Executive Summary

Q2 revenue fell 43% YoY to $8.2M and 7% QoQ, reflecting continued pressure from CMS reimbursement changes; GAAP diluted EPS printed $5.04 on an $83.8M unrealized Bitcoin fair value gain, masking a $2.1M operating loss .
Versus S&P Global consensus for “Primary EPS” and revenue, SMLR modestly beat EPS (−$0.23 vs −$0.27 est.) and missed revenue ($8.22M vs $8.40M est.); EBITDA outperformed (−$2.0M vs −$3.25M est.) as opex discipline offset volume pressure (values marked with * from S&P Global) [GetEstimates Q2 2025].
Management doubled down on the dual-engine strategy: launch of CardioVanta (heart failure/arrhythmia SaaS) while aggressively scaling BTC holdings to 5,021 by July 31 and targeting 10,000 BTC by YE25, 42,000 by YE26, 105,000 by YE27 .
Potential stock catalysts: BTC accumulation targets/financing optionality (ATM remaining >$300M as of 7/31) and a DOJ settlement “on track,” which could remove an overhang; near-term headwind remains PAD utilization under the CMS rate update .

What Went Well and What Went Wrong

What Went Well

BTC-driven earnings power: $83.8M unrealized Bitcoin gain drove $66.9M net income ($5.04 diluted EPS), despite operating loss; “We are extremely proud of the progress we are making as a Bitcoin treasury company” (Exec. Chair) .
Strategic expansion of BTC platform: Added Natalie Brunell to the board and hired a Director of Bitcoin Strategy; holdings reached 5,021 BTC by 7/31 with 31.3% YTD BTC yield .
New healthcare vector: Launched CardioVanta to pursue large markets in early detection of heart failure/arrhythmia with a SaaS model; management sees multi‑billion dollar opportunities .

What Went Wrong

Core revenue pressure: Revenues fell 43% YoY on PAD reimbursement headwinds; CFO cited “continued phase in of the 2024 CMS rate announcement” driving decreased device usage .
Operating performance: Loss from operations of $2.1M vs +$5.4M LY; opex rose to $10.3M (incl. $1.9M SBC and $0.5M DOJ legal) .
Concentration risk: Top two customers represented 45% and 31% of Q2 revenue (vs. 44%, 27%, 11% across top three in Q2’24), sustaining dependence on a few accounts .

Financial Results

GAAP P&L Summary (oldest → newest)

Metric	Q2 2024	Q1 2025	Q2 2025
Revenue ($USD Millions)	$14.47	$8.84	$8.22
Cost of Revenues ($USD Millions)	$1.26	$0.94	$0.74
Total Operating Expenses ($USD Millions)	$9.12	$39.94 (incl. $29.75M DOJ contingency)	$10.27 (incl. $1.9M SBC; $0.5M DOJ legal)
Operating (Loss) Income ($USD Millions)	$5.35	$(31.10)	$(2.05)
Net (Loss) Income ($USD Millions)	$0.01	$(64.70)	$66.93
Diluted EPS ($)	$0.00	$(6.74)	$5.04

Notes: Q1’25 opex includes $29.75M DOJ settlement contingency; Q2’25 net income driven by $83.8M Bitcoin fair value gain .

Results vs S&P Global Consensus (Q2 2025)

Metric	Consensus*	Actual*	Beat/(Miss)
Revenue ($USD)	$8,400,670*	$8,217,000*	$(183,670) (miss)*
Primary EPS ($)	$(0.27)*	$(0.2266)*	+$0.043 (beat)*
EBITDA ($USD)	$(3,246,000)*	$(1,997,000)*	+$1,249,000 (beat)*

Footnote: Values marked with * are retrieved from S&P Global (GetEstimates). Company‑reported GAAP diluted EPS was $5.04 due to $83.8M unrealized BTC gain; S&P “Primary EPS” reflects a normalized/primary measure not comparable to GAAP diluted EPS .

BTC and Capital Markets KPIs (oldest → newest)

KPI	12/31/2024	3/31/2025	6/30/2025	7/31/2025
BTC Holdings (coins)	2,298	3,192	4,636	5,021
BTC Yield % (QTD)	—	21.9%	5.8%	1.8%
BTC Yield % (YTD)	—	21.9%	29.0%	31.3%
ATM Cumulative Net Proceeds ($)	$119.6M (FY24)	—	—	$194.3M (new ATM); initial ATM $126.0M

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
BTC holdings target	YE 2025	—	10,000 BTC	New
BTC holdings target	YE 2026	—	42,000 BTC	New
BTC holdings target	YE 2027	—	105,000 BTC	New
DOJ settlement	2025 timing	Agreement in principle to pay $29.75M	“Process … progressing smoothly and on track”	Maintained
Capital availability (ATM)	As of 7/31/2025	New $500M ATM launched 4/15/25	“A little over $300M remaining” capacity	Updated status

No quantitative revenue/margin/EPS guidance was provided in Q2 materials .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q4’24, Q1’25)	Current Period (Q2’25)	Trend
Bitcoin treasury strategy & leverage	FY24: embraced BTC strategy; issued converts in Jan’25 . Q1’25: BTC holdings 3,808 by 5/12; launched BTC dashboard; new $500M ATM .	Added BTC-focused board member and strategy lead; holdings 5,021 by 7/31; exploring more leverage/financing; “one of the largest public BTC treasuries” .	Expanding
Healthcare core (PAD/CMS)	FY24: solid operating income; CMS changes flagged as risk . Q1’25: revenue −44% YoY; DOJ contingency booked .	CFO: CMS rate change phasing continues to reduce device usage and revenue .	Headwind persists
New healthcare growth vectors	Q1’25: “green shoots” in cardiovascular add-ons .	Launch of CardioVanta (HF/arrhythmia SaaS) with larger TAM .	Building
Regulatory/legal	Q1’25: DOJ settlement agreement in principle $29.75M .	Settlement “on track”; $0.5M legal expense in Q2 .	De-risking
Financing capacity	FY24: ATM $150M; Jan’25 converts $100M .	New $500M ATM; >$300M capacity remaining as of 7/31 .	Increased flexibility

Management Commentary

“We are super excited about the excellent progress we are making in our Bitcoin operations … the growth and profitability of our Bitcoin operations as reported today are truly remarkable.” — Executive Chairman .
“Total revenues in Q2 2025 were $8.2 million … due to the continued phase in of the 2024 CMS rate announcement … resulting in decreased usage of our device at some of our customers.” — CFO .
“We were very pleased to launch CardioVanta, a wholly owned subsidiary that will drive our future healthcare initiatives focused on early detection of heart failure and cardiac arrhythmia.” — CEO .
“We are targeting 10,000 Bitcoin by year end 2025, 42,000 by year end 2026, and 105,000 by year end 2027.” — Executive Chairman .
“In Q2, we issued approximately 4.1 million shares for net proceeds of $156.6 million … As of 07/31/2025, we have a little over $300 million remaining in our $500 million ATM.” — CFO .

Q&A Highlights

Competitive landscape for BTC treasuries: Not concerned about a “supply glut”; peers accelerate adoption and support monetization, benefiting early movers .
BTC acquisition cadence: Announcements may “increase in regularity and size” but cadence will be strategic; lack of announcement does not imply inactivity .
MNAV multiple framework: Management contrasted “fast money” premium-to-MNAV strategy (ATM issuance at a premium) with “slow money” sustainable leverage strategy that can outperform even at ~1x MNAV if BTC appreciates faster than interest costs .

Estimates Context

Q2 2025: S&P Global consensus — Revenue $8.40M; Primary EPS −$0.27; EBITDA −$3.25M (2–3 estimates each). Actuals on S&P basis: Revenue $8.22M, Primary EPS −$0.2266, EBITDA −$2.00M. Result: revenue miss, EPS and EBITDA beats (values from S&P Global)* [GetEstimates Q2 2025].
Methodology nuance: Company’s GAAP diluted EPS (+$5.04) diverges from S&P “Primary EPS” due to $83.8M unrealized BTC gain recognized in GAAP net income; investors should align estimate comparisons to S&P’s Primary EPS construct rather than GAAP diluted EPS .

Key Takeaways for Investors

Core healthcare under pressure near term (CMS), but opex discipline and mix kept EBITDA better than feared vs consensus*; monitoring PAD utilization and customer behavior remains key [GetEstimates Q2 2025].
BTC strategy is the dominant earnings driver quarter-to-quarter; targets to 10k/42k/105k BTC plus ample financing capacity (> $300M ATM remaining) create a clear path to scale .
Legal overhang easing: DOJ settlement process “on track”; incremental legal costs modest in Q2 ($0.5M) after Q1 reserve .
Concentration risk persists with top two customers at 76% of Q2 revenue; diversification or broader uptake of new offerings (CardioVanta) would be positive .
Watch estimate revisions: thin coverage (2–3 estimates) increases volatility; S&P “Primary EPS” beats may support sentiment even as GAAP EPS remains dominated by BTC marks* [GetEstimates Q2 2025].
Near-term trading set-ups likely skew to BTC accumulation/financing headlines, DOJ resolution, and any 510(k)/CardioVanta milestones; healthcare stabilization would add optionality .

Additional detail and source references:

Q2 2025 8‑K/press release (financials, BTC holdings, ATM): .
Q2 2025 earnings call (strategy, drivers, guidance-like targets, CFO commentary): .
Prior periods for context (Q1 2025, Q4 2024): .

Footnote on estimates: Values marked with * are retrieved from S&P Global (GetEstimates).

Semler Scientific, Inc. (SMLR)·Q2 2025 Earnings Summary