Lily

Lily, on behalf of Robbie Marcus, asked about the primary growth levers for Ceribell in 2026, specifically how the company plans to balance accelerating new account additions with driving continued utilization within existing accounts, and which levers hold the most potential for upside. She also inquired about the anticipated spend for new indication launches (pediatric, delirium, LVO stroke), asking if significant investment in sales force and commercial infrastructure is needed or if existing resources can be leveraged.

Answer

CFO Scott Blumberg identified account additions and same-store growth as core drivers, expecting more account adds in 2026 than 2025 due to sales team expansion and new product buzz. He noted 30% penetration in existing accounts with strategies for deeper utilization. CEO Jane Chao highlighted a new focus on hospital system-level acquisitions and systematic departmental expansion. Scott Blumberg added that the company plans to largely leverage its existing commercial infrastructure for new indications, with only modest upfront marketing and market development investments.

Lily asked about the main growth levers for 2026, specifically how Ceribell plans to balance accelerating account adds with driving continued utilization, and what factors hold the most potential for upside. She also inquired about the investment required for new indication launches (pediatric, delirium, LVO stroke), asking if existing sales and commercial infrastructure could be largely leveraged.

Answer

Scott Blumberg, Chief Financial Officer, outlined that core drivers remain account adds and same-store growth, expecting more account additions in 2026 due to sales team expansion, FedRAMP approval, and buzz around new products. Jane Chao, Co-founder and Chief Executive Officer, highlighted new levers like system-level account acquisition and systematic departmental expansion. Scott Blumberg confirmed that Ceribell largely intends to leverage its existing commercial infrastructure for new indications, with modest upfront investments for marketing and market development.

Lily asked for a bridge to the 19% EBITDA margin guidance for 2026, focusing on operating expense components, SG&A leverage, and confidence in improvement. She also followed up on reported free cash flow expectations for 2026, including key puts and takes.

Answer

CFO Sam Eldessouky explained that EBITDA margin expansion is driven by SG&A leverage through efficiency, reduced fixed cost structure, and targeted investments. He noted Q4 gross margin absorbed 80 basis points of tariffs. For 2026, he projects 100 basis points improvement from gross margin (61% to 62%), another 100 basis points from SG&A, offset by a 50 basis point increase in R&D (7% to 7.5%), leading to a 150 basis point jump from 17.5% (2025) to 19% (2026). Chairman and CEO Brent Saunders added that results were achieved with 500 fewer colleagues. Sam Eldessouky discussed free cash flow, noting 42% conversion in 2025 (with 12 days taken out of working capital) and expecting progression to 45% in 2026 towards the 50%+ target by 2028, supported by CapEx stepping down from 6-7% of revenue in 2025 to 5-6% in 2026.