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Lucid Diagnostics Inc. (LUCD)·Q3 2025 Earnings Summary

Executive Summary

  • Q3 2025 was steady operationally: 2,841 tests and $1.21M revenue, essentially flat QoQ and +3% YoY, with GAAP EPS of $(0.10) and non‑GAAP adjusted loss of ~$10.3M; pro forma cash rose to $47.3M following a September offering, extending runway through 2026 .
  • Medicare coverage trajectory advanced: MolDX’s September CAC delivered unanimous expert support for EsoGuard; management expects a draft LCD “soon,” likely by year‑end, followed by a mandatory 45‑day comment period and final in early 2026; claims within 12 months prior to the final LCD would be payable .
  • Wall Street consensus: LUCD modestly missed revenue ($1.21M vs $1.35M*) and beat EPS (−$0.10 vs −$0.11*) for Q3 2025; beats/misses reflect the company’s ASC 606 “variable consideration” policy recognizing revenue upon cash collection rather than delivery . Values retrieved from S&P Global.
  • Commercial coverage momentum: Highmark NY policy is live; UnitedHealthcare guideline update explicitly ties positive EsoGuard to EGD eligibility—management is pursuing direct contracting with UHC and expects more regional/national policies ahead of Medicare finalization .
  • Near‑term catalysts: Draft LCD issuance (comment period begins), growing Medicare patient mix (look‑back revenue capture), and additional commercial payer policies; September capital raise mitigated financing overhang and supports acceleration post‑LCD .

What Went Well and What Went Wrong

What Went Well

  • Unanimous CAC support on Medicare coverage: “medical experts unanimously supported Medicare coverage for EsoGuard… key step in the final stages of the LCD reconsideration process” .
  • Balance sheet strengthened: Raised ~$27M net in September; quarter‑end pro forma cash $47.3M; runway extended through 2026 to fund commercialization upon coverage .
  • Commercial access tailwinds: UnitedHealthcare guideline update references EsoGuard‑positive patients as appropriate for EGD; management moving into direct contracting discussions with UHC; Highmark policy operational since May with ongoing billing .

What Went Wrong

  • Revenue modestly below consensus due to cash‑collection timing: Q3 recognized $1.2M (~17% of ~$7.1M billed) under ASC 606 variable consideration, which can lag volume; consensus expected ~$1.35M* . Values retrieved from S&P Global.
  • Limited formal financial guidance: No revenue/margin guidance issued; core focus remains reimbursement milestones rather than top‑line targets .
  • Continued losses while awaiting coverage: GAAP net loss $(10.4)M and non‑GAAP adjusted loss $(10.3)M; burn ~$10.3M, consistent with prior quarters, until Medicare coverage and broader commercial policies improve recognition and collections .

Financial Results

Quarterly Performance (Q1–Q3 2025; oldest → newest)

MetricQ1 2025Q2 2025Q3 2025
Revenue ($USD Millions)$0.828 $1.163 $1.211
GAAP EPS ($USD)$(0.52) $(0.08) $(0.10)
Operating Expenses ($USD Millions)$13.315 $12.547 $12.970
EBITDA ($USD Millions)$(26.744) $(4.321) $(10.276)
Net Loss ($USD Millions)$(26.908) $(4.439) $(10.397)
Non‑GAAP Adjusted Loss ($USD Millions)$(11.162) $(9.946) $(10.300)
Processed Tests (Units)3,034 2,756 2,841
Cash & Equivalents ($USD Millions)$25.2 $31.1 $47.3

YoY and QoQ Change

MetricQ3 2024Q3 2025YoY ChangeQoQ Change (Q2→Q3)
Revenue ($USD Millions)$1.172 $1.211 +3% (company commentary) +4% (company commentary)
GAAP EPS ($USD)$(0.25) $(0.10) Improvement of $0.15 Deterioration of $0.02

Consensus vs Actual (Q3 2025)

MetricConsensus*ActualBeat/Miss
Revenue ($USD Millions)$1.354*$1.211 Miss
EPS ($USD)$(0.11)*$(0.10) Beat
Values retrieved from S&P Global.

KPIs by Quarter

KPIQ1 2025Q2 2025Q3 2025
Pro Forma Billed ($USD Millions)>$7.5 (company commentary) ~$6.9 ~$7.1
Recognized Revenue ($USD Millions)$0.828 ~$1.2 ~$1.2
Claims Adjudicated (%)~60% ~65% ~76%
Allowed (as % of adjudicated)~30% ~30% ~38%
Avg Allowed per Test ($USD)~$1,362 ~$1,786 ~$1,600
Revenue Recognition ModeASC 606 variable consideration (cash collection) ASC 606 variable consideration ASC 606 variable consideration

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Formal financial guidance (revenue, margins, OpEx)FY/Q4 2025None providedNone providedMaintained
Test volume targetOngoingMaintain 2,500–3,000 per quarterMaintained; Medicare mix emphasisMaintained
Medicare patient mix2H 2025 → 202610–15% current; target ~40–50%Actively shifting mix toward ≥50% of target population; look‑back payable post‑final LCDRaised focus
Medicare LCD timingQ4 2025 → early 2026Draft LCD expected in fall; formal comment then finalExpect draft by year‑end; 45‑day comment; final thereafter; one‑year look‑back payableMaintained timeline, increased confidence
Burn rate disciplineQ3 2025~$10.3M average trailing~$10.3M in Q3; flat vs Q2Maintained
Capital runwayThrough 2026~$31M cash at Q2~$47.3M at Q3 post ~$27M raise; runway through 2026Improved

Earnings Call Themes & Trends

TopicPrevious Mentions (Q1 2025)Previous Mentions (Q2 2025)Current Period (Q3 2025)Trend
Medicare LCD processPackage submitted; LCD reconsideration imminent Multi‑jurisdiction CAC announced; fall draft expected CAC unanimous expert support; draft expected by year‑end; one‑year look‑back payable Confidence rising; timeline clarifying
Commercial payer coverageEarly traction; NCCN guidelines helpful Highmark NY policy effective; pipeline expanding UHC guideline explicitly links EsoGuard+ to EGD; pursuing contracting; expect more policies pre‑Medicare final Momentum improving
Revenue recognition mechanicsASC 606 variable consideration; United Z‑code delays ~17% of billed recognized; adjudication 65% ~17% of ~$7.1M billed recognized; adjudication 76%; allowed 38% at ~$1,600/test Collections share rising; adjudication improving
Sales channels (concierge/employer/fire dept.)Programs launched; expected 2H impact Robust pipeline; CMPO added runway Firefighter summit to bolster contracted events; continued event‑based revenue Pipeline expanding; contracted mix higher
Health system partnershipsMajor system program in build Hoag partnership detailed Expanded health system calling; director‑level hires to target systems Scaling relationships
Cost structure & capacityLab/device variable costs <$200/test; capacity ample —Variable costs steady; potential future automation/AI to lower lab costs Unit economics intact; long‑term leverage

Management Commentary

  • “The overwhelmingly positive MolDx CAC meeting in September—with medical experts unanimously supporting Medicare coverage for EsoGuard—further reinforces our confidence that we are now firmly in the final stages of achieving this transformative coverage milestone.” — Lishan Aklog, M.D., Chairman & CEO .
  • “The quarterly burn rate was $10.3 million… exactly the same as the prior quarter… non‑GAAP operating expenses of $11.5 million are modestly lower than the average of $11.6 million for the last four quarters.” — Dennis McGrath, CFO .
  • “UnitedHealthcare… specifically stating that patients who are EsoGuard positive are appropriately indicated for EGD… we feel confident proceeding directly to contracting discussions.” — Lishan Aklog, M.D. .
  • “In the third quarter, we billed 2,841 tests reflecting about $7.1 million in pro forma revenue… about 17% recognized… ~76% adjudicated, ~38% allowable at ~$1,600 per test.” — Dennis McGrath .

Q&A Highlights

  • Medicare LCD timing and process: Management reiterated expectation for a draft LCD by year‑end, a 45‑day comment period, and a final thereafter, characterizing the draft‑to‑final phase as largely a formality given the reconsideration “flip” from non‑coverage to coverage .
  • Commercial payer momentum: Beyond Highmark NY, management highlighted UHC guideline language and active contracting discussions; expects additional regional and potentially national policies even ahead of Medicare final .
  • Mix shift to Medicare patients: Actively incentivizing the sales force to increase Medicare mix toward 40–50% of target population, enabling look‑back claims upon final LCD .
  • Unit economics and COGS: Variable costs remain <$200/test (device ~$50; lab ~$120–$125), with potential future reductions via automation/AI; fixed lab costs ~$1.2M/quarter .
  • Capacity: Significant slack in lab and manufacturing; able to scale volume without major capex .

Estimates Context

  • Q3 2025 EPS and revenue vs consensus: EPS beat (−$0.10 actual vs −$0.11*), revenue miss ($1.211M actual vs $1.354M*). The variance continues to reflect ASC 606 recognition when cash is collected rather than at delivery, plus payer adjudication dynamics during the reimbursement transition . Values retrieved from S&P Global.

Key Takeaways for Investors

  • Medicare draft LCD is the principal near‑term catalyst; a year‑end issuance would likely trigger a 45‑day comment window and set up a final LCD early 2026, enabling one‑year look‑back claim payments and accelerating revenue recognition .
  • Commercial tailwinds are building: UHC guideline language referencing EsoGuard and the active pipeline beyond Highmark suggest incremental coverage before a Medicare final; watch for contracting announcements that improve in‑network collections .
  • Expect mix shift toward Medicare patients in coming quarters as the team targets ≥50% of the addressable population; this should increase collectible claims and shrink the realization gap .
  • Cash runway through 2026 de‑risks execution into coverage milestones; burn is disciplined (~$10.3M/quarter) and flat, with non‑GAAP OpEx ~$11.5M .
  • KPIs point to improving payer processing: adjudication rates rising (76%), higher allowable share (38%), and average allowed ~$1,600/test—indicators that recognition should scale with coverage .
  • Near‑term trading setup: a draft LCD headline and additional payer policies could re‑rate the reimbursement trajectory; conversely, any delay/slippage into mid‑2026 would likely weigh on sentiment—monitor CAC follow‑through and MAC workflows .
  • Medium‑term thesis: With guideline support (GI societies, NCCN), compelling real‑world utility, and favorable unit economics, broader coverage (Medicare + commercial) should unlock operating leverage; health system partnerships (e.g., Hoag) and event‑based contracted testing provide diversified ramps .