- **Revenue momentum**: Q3 revenue $37.3M (+11% pro forma YoY), driven by 25% Greenbrook clinic growth and 40 NeuroStar systems shipped
- **SPRAVATO optimization**: 86% A&O mix in Q3, with B&Bill expanded to 5 states for margin optimization
- **Cash flow progress**: Sequential improvement to $0.8M Q3 use, targeting Q4 positivity
- **Strategic partnerships**: 3-year Elite DNA agreement to be sole TMS provider for 30+ Florida clinics
- **CEO transition**: Keith Sullivan to retire in June 2026 after 5+ years leading $147M+ revenue business

**【CEO Summary Section】**
- Total revenue reached $37.3 million, up 11% on a pro forma basis year-over-year, driven by Greenbrook clinic growth (25% adjusted pro forma increase) and strong NeuroStar system sales (40 systems shipped). 
- NeuroStar treatment session utilization grew 11% YoY, with SPRAVATO volumes up sequentially and 84/89 eligible clinics now offering the therapy.
- Operational improvements include: 
  - $0.8 million cash used in operations (vs. $17M Q1), with full-year cash flow positivity targeted
  - Kiosk adoption reducing front desk bottlenecks and improving collections
  - Streamlined organizational structure reducing management layers
- Strategic partnerships with Elite DNA and Transformations Care Network expand TMS access, with 3-year agreement to be sole provider for 30+ Florida clinics.
- New York State Medicaid now covers NeuroStar TMS for 5M+ members, broadening patient access.

**【CFO Financial Commentary】**
- Q3 2025 revenue: $37.3M (101% YoY growth, 11% pro forma)
- NeuroStar system revenue: $3.5M (30+ ASP above target)
- Clinic revenue: $21.8M (25% YoY growth)
- Gross margin: 45.9% (down from 75.6% YoY due to Greenbrook integration)
- Operating expenses: $24.4M (12% YoY increase)
- Cash position: $34.5M (including $10M debt draw)
- Q4 2025 guidance: $40-43M revenue
- Full-year 2025 guidance: $147-150M revenue (down from prior $149-155M due to SPRAVATO Buy & Bill optimization)

**【Q&A Highlights】**
- **Greenbrook vs. NeuroStar dynamics**: Greenbrook clinics driving 28% YoY growth, while NeuroStar utilization growth (11%) not yet translating to revenue due to 2024 inventory buildup
- **Gross margin challenges**: 70bp Q3 margin decline due to capital sales mix, SPRAVATO A&O shift, and one-time Compass revenue
- **SPRAVATO strategy**: 86% A&O mix in Q3 (vs. 56% Q2), with B&Bill expanded to 5 states where economics favorable
- **Cash flow progress**: Sequential improvement from $3.5M Q2 burn to $0.8M Q3 use, targeting Q4 positivity
- **2026 outlook**: Normalized NeuroStar inventory levels, continued SPRAVATO optimization, and automation investments (e.g., patient text alerts, intake process digitization)

Neuronetics, Inc. (STIM) Q3 2025 Earnings Call Transcript

Neurostar Advanced Therapy System

STIM

STIM fundamentals

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