Executive Summary

Q3 2025 delivered outsized growth and profitability: revenue rose to $267.8M (from $78.8M in Q3’24 and $244.0M in Q2’25) and diluted EPS came in at $7.76, driven by hospital division revenue and elevated collections through No Surprises Act IDR; Adjusted EBITDA was $98.5M .
Results materially beat limited sell-side coverage: EPS $7.76 vs $1.82 consensus*, revenue $267.8M vs $213.8M consensus*, and EBITDA of $91.8M actual vs $66.6M consensus*; beats were powered by higher-acuity care and >85% IDR win rates with ~80% average collections on wins .
Sequential acceleration despite Q2’s heavy non-cash stock-based comp (SBC): revenue rose from $244.0M (Q2) to $267.8M (Q3); Q3 SBC dropped to $13.2M (from $78.7M in Q2), supporting earnings leverage .
Corporate clean-up progressing: company regained Nasdaq filing compliance with its 10-Q filings and plans a Dec 2 call to discuss restated FY2024 and the first three quarters of 2025; strong balance sheet with $166.0M cash at 9/30/25 is a near-term support for growth plans .

What Went Well and What Went Wrong

What Went Well
- Outsized top-line growth with strong profitability: Q3 revenue $267.8M (+239.9% YoY) and operating income $130.4M, with Adjusted EBITDA $98.5M; CEO cited “another successful and profitable quarter,” and CFO highlighted “record year” momentum .
- IDR/arbitration execution: 60–70% of visits submitted to IDR; >85% legal determination win rate; ~80% average collections on wins; ~$182.1M (~70%) of Q3 hospital revenue tied to higher acuity and IDR success .
- Liquidity improvement: operating cash flow $99.5M in Q3; cash $166.0M at quarter-end, enabling growth investments and providing a cushion while navigating payer dynamics .
What Went Wrong
- Elevated arbitration-related costs: approximately 24–26% of arbitration-related revenue, tempering drop-through from IDR-driven revenue .
- SBC remains a swing factor: while Q3 SBC fell to $13.2M, it remains elevated due to one-time obligations for under-construction and ramping hospitals (99.5% of Q3 SBC), and was a large headwind in Q2 ($78.7M) .
- Mature hospital visits essentially flat: mature hospitals’ visits declined 0.6% YoY in Q3 despite revenue growth, suggesting mix/acuity and IDR rather than volume were key drivers; reliance on IDR outcomes remains an investor focus area .

Financial Results

Metric	Q3 2024	Q2 2025	Q3 2025
Total Revenue ($USD)	$78.795M	$243.985M	$267.804M
Diluted EPS ($)	($1.72)	($2.95)	$7.76
Net Income Attributable to Nutex ($USD)	($8.788M)	($17.697M)	$55.435M
EBITDA ($USD)	$4.342M	($0.458M)	$91.787M
Adjusted EBITDA ($USD)	$9.670M	$71.614M	$98.530M
Operating Income ($USD)	$9.663M	$33.679M	$130.367M
Stock-based Compensation ($USD)	$1.964M	$78.747M	$13.217M

Selected P&L drivers (Q3 2025): Gross profit $154.881M; payroll $38.817M; contract services $53.837M; medical supplies $3.307M .
Cash flow and balance sheet: Q3 operating cash flow $99.5M; cash and cash equivalents $166.0M; total assets $964.5M; long-term debt, net $25.6M as of 9/30/25 .

Segment revenue breakdown

Segment Revenue	Q3 2024	Q2 2025	Q3 2025
Hospital Division ($USD)	$71.733M	$236.302M	$260.239M
Population Health Management ($USD)	$7.062M	$7.683M	$7.565M

Key KPIs

KPI	Q3 2024	Q2 2025	Q3 2025
Total Hospital Division Visits (units)	41,668	45,573	46,232
Mature Hospitals Visit Growth	—	+0.6% YoY	(0.6%) YoY
IDR/Arbitration Share of Hospital Revenue	—	—	$182.1M (~70%)
IDR Win Rate / Collections	—	—	>85% win rate; >80% avg collection on wins
Arbitration Costs	—	—	~24–26% of arbitration-related revenue

Estimate vs. Actual (Q3 2025)

Metric	Actual	Consensus*	Surprise
Revenue ($USD)	$267.804M	$213.812M*	+$53.992M
EPS (Diluted) ($)	$7.76	$1.82*	+$5.94
EBITDA ($USD)	$91.787M	$66.605M*	+$25.182M

Coverage depth: 3 revenue and 3 EPS estimates for Q3 2025*.
Values marked with * retrieved from S&P Global.

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Financial Guidance	FY/Q4/2025	None provided	None provided	Maintained (no formal guidance)

Notes: Company did not issue formal quantitative forward guidance in the Q3 materials. It did announce a previously authorized $25M share repurchase program on Aug 14 (disclosed with Q2 results), to be executed opportunistically subject to reporting compliance .

Earnings Call Themes & Trends

Note: The Q3 earnings call is scheduled for Dec 2, 2025; no Q3 transcript is available yet .

Topic	Previous Mentions (Q1’25 and Q2’25)	Current Period (Q3’25)	Trend
IDR/arbitration strategy	Q1/Q2: 60–70% of visits through IDR; >80% win rate; 200–300% uplift vs initial insurer payments; ongoing as core revenue cycle process .	Q3: ~$182.1M (~70%) of hospital revenue tied to higher acuity and IDR; >85% win rate; >80% average collection on wins; costs ~24–26% .	Increasing contribution; execution consistent with strong win rates.
Volume and acuity	Q1: visits +20.5% YoY; mature +5.3% . Q2: visits +10.6% YoY; mature +0.6% .	Q3: visits +11.0% YoY; mature visits (0.6%) YoY .	Mix/acuity and IDR more important than mature visit growth.
Stock-based compensation and one-time earnouts	Q1/Q2: Large non-cash SBC mainly tied to under-construction/ramping hospitals; Q2 SBC $78.7M .	Q3 SBC fell to $13.2M; ~99.5% tied to one-time obligations .	Headwind abating sequentially.
Audit/restatement/Nasdaq compliance	Q2 call Q&A: CFO framed impacts as largely non-cash; fundamentals intact .	Company regained Nasdaq compliance (timely filings) on Nov 19, 2025 .	Overhang easing.
Technology/AI initiatives	Q1 ops: exploring AI for check-ins, staffing optimization, provider note writing, coding .	No incremental disclosures in Q3 release.	Ongoing ops efficiency focus.
Population Health (IPAs)	Q1 IPA revenue +5.4% YoY; >40,000 patients; ~1,400 MA members .	Division revenue $7.565M in Q3; broadly stable .	Stable, small share of revenue mix.

Management Commentary

CFO: “We are continuing to add to a record year with 225% revenue growth, Adjusted EBITDA attributable to Nutex Health of $243.0 million, a 629% increase in gross profit and a record high cash balance of $166.0 million.”
CEO: “With the audit revisions and related activities behind us, our team is fully focused on driving future growth both within existing operations and through new facilities. Our pipeline remains strong...”

Q&A Highlights

Q3 2025: No Q3 earnings call transcript yet; call scheduled for Dec 2, 2025 .
From Q2 context: CFO emphasized that the review and delays pertained largely to non-cash SBC classification; core operational fundamentals showed no material changes, addressing investor concerns about the sustainability of improvements .

Estimates Context

Versus S&P Global consensus: Nutex beat on revenue ($267.8M vs $213.8M*) and EPS ($7.76 vs $1.82*); EBITDA also exceeded ($91.8M vs $66.6M*). The magnitude of the beat reflects IDR-driven revenue recognition and higher acuity, partially offset by arbitration costs (24–26%). Limited coverage (3 estimates) suggests models may need substantial upward revisions to reflect IDR throughput and collections cadence .
Values marked with * retrieved from S&P Global.

Key Takeaways for Investors

IDR execution is the primary earnings engine: ~70% of hospital revenue in Q3 tied to higher-acuity/IDR outcomes, with >85% win rates and >80% collections; expect continued volatility in working capital but strong profitability if processes hold .
Sequential normalization of SBC supports EPS quality vs Q2: SBC dropped to $13.2M in Q3 from $78.7M in Q2, enabling operating leverage on accelerating revenue .
Liquidity and balance sheet strength: $166.0M cash at quarter end and strong operating cash flow ($99.5M in Q3) underpin growth pipeline and optionality (e.g., repurchases once disclosure constraints lift) .
Regulatory/process risk remains a watch item: IDR outcomes and arbitration costs are crucial to margins; any rule or payer behavior changes could impact sustainability; management is monitoring developments closely .
Narrative into the Dec 2 call: With Nasdaq compliance regained and restatements addressed, focus should shift to cadence of IDR wins/collections, arbitration cost efficiency, mature hospital growth reacceleration, and capital deployment roadmap .

View sources: Q3 2025 press release and 8-K ; Q2 and Q1 releases and 8-Ks ; Corporate update/IDR metrics and compliance .

Notes: S&P Global consensus figures are marked with an asterisk and were retrieved from S&P Global.

Nutex Health, Inc. (NUTX)·Q3 2025 Earnings Summary