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Lucid Diagnostics Inc. (LUCD)·Q2 2025 Earnings Summary

Executive Summary

  • Q2 2025 revenue was $1.163M, up 40% sequential and 19% YoY; processed 2,756 EsoGuard tests, and ended the quarter with $31.1M cash, extending runway into 2026 .
  • EPS beat consensus: Primary EPS came in at -$0.10 vs -$0.122 consensus (beat by $0.022); revenue slightly beat consensus ($1.163M vs $1.145M)*.
  • Catalysts: Multi-jurisdictional Medicare CAC meeting for EsoGuard on Sept 4, expected to support a draft LCD thereafter; Highmark Blue Cross Blue Shield coverage effective May 26 with patient testing/billing initiated .
  • Management emphasized confidence in Medicare coverage, scalable capacity (lab/manufacturing), and growing commercial traction (concierge, employer contracting) .

What Went Well and What Went Wrong

What Went Well

  • Revenue increased 40% sequentially to $1.163M, matching prior quarterly high; test volume maintained within 2,500–3,000 target while pivoting toward contractually guaranteed channels .
  • Highmark BCBS policy became effective with active billing; partnership launched with Hoag health system for system-wide EsoGuard program .
  • Clinical momentum: AJG publication from NCI-sponsored pilot showing EsoGuard effectiveness in patients without GERD symptoms; management views CAC as “final stages” toward positive Medicare coverage. Quote: “We really are confident that we are gonna get Medicare coverage not a matter of if but when.” .

What Went Wrong

  • Test volumes declined vs Q4 2024 (2,756 vs 4,042) as mix leaned into larger, lumpier health events and focus shifted to revenue quality .
  • Continued reliance on collections-based revenue recognition (ASC 606 variable consideration); adjudication still lengthy (65% adjudicated, backlog being worked), constraining reported revenue conversion .
  • Medicare timeline pushed from “1H” expectations earlier in 2025 to a CAC in September and a hoped-for draft before year-end, introducing timing uncertainty .

Financial Results

MetricQ2 2024Q4 2024Q1 2025Q2 2025
Revenue ($USD Millions)$0.976 $1.197 $0.828 $1.163
GAAP EPS (Basic & Diluted, $USD)$(0.23) $(0.20) $(0.52) $(0.08)
Operating Expenses ($USD Millions)$12.168 $13.571 $13.315 $12.547
Net Loss Attributable to Common ($USD Millions)$(11.005) $(11.541) $(36.018) $(7.888)
Non-GAAP Adjusted Loss ($USD Millions)$(9.672) $(10.882) $(11.162) $(9.946)
Non-GAAP Adjusted Loss/Share ($USD)$(0.20) $(0.19) $(0.16) $(0.10)

Notes:

  • EPS discrepancy: Press release GAAP EPS was $(0.08) in Q2; S&P Global Primary EPS used for estimate comparisons was -$0.10, reflecting methodological differences *.

KPIs

KPIQ4 2024Q1 2025Q2 2025
Tests Processed (units)4,042 3,034 2,756
Cash & Cash Equivalents ($USD Millions)$22.4 $25.2 $31.1
Quarterly Burn Rate ($USD Millions)$10.1 $11.3 $10.3
Claims Adjudicated (%)——65%
Allowable Outcomes (% of adjudicated)——30%

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Medicare LCD pathPost-CACExpected 1H 2025 progress toward coverage CAC on Sept 4; aiming for a draft LCD thereafter, “hope” before year-end Timing deferred (awaiting draft LCD)
Cash runway2025–2026“Well into 2026” with >$40M pro forma cash at Q1 “Into 2026” with >$30M pro forma cash at Q2 Maintained runway (lower quarter-end balance)
Volume targetOngoingTarget 2,500–3,000 tests/quarter Maintained 2,500–3,000 target while prioritizing guaranteed revenue and Medicare focus Maintained

No formal numerical guidance on revenue, margins, OpEx, OI&E, tax rate, or dividends was provided in Q2 materials .

Earnings Call Themes & Trends

TopicPrevious Mentions (Q4 2024, Q1 2025)Current Period (Q2 2025)Trend
Medicare coverage / LCDExpect decision/progress in 1H 2025; reconsideration submitted Multi-jurisdictional CAC set for Sept 4; aim for draft LCD soon after; hope before year-end Advancing (timing modestly deferred)
Commercial payer coverageHighmark policy; BCBS RI under biomarker legislation Highmark effective; billing initiated; ongoing regional/national dialogues Expanding
Concierge cash-pay channel>20 contracts; expected 2H revenue impact Continued traction; complements Medicare focus; no headcount expansion before coverage Building
Employer/self-insured contractingRobust pipeline; converting high-volume events Ongoing; pushing contracts with municipalities/fire departments to guarantee payment Building
Clinical utility / evidenceCLUE and ENVET-BE; NCCN guideline update; NIH grant AJG publication in non-GERD; continued emphasis on utility; expected CAC support Strengthening
Capacity & scalabilityLab/manufacturing scalable; ample capacity ~5x lab capacity available with minimal personnel; scalable manufacturing Ample capacity
Revenue recognition dynamicsVariable consideration; long collection cycles; backlog 65% adjudicated; backlog ~$15M; expect shrinking realization gap Improving adjudication

Management Commentary

  • CEO: “We really are confident that we are gonna get Medicare coverage not a matter of if but when. And this CAC meeting is sort of an indicator that we're in the late stages.”
  • CEO: “EtherCAT [EsoGuard] test volume for the second quarter was 2,756… Revenue was $1,200,000 — a 40% increase from the first quarter and matches our previous quarterly high.”
  • CFO: “The next patient in the door drives a 90% contribution margin… under $200 to process the next patient… fixed lab costs about $1.2M per quarter.”
  • CEO: “We have 30,000,000 in pro forma cash… runway well into 2026… and sufficient resources to ramp up our commercial efforts after we secure Medicare approval.”
  • CEO: On Highmark coverage: “It’s not just a theoretical policy… we’re already seeing patients… billing under this policy.”

Q&A Highlights

  • Medicare timeline: Post-CAC, a draft LCD would trigger a 45-day comment period; management hopes the draft before year-end and expects final in early 2026, with 12-month lookback for Medicare claims upon final LCD .
  • Medicare mix and targeting: Current Medicare mix ~10–15% of tests; goal ~40% of volume post-coverage via targeted geographies and PCP engagement .
  • Burn/runway/optionality: ~$31.1M cash, ~$10.3M quarterly burn; optionality via ATM; expect backlog collections and cash-pay channels to reduce burn in 2H .
  • Capacity: ~5x lab capacity; scalable manufacturing; no significant capex required to ramp volume .
  • Hoag partnership: System-wide program across GI, primary care, concierge, with Lucid supporting training/workflows and EHR-driven patient identification .

Estimates Context

MetricConsensus (Q2 2025)Actual (Q2 2025)# of Estimates
Revenue ($USD)$1,145,170$1,163,0006
Primary EPS ($USD)-$0.122-$0.105

Interpretation:

  • Revenue slight beat vs consensus; Primary EPS beat (less negative). Estimate revisions may trend upward modestly as Medicare path clarifies and Highmark contributions flow through.*

Key Takeaways for Investors

  • Sequential revenue growth with a modest top-line beat and EPS beat; operational execution steady despite claims-based recognition *.
  • The Sept 4 CAC is a key near-term catalyst; management expects a draft LCD thereafter and remains confident on coverage outcome .
  • Commercial traction is building (Highmark effective; concierge/employer channels), offering nearer-term revenue that is more contractually determinable .
  • Margin structure is attractive (90% contribution per incremental test) and scalable; Medicare coverage would accelerate cash conversion and revenue recognition .
  • Short-term: Stock sentiment likely sensitive to CAC outcomes and timing of draft LCD; watch for additional regional payer wins and cash-pay ramp .
  • Medium-term: With coverage, expect higher Medicare mix (~40%) and improved receivable cycles; operating leverage from fixed lab costs supports path to profitability as volumes scale .
  • Risk: Timeline slippage (draft/final LCD) and continued variability in collections; management is preserving burn and has financing optionality .

Footnote:

  • Values retrieved from S&P Global.