AMERICAN SHARED HOSPITAL SERVICES (AMS) Q3 2025 Earnings Summary

Executive Summary

Q3 2025 revenue was $7.17M (+2.5% YoY), Adjusted EBITDA rose 42.3% YoY to $1.94M, and net loss narrowed to $17K; direct patient services drove growth while leasing softness persisted .
Revenue missed Wall Street consensus by 4.6% ($7.17M vs $7.52M); EPS was in line at $0.00. The miss was primarily due to lower PBRT volumes and leasing segment pressure even as direct patient services ramped .
Management highlighted ramping volumes in Rhode Island and strong traction in Puebla, Mexico; signed a 10‑year extension for an Esprit Gamma Knife with an existing health system .
Project timing shifted: Esprit installation in Guadalajara now expected to start up in Q2 2026 vs “late 2025” previously, which is a potential near-term negative narrative shift despite longer-term growth positioning .

What Went Well and What Went Wrong

What Went Well

Direct patient services revenue rose 9.4% YoY to $4.0M and comprised 56% of sales (vs 53% prior-year), driven by physician ramp in Rhode Island and strong Puebla volumes .
Gross margin improved to 22.1% (vs 19.6% YoY) with gross margin dollars up to $1.59M, helped by higher treatment volumes .
EBITDA grew 42.3% YoY to $1.94M; CFO emphasized operational enhancements, cost efficiencies, and debt paydown supporting profitability momentum .
- CEO: “Our new radiation therapy center in Puebla Mexico is off to a fantastic start where revenue has grown significantly.”
- CFO: “We remain extremely focused on our operational enhancements and cost efficiencies…paid down short-term debt while also making CapEx investments for our Gamma Knife Facility in Peru.”

What Went Wrong

Leasing segment revenue fell 5.3% YoY to $3.1M; PBRT volumes remained weak, offsetting strength in direct services .
Cash declined to $5.35M from $11.28M at year-end, reflecting $7.5M of capex YTD; current liabilities increased vs year-end, tightening near-term liquidity .
Guadalajara Esprit timing slipped to Q2 2026 from “late 2025,” pushing out a growth catalyst and heightening execution risk on the pipeline .

Financial Results

Multi-period comparison (actuals; oldest → newest)

Metric	Q3 2024	Q2 2025	Q3 2025
Revenue ($USD)	$6,999,000	$7,071,000	$7,171,000
Gross Margin ($USD)	$1,370,000	$1,630,000	$1,586,000
Gross Margin (%)	19.6%	23.0% (calc from $1,630,000 ÷ $7,071,000)	22.1%
Diluted EPS ($)	($0.03)	($0.04)	$0.00
Net (Loss) Income Attributable ($USD)	($207,000)	($280,000)	($17,000)
Adjusted EBITDA ($USD)	$1,366,000	$1,701,000	$1,944,000

Actuals vs Wall Street Consensus (Q3 2025)

Metric	Actual Q3 2025	Consensus Q3 2025	Surprise
Revenue ($USD)	$7,171,000	$7,520,000*	($349,000), −4.6% (computed)
Primary EPS ($)	$0.00	$0.00*	In line

Values marked with * retrieved from S&P Global.

Segment Breakdown ($USD)

Segment	Q3 2024	Q2 2025	Q3 2025
Direct Patient Services Revenue	$3,699,000 (computed: $6,999,000 − $3,300,000)	$3,500,000	$4,000,000
Medical Equipment Leasing Revenue	$3,300,000	$3,571,000	$3,100,000
Direct % of Total	53%	49.5% (calc: $3.5M ÷ $7.071M)	56%

KPIs and Balance Sheet Highlights

KPI	Q3 2024	Q2 2025	Q3 2025
Adjusted EBITDA ($USD)	$1,366,000	$1,701,000	$1,944,000
Cash, Cash Equivalents & Restricted Cash ($USD)	N/A	$11,331,000	$5,345,000
Shareholders’ Equity (ex-NCI) ($USD)	N/A	$24,481,000	$24,565,000

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Guadalajara Esprit start-up timing	Project milestone	“Late 2025” (Q2 commentary)	“Q2 2026” (Q3 commentary)	Delayed
Revenue outlook	FY25/FY26 qualitative	Expect recovery and continued long-term growth (Q1/Q2)	Expect further revenue growth with Esprit in Guadalajara and 10-year Esprit extension; continued ramp in RI and Mexico (Q3)	Maintained qualitative growth outlook
Margin focus	Ongoing	Operational efficiencies and cost controls to improve profitability (Q1/Q2)	Emphasis maintained; gross margin improved in Q3; paying down debt and investing in growth	Maintained

No formal numeric guidance ranges for revenue, EPS, margins, OpEx, OI&E, or tax rate were provided in company materials .

Earnings Call Themes & Trends

(Transcript not available; company provided call details only)

Topic	Previous Mentions (Q1 & Q2)	Current Period (Q3)	Trend
Direct patient services ramp (RI & Puebla)	RI acquisition and Puebla launch; linear accelerator revenue growth; recovery expected in 2H25	Continued ramp; strong Puebla; direct revenue +9.4% YoY; mix to 56%	Positive mix shift to services
Gamma Knife (Esprit) expansion	Guadalajara Esprit start-up “late 2025”	Guadalajara Esprit now Q2 2026; signed 10-year Esprit extension at existing system	Mixed: timing delay, offset by extension
PBRT volumes	Lower volumes due to cyclical fluctuations (Q1/Q2)	Leasing revenue −5.3% YoY; continued PBRT softness	Persistent headwind
Liquidity/capex	Strong cash at mid-year; capex ongoing	Cash down to $5.35M; $7.5M capex YTD	Near-term liquidity tighter due to investment
Operational efficiency	Emphasis on cost controls and efficiencies	Maintained; debt paydown; margin improved	Positive execution focus

Management Commentary

CEO: “Our new radiation therapy center in Puebla Mexico is off to a fantastic start where revenue has grown significantly…we expect further growth in revenue from the new Esprit being installed in our new Gamma Knife center in Guadalajara, Mexico…expected to startup in the second quarter of 2026.”
CFO: “We remain extremely focused on our operational enhancements and cost efficiencies…paid down short-term debt while also making CapEx investments for our Gamma Knife Facility in Peru…position us well for…long-term growth and profitability.”
Executive Chairman: “Our track record of consecutive years of revenue growth and improved margins is expected to position us well for building long-term shareholder value…new business development initiatives…drive continued momentum and growth.”

Q&A Highlights

Transcript not available; company provided dial-in, webcast, and replay details only .
No published Q&A clarifications or guidance updates beyond press release disclosures .

Estimates Context

Revenue missed consensus by 4.6% ($7.17M actual vs $7.52M consensus); EPS was in line at $0.00. Revenue softness stemmed from leasing segment declines and lower PBRT volumes despite direct services strength .
Consensus inputs were limited (one estimate for revenue and EPS), which can magnify surprise percentages in micro-cap coverage. Values retrieved from S&P Global.*

Key Takeaways for Investors

Services-led growth is taking hold: direct patient services reached 56% of mix with strong RI and Mexico traction; this should reduce reliance on cyclical PBRT volumes .
Near-term headwind: revenue fell short of consensus due to leasing/PBRT softness; monitor leasing stabilization and PBRT volume recovery into FY26 .
Project timing risk: Guadalajara Esprit start-up delay to Q2 2026 pushes out a growth catalyst; however, the 10-year Esprit extension adds backlog durability .
Margin improvement and cost discipline: gross margin and EBITDA improved; management emphasized operational efficiencies and debt paydown, supporting profitability momentum .
Liquidity watch: cash declined to $5.35M on $7.5M YTD capex; continued investment is strategic, but raises the importance of cash generation and potential financing flexibility .
For the trade: narrative hinges on services ramp vs PBRT softness and project execution; any updates accelerating Guadalajara or additional extensions/acquisitions could be positive catalysts .
Estimate trajectory: With limited coverage, small operational shifts can drive outsized beats/misses; expect adjustments to revenue models reflecting mix shift to lower-margin services and project timing changes .

Footnote: Values marked with * retrieved from S&P Global.