Oncology (cancer) diagnostics company NeoGenomics (NASDAQ: NEO) reported Q4 CY2025 results exceeding the market’s revenue expectations, with sales up 10.6% year on year to $190.2 million. The company expects the full year’s revenue to be around $797 million, close to analysts’ estimates. Its non-GAAP profit of $0.06 per share was $0.02 above analysts’ consensus estimates.
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NeoGenomics (NEO) Q4 CY2025 Highlights:
- Revenue: $190.2 million vs analyst estimates of $188.3 million (10.6% year-on-year growth, 1% beat)
- Adjusted EPS: $0.06 vs analyst estimates of $0.04 ($0.02 beat)
- Adjusted EBITDA: $13.38 million vs analyst estimates of $13.77 million (7% margin, 2.8% miss)
- Adjusted EPS guidance for the upcoming financial year 2026 is $0.19 at the midpoint, missing analyst estimates by 0.9%
- EBITDA guidance for the upcoming financial year 2026 is $56 million at the midpoint, below analyst estimates of $57.38 million
- Operating Margin: -7.1%, up from -10.7% in the same quarter last year
- Free Cash Flow was -$6.53 million compared to -$1.80 million in the same quarter last year
- Market Capitalization: $1.47 billion
Company Overview
Operating a network of CAP-accredited and CLIA-certified laboratories across the United States and United Kingdom, NeoGenomics (NASDAQ: NEO) provides specialized cancer diagnostic testing services, including genetic analysis, molecular testing, and pathology consultation for oncologists and healthcare providers.
Revenue Growth
A company’s long-term sales performance is one signal of its overall quality. Any business can put up a good quarter or two, but many enduring ones grow for years. Luckily, NeoGenomics’s sales grew at a decent 10.4% compounded annual growth rate over the last five years. Its growth was slightly above the average healthcare company and shows its offerings resonate with customers.
Long-term growth is the most important, but within healthcare, a half-decade historical view may miss new innovations or demand cycles. NeoGenomics’s annualized revenue growth of 10.9% over the last two years aligns with its five-year trend, suggesting its demand was stable. 
This quarter, NeoGenomics reported year-on-year revenue growth of 10.6%, and its $190.2 million of revenue exceeded Wall Street’s estimates by 1%.
Looking ahead, sell-side analysts expect revenue to grow 9.5% over the next 12 months, similar to its two-year rate. Still, this projection is commendable and indicates the market sees success for its products and services.
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Operating Margin
NeoGenomics’s high expenses have contributed to an average operating margin of negative 19.9% over the last five years. Unprofitable healthcare companies require extra attention because they could get caught swimming naked when the tide goes out. It’s hard to trust that the business can endure a full cycle.
On the plus side, NeoGenomics’s operating margin rose by 8.6 percentage points over the last five years, as its sales growth gave it operating leverage. Zooming in on its more recent performance, we can see the company’s trajectory is intact as its margin has also increased by 2.3 percentage points on a two-year basis.
NeoGenomics’s operating margin was negative 7.1% this quarter.
Earnings Per Share
Revenue trends explain a company’s historical growth, but the long-term change in earnings per share (EPS) points to the profitability of that growth – for example, a company could inflate its sales through excessive spending on advertising and promotions.
Sadly for NeoGenomics, its EPS declined by 3% annually over the last five years while its revenue grew by 10.4%. However, its operating margin actually improved during this time, telling us that non-fundamental factors such as interest expenses and taxes affected its ultimate earnings.
Diving into the nuances of NeoGenomics’s earnings can give us a better understanding of its performance. A five-year view shows NeoGenomics has diluted its shareholders, growing its share count by 12.6%. This dilution overshadowed its increased operational efficiency and has led to lower per share earnings. Taxes and interest expenses can also affect EPS but don’t tell us as much about a company’s fundamentals. 
In Q4, NeoGenomics reported adjusted EPS of $0.06, up from $0.04 in the same quarter last year. This print easily cleared analysts’ estimates, and shareholders should be content with the results. Over the next 12 months, Wall Street expects NeoGenomics’s full-year EPS of $0.12 to grow 50%.
Key Takeaways from NeoGenomics’s Q4 Results
It was good to see NeoGenomics beat analysts’ EPS expectations this quarter. We were also happy its revenue narrowly outperformed Wall Street’s estimates. On the other hand, its full-year EPS guidance slightly missed and its full-year EBITDA guidance fell short of Wall Street’s estimates. Zooming out, we think this was a mixed quarter. The market seemed to be hoping for more, and the stock traded down 2.9% to $11.05 immediately following the results.
So should you invest in NeoGenomics right now? If you’re making that decision, you should consider the bigger picture of valuation, business qualities, as well as the latest earnings. We cover that in our actionable full research report which you can read here (it’s free).
