Gregory Brennan: So some of the benefit is baked into the guide, but there is potentially upside if you accelerate activations?

Warren Stone: Correct. If we are able to accelerate implementations beyond what we put in the guide, there is upside. If the pull-through is as significant as articulated in independent studies, there is upside as well. We did not assume the most radical uplift, but studies point to that potential.

Operator: Your next question is coming from Michael Leonidovich Ryskin from Bank of America. Your line is live.

Michael Leonidovich Ryskin: Thanks. A couple of quick ones. You commented on growth expectations through the year for both NGS and non-NGS. What is the implicit contribution from some of the salesforce expansion? Is that playing a role in the second half, or more of a 2027 benefit?

Tony Zook: The salesforce has been quite productive for us. If you look at the size of our salesforce and our spend, we are relatively under-indexed versus many competitors. Our sales and marketing ratio is around 13%. The oncology outside sales team, being in the 50s, is a relatively low number, yet they have proven to be productive. The share gains you have seen with the NGS portfolio are driven in large part by increased penetration into the community oncology space. We see the salesforce as a lever to continue to drive growth and as an opportunity with products like RADAR ST, where market penetration is still low.

We will be selective in how we expand to avoid disrupting established customer relationships, but it is clearly a growth driver. I do not think we would be where we are today with 26% NGS growth had it not been for the investment made a year ago.

Michael Leonidovich Ryskin: Follow-up: on Pathline contribution—it continues to step down and stepped down a bit more this quarter. You called out benefit in the Northeast and broader uplift, but anything specific to call out? Do we expect that to continue, or was it weather?

Tony Zook: It should not be a surprise that there might have been a slight step down in volumes associated with Pathline because we exited some non-oncology business. We are also doing load balancing—tests do not always have to go through Pathline; they can be run in Fort Myers or Aliso Viejo. That is why I put more stock into the Northeast performance. Pathline delivered what we expected in its range of revenue, but the growth driver we see in the Northeast is the catalyst.

Warren Stone: The Northeast was probably the area most affected by weather in the first quarter. So you have weather, non-oncology business that we stepped out of, and leveraging our lab network for best possible turnaround time and scale. Some testing historically done in Ramsey has moved to other parts of our network. Overall, we are very pleased with developments—1.5 times market growth in the Northeast is really encouraging.

Operator: Our next question comes from Michael Stephen Matson from Needham. Your line is live.

Michael Stephen Matson: Thanks. I thought I heard you say that within the NGS business, there is some price benefit. I know NGS is growing as part of the overall mix and driving price, but is there positive pricing mix within NGS and what is driving it?

Abhishek Jain: In NGS, we grew 26%. Sixteen percent was driven by volume, and the other 10% came from AUP increase. The AUP increase has been due to RCM initiatives we have put in place and also an increasing share of larger CGP panels within NGS as we move away from single-gene panels. That shift to higher-value testing is helping drive AUP higher.

Michael Stephen Matson: The $20 billion MRD market—when you get these additional two indications covered and you are at four, you said that would double the available market to you. What portion of that $20 billion will you be covering?

Warren Stone: Based on our analysis, we will be north of 45% of the market across those four indications.

Operator: That concludes our Q&A session. I will now hand the conference back to Tony Zook for closing remarks. Please go ahead.

Tony Zook: I would like to thank everybody for joining us on the call. I would also like to thank our roughly 2,400 teammates at NeoGenomics, Inc. for their continued hard work and unwavering commitment to our mission. With meaningful additions to our therapy selection and MRD test offerings during the first quarter, I am very excited for the year ahead as well as 2027 and beyond, as these high-value tests represent a growing portion of our clinical business. I look forward to our next quarterly update in July when we report our second quarter results. Thank you again, and have a great day.

Operator: Thank you. Everyone, this concludes today's event. You may disconnect at this time, and have a wonderful day. Thank you for your participation.

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