Nutex Health, Inc. (NUTX)·Q2 2025 Earnings Summary

Executive Summary

• Q2 2025 revenue rose 220.7% year over year to $243.985M, driven by hospital division growth; gross margin expanded to 51.2% from 29.7% in Q2 2024 .
• Revenue modestly increased vs Q1 2025 ($243.985M vs $211.789M), but diluted EPS swung to a loss of $2.95 due to $78.7M non‑cash stock‑based compensation tied to under‑construction/ramping hospitals .
• Nutex authorized a $25.0M share repurchase program to offset stock compensation dilution, contingent on reporting compliance; management emphasized shares are “undervalued” .
• Wall Street consensus for Q2 2025 was $221.9M revenue and -$1.43 EPS; Nutex delivered a top‑line beat but a larger‑than‑expected EPS loss; reported EBITDA was below consensus while Adjusted EBITDA was strong at $71.6M (definition differences matter) .
• Call focused on NSA/IDR arbitration: ~71% of Q2 hospital revenue related to IDR; ~85% win rate; ~75% collection rate to date; arbitration costs ~26–28% of arbitration revenue—key drivers of margin and cash trends .

What Went Well and What Went Wrong

What Went Well

• Strong revenue growth and margin expansion: Q2 revenue $243.985M (+220.7% y/y), gross margin 51.2% (vs 29.7% y/y) .
• Adjusted EBITDA inflected to $71.6M (vs $6.8M y/y), supported by arbitration wins and scale leverage; CFO noted “continued positive trend…since 2024” .
• Liquidity improved: cash reached $96.7M at quarter-end; operating cash flow $27.3M in Q2 and $78.2M YTD; management highlighted “record high cash balance” .

Selected quotes:

• “We are pleased to report 217.5% revenue growth… and a record high cash balance of $96.7 million” — CFO Jon Bates .
• “Arbitration… is now an ongoing part of our revenue cycle management process” — CEO Tom Vo .

What Went Wrong

• EPS miss and GAAP EBITDA softness: diluted EPS -$2.95 (vs -$0.07 y/y, +$3.33 in Q1) primarily due to $78.7M non‑cash stock‑based comp; reported EBITDA of -$0.458M missed consensus .
• Reporting delays/restatement created uncertainty: Q2 10‑Q was delayed for non‑cash reclassification of stock comp obligations; Nasdaq notice received; timeline to remediate reiterated on the call .
• Heavy arbitration dependence: ~71% of hospital revenue tied to IDR in Q2; collections ~75% of awards and timelines ~4–5 months; costs ~26–28% of arbitration revenue—execution and regulatory risks persist .

Financial Results

Headline P&L vs Prior Periods

Key drivers and non‑GAAP context: Stock‑based compensation rose to $78.7M in Q2 (99% tied to under‑construction/ramping hospitals), materially impacting GAAP EPS/EBITDA; Adjusted EBITDA excludes this and finance lease payments under ASC 842 (now separately disclosed) .

Segment Revenue

KPIs and Cash

Guidance Changes

Earnings Call Themes & Trends

Management Commentary

• “We are pleased to report 217.5% revenue growth, Adjusted EBITDA… and a record high cash balance of $96.7 million” — CFO Jon Bates .
• “The arbitration process… is now an ongoing part of our revenue cycle management process… our share repurchase program underscores our confidence in the long-term prospects” — CEO Tom Vo .
• “Of the $236M in hospital revenue, $167.7M related to IDR revenue (~71%)… arbitration costs approximating 26% to 28% of arbitration revenue” — CFO Jon Bates .
• “We strongly disagree with the allegations in the short seller report… independent federal arbitration is now… integral to our revenue cycle” — CEO Tom Vo .

Q&A Highlights

• Restatement/filing timeline: management working to complete Q4’24 and Q1’25 corrections and file Q2’25 10‑Q within Nasdaq’s 60‑day window; reiterated non‑cash nature of changes .
• IDR collections and revenue recognition: accrual conservatively reflects ~75% collection rate; enforcement proposals could improve timeliness; options include payer engagement and potential litigation .
• New hospital openings: two TX facilities likely in Q4 (Sherman in Oct; Houston in Nov); San Antonio contingent on construction, may slip to 2026 .
• Margin dynamics: EBITDA margin compressed vs prior quarters due to supplier payments ahead of openings and higher arbitration‑related costs; large tax payments also affected cash pacing .
• Data transparency: company may provide more unaudited detail when appropriate; emphasized fundamentals unchanged aside from non‑cash stock comp accounting reclassification .

Estimates Context

Values marked with an asterisk were retrieved from S&P Global consensus estimates via our GetEstimates tool. Values retrieved from S&P Global.

Context: Street appears to track EBITDA (standard definition). Company’s reported Adjusted EBITDA was $71.614M, which better reflects underlying operations but is non‑GAAP; consensus likely did not align to this adjusted figure .

Key Takeaways for Investors

• Top‑line momentum and mix: Nutex delivered a revenue beat vs consensus and continued gross margin expansion; hospital division remains the growth engine .
• Earnings optics matter: GAAP EPS and EBITDA were weighed by non‑cash stock‑based comp and finance lease effects; Adjusted EBITDA was strong, but investors should parse GAAP vs non‑GAAP carefully .
• Arbitration dependence is high: ~71% of hospital revenue tied to IDR with ~85% win and ~75% collections; costs at ~26–28%—execution, regulatory, and cash timing remain critical watch‑items .
• Liquidity buffer: $96.7M cash and $78.2M YTD operating cash flow provide flexibility for openings and buybacks; accounts receivable growth reflects IDR cycle timing .
• Capital return catalyst: $25.0M repurchase authorization (pending reporting compliance) may support EPS and sentiment amid dilution from earn‑out stock comp .
• Near‑term risks: 10‑Q delay and restatements (non‑cash) plus short‑seller noise/legal overhang could drive volatility; management addressed allegations and reiterated compliance .
• Pipeline and network: Two TX hospitals likely to open in Q4 2025; IPAs managing ~41k lives with improving profitability—integrated model supports medium‑term thesis .