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STRATA Skin Sciences, Inc. (SSKN)·Q2 2025 Earnings Summary

Executive Summary

  • Q2 2025 revenue was $7.66M, down 9% YoY and below Wall Street consensus of $8.56M; EPS was -$0.60 vs. consensus -$0.29. Both revenue and EPS missed estimates, driven by international headwinds and higher OpEx. * Values retrieved from S&P Global
  • Gross margin improved sequentially to 56% (from 53.5% in Q1), but gross profit declined YoY to $4.31M; net loss widened to $2.49M.
  • Strategic catalyst: AMA CPT descriptor expansion for excimer laser treatments, potentially tripling the reimbursable patient pool; STRATA is working with CMS to secure temporary G-codes for 2026 and submitted economic data to increase reimbursement rates per procedure.
  • Operational update: 19 device placements (highest in six quarters) and removal of 21 underperforming devices; DTC drove ~1,100 appointments with 61% show rate; domestic average gross billings/device rose 2.7% YoY.
  • Key headwinds: International revenue declined 15% YoY amid tariff uncertainty and distributor issues; OpEx up ~$1.1M YoY, including ~$340K legal costs; equipment revenue down 18% YoY.

What Went Well and What Went Wrong

What Went Well

  • CPT code expansion accepted for 96920–96922 to include inflammatory/autoimmune conditions (e.g., vitiligo, atopic dermatitis, alopecia areata), positioning a potential tripling of the addressable patient population. “These developments open our addressable market to 30,000,000 patients, expanding our total available market threefold.”
  • Device placement activity improved: “We removed 21 XTRAC devices from underperforming accounts during the quarter and placed 19, the highest number of placements in six quarters.”
  • DTC and practice support gaining traction: “We generated roughly 1,100 DTC driven patient appointments in the second quarter with a 61% show rate… our proprietary RDX system handled benefits for approximately 5,100 patients.”

What Went Wrong

  • International headwinds: “We generated international revenue of $2,600,000 in the second quarter, which declined 15% compared to the prior year period… lingering trade disruptions in China and distributor challenges in Korea.”
  • Profitability and costs: Adjusted EBITDA was -$0.76M; total OpEx rose to $6.53M (+$1.07M YoY), with litigation costs (~$340K) and higher sales/call center headcount/DTC spend.
  • Equipment revenue softness: Equipment revenue fell to $2.5M (-18% YoY), reflecting international market issues and tariffs.

Financial Results

MetricQ2 2024Q1 2025Q2 2025
Revenue ($USD Millions)$8.44 $6.81 $7.66
Gross Profit ($USD Millions)$4.98 $3.65 $4.31
Gross Margin (%)59.0% 53.5% 56.0%
Net Loss ($USD Millions)$0.10 $2.43 $2.49
EPS ($USD)-$0.03 -$0.58 -$0.60
Cash & Equivalents ($USD Millions)N/A$7.85 $5.97

Segment breakdown

SegmentQ4 2024Q1 2025Q2 2025
Global Recurring Revenue ($USD Millions)$5.80 $4.70 $5.10
Equipment Revenue ($USD Millions)$3.80 $2.10 $2.50

KPIs

KPIQ4 2024Q1 2025Q2 2025
XTRAC Gross Domestic Recurring Billings (non-GAAP, $USD Millions)$4.87 $4.09 $4.65
GAAP Domestic Revenue ($USD Millions)$5.10 $4.04 $4.42
Avg Net Revenue per Domestic XTRAC System ($)$5,906 $4,776 N/A
Avg Gross Billings per Device ($)N/AN/A$5,512 (+2.7% YoY)
XTRAC Installed Base (US units)864 846 844
Devices Removed / Placed (count)N/AN/A21 removed / 19 placed
DTC Appointments / Show RateN/A>1,000 appointments ~1,100 appointments; 61% show
RDX Benefits Processed (patients)N/A+33% YoY (count not provided) ~5,100 patients
International Revenue ($USD Millions)$4.10 (Q4 2024) $2.50 $2.60
TheraClear X Installed Base (US devices)N/A160 161

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
International revenue run-rate2H 2025None“Roughly similar to prior year,” subject to tariff outcomes; no specific guidance figures Maintained (directional), with caution
SeasonalityFY 2025NoneExpect normal seasonality gaining momentum into year-end Maintained (directional)
CMS temporary G-codes for expanded indications2026 rule cycleN/AWorking with CMS to secure temporary codes to accelerate 2027 CPT expansion; final rule anticipated Nov 2025 New initiative
Reimbursement rates (practice expense/time)2026 rule cycleN/ASubmitted economic data; seeking increase in reimbursement (practice expense ~4.5x; time component under RUC survey) New initiative
TheraClear X installed baseYE 2025N/ATarget “closer to 200 devices” by YE 2025 Raised (directional target)

Earnings Call Themes & Trends

TopicPrevious Mentions (Q1 2025)Current Period (Q2 2025)Trend
Reimbursement/CPT expansionAnticipated favorable AMA CPT editorial outcomes; focus on expanding coverage beyond psoriasis AMA accepted CPT expansion; pursuing CMS temporary G-codes for 2026; RUC survey underway; submitted economic data to increase reimbursement rates Improving (regulatory tailwinds)
Tariffs/macro (International)Cautioned tariffs could reduce international revenue; Q1 not materially impacted International revenue down; China/Korea disruptions; 90-day tariff pause mitigated deeper impact Deteriorating near-term
Device utilization/DTCElevate360 rollout; consecutive QoQ growth in per-device revenue; >1,000 appointments ~1,100 appointments; 61% show; RDX ~5,100 patients; 19 placements (6-quarter high); ongoing removals of underperformers Improving
TheraClear XInstalled base 160; prioritizing insurance-billed clinics; growth in patients submitted (+138% YoY) Installed base 161; aim ~200 by YE 2025; still “small but growing” revenue contribution Gradual improvement
Legal/regulatory (LaserOptek litigation)Injunction in place; motion for civil contempt filed Feb 2025 Court adds LaserOptek Korea and C. Dalton LLC as defendants; potential damages; legal costs impacting G&A Advancing case; cost headwind

Management Commentary

  • “These revised reimbursement code descriptors, and the temporary codes we’ve applied for, have the potential to more than triple our available patient population by expanding into new indications.” — Dr. Dolev Rafaeli, President & CEO
  • “Assuming successful implementation of the temporary G codes into the 2026 reimbursement period, we have the potential to pull forward revenue opportunities by one year… These developments open our addressable market to 30,000,000 patients.” — CEO prepared remarks
  • “We generated roughly 1,100 DTC driven patient appointments in the second quarter with a 61% show rate… our proprietary RDX system handled benefits for approximately 5,100 patients.” — CEO
  • “Selling and marketing increased… due primarily to increases in headcount in the sales and call center and increase in DTC spending… roughly $340,000 relates to the legal expenses.” — VP Finance
  • “The court has agreed… LaserOptek Co. Ltd… should be added as a defendant… we are further gratified by the significant potential damages that may be awarded.” — CEO

Q&A Highlights

  • International trajectory: Management expects 2H 2025 international results to be roughly similar to prior year but cautioned tariff-driven volatility; the 90-day pause prevented deeper Q2 impact. No specific guidance given.
  • Litigation details: Management described false advertising/reimbursement claims by LaserOptek and indicated potential damages in “eight digit range,” with most legal expenses “behind us” post-discovery; G&A included ~$340K legal costs in Q2.
  • CMS G-code timeline: Draft rule for 2026 issued; comment period ends September; final rule anticipated November 2025; seeking higher practice expense and time components and temporary G-codes linked to expanded CPT descriptor.
  • Elevate360 impact: ~100 accounts engaged; anecdotal case studies show significant revenue uplift and multi-clinic expansion following process implementation (analytics, scheduling, pre-authorization). More metrics to be shared in future.
  • TheraClear strategy: Focus remains on XTRAC; TheraClear installed base targeted “closer to 200” by YE 2025; insurance-billed clinics prioritized; device breakeven ~$2,500/quarter revenue.

Estimates Context

MetricConsensus (Q2 2025)Actual (Q2 2025)# of Estimates
Revenue ($USD)$8,564,000*$7,663,000 2*
EPS ($USD)-$0.29*-$0.60 2*

*Values retrieved from S&P Global

Implications: Revenue and EPS missed consensus meaningfully; estimate revisions may drift lower near term given international uncertainty and higher OpEx, partially offset by regulatory tailwinds from CPT expansion and prospective CMS actions.

Key Takeaways for Investors

  • Q2 print was weaker than expected with both revenue and EPS missing consensus; softness concentrated in international equipment sales and elevated OpEx. * Values retrieved from S&P Global
  • Sequential margin improvement (56% vs. 53.5%) suggests operational efficiencies are taking hold despite lower volumes; watch if RDX/DTC and Elevate360 continue to lift device utilization in Q3/Q4.
  • Regulatory catalysts are significant: CPT expansion (effective 1/1/2027) and potential CMS temporary G-codes for 2026 could drive both volume and reimbursement per procedure; final rule expected November 2025.
  • International tariffs remain the primary swing factor; management flagged uncertainty in China/Korea and service/warranty import costs; monitor trade policy developments and November call.
  • Litigation progress could deter competitive encroachment and potentially yield damages; near-term G&A may normalize as major legal work is “behind us.”
  • Device footprint optimization continues: net installed base slightly down to 844, but 19 new placements (six-quarter high) and rising per-device activity support the domestic recurring model.
  • Near-term trading catalyst stack: CMS rule comment period (Sep 2025) and final rule (Nov 2025), Q3 results mid-November, and any tariff updates—position sizing should reflect binary policy risk vs. multi-year reimbursement upside.