Lumexa Imaging (LMRI) Q4 2025 earnings summary

Executive summary

• Achieved strong Q4 and full-year 2025 results, with revenue and Adjusted EBITDA growth exceeding guidance, driven by advanced imaging volumes and new center openings.

• Completed IPO, rebranded, and expanded into new markets, including a partnership with UPMC and entry into Pennsylvania.

• Opened a record number of new centers in 2025, including nine de novo and one acquired, with plans for 8-10 de novo openings annually.

• Returned in-network with a major payer in New Jersey, supporting future growth.

• Focused on advanced imaging modalities, operational efficiency, and strategic service line expansion.

Financial highlights

• Q4 2025 consolidated revenue: $267.7M, up 7.9% year-over-year; Adjusted EBITDA: $63.8M, up 18.6%, with a 23.8% margin.

• Full-year 2025 consolidated revenue: $1.023B, up 7.8%; Adjusted EBITDA: $230.2M, up 14.6%, with a 22.5% margin.

• Net loss improved to $47.1M in 2025 from $94.1M in 2024; Q4 GAAP net loss: $28.7M, impacted by IPO and debt refinancing costs.

• Achieved a two-turn reduction in leverage, saving over $50M in annual cash interest.

• Professional fee revenue in Q4: $66.8M, up 10.6% year-over-year.

Outlook and guidance

• 2026 revenue guidance: $1.045B–$1.097B; Adjusted EBITDA: $234M–$242M, including ~$7M in new public company costs.

• Adjusted EPS guidance for 2026: $0.71–$0.77 per share.

• Advanced imaging expected to grow faster than routine, driving higher revenue per procedure and margins.

• Margin expansion and continued growth expected, supported by outpatient care trends and geographic expansion.

• Q1 2026 Adjusted EBITDA expected to be flat year-over-year due to volume pull-forward and weather impacts, with full-year guidance reaffirmed.