BillionToOne (BLLN) Q4 2025 earnings summary

Executive summary

• Achieved 100% year-over-year revenue growth in 2025, reaching $305.1 million, with Q4 revenue at $96.1 million, driven by strong prenatal and oncology segments.

• Delivered positive GAAP operating margin and cash flow, with net income of $7.4 million for the year and positive operating income in both Q4 and full year.

• Gross margin expanded to 71.4% in Q4 2025, up 14–15 percentage points year-over-year.

• Ended 2025 with $496 million in cash and only $50 million in term debt.

• Launched new prenatal and oncology products, expanding the test portfolio and market reach.

Financial highlights

• Full year 2025 revenue: $305.1 million, up 100% from $152.6 million in 2024.

• Q4 gross profit: $68.6 million (gross margin 71.4%), up from $25.7 million (57%) in Q4 2024.

• Q4 operating income: $10.3 million (11% margin), compared to a loss of $11.7 million last year.

• Net income in Q4: $4.4 million, or $0.11 per diluted share; full year net income $2.9–$7.4 million.

• Oncology revenue grew 8.5x year-over-year to $25 million; prenatal revenue up 87% to $280.2 million.

Outlook and guidance

• 2026 revenue guidance raised to $430–$445 million, representing 41–46% growth.

• Expects continued positive GAAP operating income in 2026.

• Guidance does not include potential upside from new health system adoptions or UnitedHealthcare contract.

• Key growth drivers: expanded sales teams, new product launches, Medicaid coverage, and COGS reductions.