Q4 2025 Lumexa Imaging Holdings Inc Earnings Call

March 26, 2026

Speaker #1: Mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question, you will need to press star when one of your telephone keypad.

Speaker #1: Please note that this conference is being recorded. I would now like to introduce Sue Dooley, Lumexa Imaging's Head of Investor Relations. Sue, please go ahead.

Speaker #2: Thank you. And good morning, everyone. We appreciate you joining us today. Leading today's call are our Chief Executive Officer, Caitlin Zulla, and Tony Martin, our Chief Financial Officer.

Operator: Good morning, and welcome to Lumexa Imaging's Q4 and full year 2025 earnings call. At this time, all participants are on a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question, you will need to press star one one on your telephone keypad. Please note that this conference is being recorded. I would now like to introduce Sue Dooley, Lumexa Imaging's Head of Investor Relations. Sue, please go ahead.

Speaker #2: Before we begin, I want to note that we will be discussing non-gap financial measures that we consider helpful in evaluating Lumexa Imaging's performance. You can find details on how these relate to our gap measures along with reconciliations in the press release that is available on our website.

Speaker #2: We'll also be making forward-looking statements based on our current expectations and assumptions which are subject to risk and uncertainties, including factors listed in our press release and in our various SEC filings.

Sue Dooley: Thank you, and good morning, everyone. We appreciate you joining us today. Leading today's call are our Chief Executive Officer, Caitlin Zulla, and Tony Martin, our Chief Financial Officer. Before we begin, I wanna note that we will be discussing non-GAAP financial measures that we consider helpful in evaluating Lumexa Imaging's performance. You can find details on how these relate to our GAAP measures along with reconciliations in the press release that is available on our website. We'll also be making forward-looking statements based on our current expectations and assumptions, which are subject to risks and uncertainties, including factors listed in our press release and in our various SEC filings. Actual results could differ materially, and we assume no obligation to update these forward-looking statements. With that, I'd like to now turn the call over to Caitlin. Caitlin, please go ahead.

Speaker #2: Actual results could differ materially, and we assume no obligation to update these forward-looking statements. With that, I'd like to now turn the call over to Caitlin.

Speaker #2: Caitlin, please go ahead.

Speaker #3: Thanks, Sue. Good morning, and thank you all for joining us today on our first earnings call as a public company. The fourth quarter of 2025 marked a strong close to an important year for Lumexa Imaging, and we delivered steady and consistent growth in revenue and EBITDA, that exceeds our preliminary earnings announcement.

Speaker #3: We generated consolidated revenue of $267.7 million up 7.9% over Q4 of last year. Adjusted EBITDA of $63.8 million represented an 18.6% increase over Q4 of last year, and delivered a 23.8% adjusted EBITDA margin.

Caitlin Zulla: Thanks, Sue. Good morning, and thank you all for joining us today on our first earnings call as a public company. Q4 of 2025 marked a strong close to an important year for Lumexa Imaging, and we delivered steady and consistent growth in revenue and EBITDA that exceeds our preliminary earnings announcement. We generated consolidated revenue of $267.7 million, up 7.9% over Q4 of last year. Adjusted EBITDA of $63.8 million represented an 18.6% increase over Q4 of last year and delivered a 23.8% adjusted EBITDA margin. We completed 1.4 million advanced imaging exams system-wide in the quarter, which is a 7.7% increase year-over-year. 2025 was a year marked by several meaningful achievements for Lumexa Imaging. Here are a few of the highlights.

Speaker #3: We completed $1.4 million advanced imaging exams, system-wide in the quarter, which is a 7.7% increase year over year. 2025 was a year marked by several meaningful achievements for Lumexa Imaging.

Speaker #3: Here are a few of the highlights. We advanced our growth plans, achieving a record number of de novo openings and driving strong same-center growth.

Speaker #3: We launched a successful rebrand of the company, rolling out our new name, Lumexa Imaging. To better represent our shared purpose, our innovative spirit, and our commitment to bringing greater access and exceptional care to more patients and more communities.

Speaker #3: We completed our IPO, bringing greater awareness of our company to the investment community, broadening access to our value creation opportunity, and by using proceeds to reduce our leverage profile, freeing up more cash to support our plans for profitable growth.

We completed 1.4 million Advanced Imaging exams systemwide in the quarter, which is a 7.7% increase year-over-year.

Caitlin Zulla: We advanced our growth plans, achieving a record number of de novo openings and driving strong same-center growth. We launched a successful rebrand of the company, rolling out our new name, Lumexa Imaging, to better represent our shared purpose, our innovative spirit, and our commitment to bringing greater access and exceptional care to more patients in more communities. We completed our IPO, bringing greater awareness of our company to the investment community, broadening access to our value creation opportunity, and by using proceeds to reduce our leverage profile, freeing up more cash to support our plans for profitable growth. I'd like to take a moment to reflect on the fundamentals of our business and the reason I believe we have a strong runway for continued growth.

With a year marked by several meaningful achievements, for Lumexa Imaging, here are a few of the highlights.

Speaker #3: I'd like to take a moment to reflect on the fundamentals of our business and the reason I believe we have a strong runway for continued growth.

We Advanced our growth plans, achieving a record number of the novo openings and driving strong same Center growth.

Speaker #3: Our straightforward value proposition continues to resonate with patients, providers, and payers, as demonstrated by our high patient net promoter scores, which are consistently over 90.

We launched a successful rebrand of the company, rolling out our new name, Lumexa Imaging, to better represent our shared purpose, our innovative spirit, and our commitment to bringing greater access and exceptional care to more patients and more communities.

Speaker #3: We've provided enhanced access to high-quality imaging that helps move patients through treatment in more convenient settings and at meaningfully lower costs than hospital outpatient department or HOPD sites of care.

Speaker #3: We've benefited from several long-term demand tailwinds, including aging populations with complex and chronic conditions, new treatment paradigms that require advanced imaging, increasing rates of preventative screening, and an ongoing migration from hospital and inpatient settings to outpatient imaging, amidst a fragmented and capacity-constrained industry landscape.

We completed our IPO bringing greater awareness of our company, to the investment Community, broadening access to our value creation opportunity. And by using proceeds to reduce our leverage profile, freeing up more cash to support our plans for profitable growth.

Caitlin Zulla: Our straightforward value proposition continues to resonate with patients, providers, and payers, as demonstrated by our high patient Net Promoter Scores, which are consistently over 90. We provide enhanced access to high-quality imaging that helps move patients through treatment in more convenient settings and at meaningfully lower costs than hospital outpatient department or HOPD sites of care. We benefit from several long-term demand tailwinds, including aging populations with complex and chronic conditions, new treatment paradigms that require advanced imaging, increasing rates of preventative screening, and an ongoing migration from hospital and inpatient settings to outpatient imaging amidst a fragmented and capacity-constrained industry landscape. Our commercial efforts are directed at higher growth and higher reimbursing advanced imaging modalities, including MRI, CT, and PET scans.

I'd like to take a moment to reflect on the fundamentals of our business and the reason I believe we have a strong runway for continued growth.

Our straightforward value proposition continues to resonate with patients, providers, and payers.

As demonstrated by our high patient net promoter scores, which are consistently over 90.

Speaker #3: Our commercial efforts are directed at higher growth and higher reimbursing, advanced imaging modalities, including MRI, CT, and PET scans, we also offer routine modalities like X-ray and ultrasound, which are strategic and position us as a convenient and comprehensive solution for patients even though those modalities are a less meaningful driver of our financial results.

We provide enhanced access to high-quality Imaging that helps move patients through treatment in more convenient settings and at meaningfully lower costs than Hospital outpatient department or hopd sites of care.

Speaker #3: We are deploying a focused and disciplined profitable growth algorithm grounded in same-center growth, geographic expansion, strategic service line expansions, and delivering efficiencies across our company including select AI-enabled solutions.

To outpatient Imaging.

Admits a fragmented and capacity. Constraint industry landscape.

Speaker #3: And by leveraging technology, including our existing tech stack as well as innovations being developed and coming months and years, we are well positioned to drive better outcomes and efficiencies.

Caitlin Zulla: We also offer routine modalities like X-ray and ultrasound, which are strategic and position us as a convenient and comprehensive solution for patients, even though those modalities are a less meaningful driver of our financial results. We are deploying a focused and disciplined profitable growth algorithm grounded in same-center growth, geographic expansion, strategic service line expansion, and delivering efficiencies across our company, including select AI-enabled solutions. By leveraging technology, including our existing tech stack, as well as innovations being developed in coming months and years, we are well-positioned to drive better outcomes and efficiencies. We turn the page to 2026 with confidence fueled by strong execution and a sense that at Lumexa Imaging, we are in the early innings of capitalizing on the opportunities ahead of us.

Our commercial efforts are directed at higher-growth and higher-reimbursing advanced imaging modalities, including MRI, CT, and PET scans.

Speaker #3: We turn the page to 2026 with confidence fueled by strong execution and a sense that at Lumexa Imaging, we are in the early innings of capitalizing on the opportunities ahead of us.

We also offer routine modalities like X-ray and ultrasound, which are strategic and position us as a convenient and comprehensive solution for patients, even though those modalities are a less meaningful driver of our financial results.

Speaker #3: We are inspired by our mission to expand access to high-quality imaging through elevated, compassionate care, improving lives and advancing healthcare across the country. Next, I would like to take a moment to review the key strategic initiatives we have in our sights for 2026.

We are deploying a focused and disciplined, profitable growth algorithm grounded in same-center growth, geographic expansions, strategic service line expansions, and delivering efficiencies across our company, including select AI-enabled solutions.

Speaker #3: First, driving same-center growth is our primary strategic focus. As a reminder, increased procedure volume generally accounts for approximately two-thirds of our revenue growth, and the remaining third is attributed to rates.

And, by leveraging technology—including our existing tech stack as well as innovations being developed and coming in the months and years ahead—we are well positioned to drive better outcomes and efficiencies.

Speaker #3: Driven by both increases in both rate per unit and acuity mix, or percentage of advanced modalities. Our commercial team is laser-focused on driving same-center growth.

Caitlin Zulla: We are inspired by our mission to expand access to high-quality imaging through elevated, compassionate care, improving lives and advancing healthcare across the country. Next, I would like to take a moment to review the key strategic initiatives we have in our sights for 2026. First, driving same-center growth is our primary strategic focus. As a reminder, increased procedure volume generally accounts for approximately 2/3 of our revenue growth, and the remaining 1/3 is attributed to rates, driven by both increases in rate per unit and acuity mix or percentage of advanced modalities. Our commercial team is laser-focused on driving same-center growth. To bring this to life, I'll share a couple examples from Q4. In orthopedic, we launched a targeted marketing and sales outreach campaign which drove incremental growth from one of our highest referring specialty provider categories during their peak surgical season.

We turn the page to 2026 with confidence, fueled by strong execution and a sense that, at Lumexa Imaging, we are in the early innings of capitalizing on the opportunities ahead of us.

Speaker #3: To bring this to life, I'll share a couple of examples from the fourth quarter. In orthopedic, we launched a targeted marketing and sales outreach campaign which drove incremental growth from one of our highest referring specialty provider categories during their peak surgical season.

We're inspired by our mission to expand access to high-quality imaging through elevated, compassionate care—improving lives and advancing healthcare across the country.

Next, I would like to take a moment to review the key strategic initiatives. We have in our sites for 2026,

Speaker #3: Another area where our teams are driving momentum is mammography. Approximately 85% of our screening volume comes from existing patients who return for their annual exams.

First, driving same center growth is our primary strategic focus.

Speaker #3: Reflecting high levels of patient trust and retention, leveraging our CRM capabilities and proactive scheduling during patient visits we were able to meaningfully increase our annual screening compliance rate.

As a reminder, increased procedure volume generally accounts for approximately two-thirds of our revenue growth. The remaining third is attributed to rate, driven by increases in both rate per unit and acuity mix, or percentage of advanced modalities.

Speaker #3: We also initiated marketing efforts to drive a healthy increase in new mammography patients in 2025. When annual compliance rates increase, more instances of breast cancer are detected and treated early, saving lives and lowering the cost of healthcare.

Our commercial team is laser focused on driving same center growth. To bring this to life, I'll share a couple examples from the fourth quarter.

Caitlin Zulla: Another area where our teams are driving momentum is mammography. Approximately 85% of our screening volume comes from existing patients who return for their annual exam, reflecting high levels of patient trust and retention. Leveraging our CRM capabilities and proactive scheduling during patient visits, we were able to meaningfully increase our annual screening compliance rates. We also initiated marketing efforts to drive a healthy increase in new mammography patients in 2025. When annual compliance rates increase, more instances of breast cancer are detected and treated early, saving lives and lowering the cost of healthcare. As we drive more demand within our existing centers, we are also taking steps to become more efficient to meet this growing outpatient imaging volume. Here are a few examples. With the benefit of an AI-enabled, faster scanning technology, we increased schedule throughput by nearly 40% while also improving image clarity since introduction.

In Orthopedic, we launched a targeted marketing and sales Outreach Campaign, which drove incremental growth from 1 of our highest referring specialty provider categories during their Peak surgical season.

Another area where our teams are driving momentum is mammography.

Speaker #3: As we drive more demand within our existing centers, we are also taking steps to become more efficient, to meet this growing outpatient imaging volume.

Speaker #3: Here are a few examples. With the benefit of an AI-enabled, faster scanning technology, we increased schedule throughput by nearly 40% while also improving image clarity, since introduction.

Approximately 85% of our screening volume comes from existing patients, who returned for their annual exams, reflecting high levels of patient trust and retention.

Leveraging. Our CRM capabilities and proactive scheduling during patient visits, we were able to meaningfully increase our annual screening compliance rate

Speaker #3: Our FastScan integration and rollout was approximately 50% complete across all of our centers by the end of 2025, and we expect to reach about two-thirds adoption by the end of 2026.

We also initiated marketing efforts to drive a healthy increase in new mamography patients in 2025.

Speaker #3: Another innovation we are integrating is virtual cockpit for remote MRI scanning. This technology allows us to minimize the impact of machine downtime and flex our staffing schedules and extend hours to serve our patients.

When annual compliance rates, increase more instances of breast cancer are detected and treated early, saving lives and lowering the cost of healthcare.

As we drive more demand, within our existing centers, we're also taking steps to become more efficient to meet this growing outpatient Imaging volume.

Here are a few examples.

Speaker #3: Our next strategic priority for 2026 involves geographic expansion. We aim to achieve this through new de novo openings, JV partnerships, and carefully selected M&A.

Caitlin Zulla: Our Fast Scan integration and rollout was approximately 50% complete across all of our centers by the end of 2025, and we expect to reach about two-thirds adoption by the end of 2026. Another innovation we are integrating is Virtual Cockpit for remote MRI scanning. This technology allows us to minimize the impact of machine downtime, flex our staffing schedules, and extend hours to serve our patients. Our next strategic priority for 2026 involves geographic expansion. We aim to achieve this through new de novo openings, JV partnerships, and carefully selected M&A. We view de novo openings as foundational to driving future growth. In 2025, we opened nine new centers, a record for our company.

With the benefit of an AI-enabled faster scanning technology, we increased schedule throughput by nearly 40% while also improving image clarity since introduction.

Speaker #3: We view de novo openings as foundational to driving future growth. In 2025, we opened nine new centers, a record for our company. As a reminder, our typical de novo ramps and reaches break-even in about one year, and our 2024 and 2025 cohorts of centers are tracking right in line with those expectations.

Our fast scan integration and roll out was approximately 50% complete across all of our centers by the end of 2025 and we expect to reach about 2/3 adoption by the end of 2026.

Another innovation we are integrating is Virtual Cockpit for remote MRI scanning.

Speaker #3: Looking ahead, we plan to open 8 to 10 de novos annually, and our agnostic as to whether those are in wholly owned or joint venture structures.

This technology allows us to minimize the impact of machine downtime, flex our staffing schedules, and extend hours to serve our patients.

Speaker #3: We opened our first de novo of the year in February, and currently have very good line of sight to reaching our 2026 goal for new sites.

Our next strategic priority for 2026 involves geographic expansion.

We aim to achieve this through new denovo, openings, JV Partnerships and carefully selected m&a.

Speaker #3: We look forward to providing you with more details as the year unfolds. Joint ventures represent the next area of our strategic focus for 2026.

We view de novo openings as foundational to driving future growth.

Caitlin Zulla: As a reminder, our typical de novo ramps and reaches breakeven in about 1 year, and our 2024 and 2025 cohorts of centers are tracking right in line with those expectations. Looking ahead, we plan to open 8 to 10 de novos annually and are agnostic as to whether those are in wholly owned or joint venture structures. We opened our first de novo of the year in February and currently have very good line of sight to reaching our 2026 goal for new sites. We look forward to providing you with more details as the year unfolds. Joint ventures represent the next area of our strategic focus for 2026. Joint ventures are a key differentiator, aligning health system priorities with our expansion strategy.

In 2025, we opened 9 new centers, a record for our company.

Speaker #3: Joint ventures are a key differentiator, aligning health system priorities with our expansion strategy. Health systems are increasingly seeking ways to participate in the rapid site-of-care shift to outpatient imaging and opportunities to grow their outpatient ambulatory footprint.

As a reminder, our typical de novo ramps and reaches break even in about one year. And our 2024 and 2025 cohorts of centers are tracking right in line with those expectations.

Speaker #3: Our JV model provides a highly effective entry point. Through the clinical, commercial, and operational excellence we demonstrate, particularly in de novo developments, Lumexa Imaging is well positioned to help systems execute against these ambitions while remaining focused on their broader enterprise priorities.

Looking ahead. We plan to open 8 to 10 denovos annually and are agnostic. As to whether those are in wholly owned or joint venture structures.

We opened our first de novo of the year in February and currently have very good line of sight to reaching our 2026 goal for new sites.

We look forward to providing you with more details as the year unfolds.

Speaker #3: In return, these partnerships accelerate our presence in any given market. We are cultivating a robust pipeline of potential partners with multiple ongoing conversations at various stages.

Joint ventures represent the next area of our strategic focus for 2026.

Caitlin Zulla: Health systems are increasingly seeking ways to participate in the rapid site of care shift to outpatient imaging and opportunities to grow their outpatient ambulatory footprint. Our JV model provides a highly effective entry point. Through the clinical, commercial, and operational excellence we demonstrate, particularly in de novo development, Lumexa Imaging is well-positioned to help systems execute against these ambitions while remaining focused on their broader enterprise priorities. In return, these partnerships accelerate our presence in any given market. We are cultivating a robust pipeline of potential partners with multiple ongoing conversations at various stages. I'd like to highlight a recent example that illustrates the power of our approach to joint ventures. In the back half of last year, we entered into a new partnership with University of Pittsburgh Medical Center.

Speaker #3: I'd like to highlight a recent example that illustrates the power of our approach to joint ventures. In the back half of last year, we entered into a new partnership with University of Pittsburgh Medical Center.

Health systems are increasingly seeking ways to participate in the rapid shift of care to outpatient imaging, and opportunities to grow their outpatient, ambulatory footprints.

Our JV model provides a highly effective entry point.

Speaker #3: Through this, we're working with UPMC to help them achieve their goals of providing access to lower-cost, high-quality, and more convenient imaging. At the same time, we are broadening our own footprint to include Pennsylvania, expanding our reach to 14 states.

Through clinical, commercial, and operational excellence, we demonstrate—particularly in de novo development—Lumexa Imaging is well positioned to help systems execute against these ambitions, while remaining focused on their broader enterprise priorities.

Speaker #3: It's early on in our partnership, but we are actively advancing site location planning. We are energized to have been chosen as a partner by this results-oriented and forward-thinking health system.

In return, these partnerships accelerate our presence in any given market.

We are cultivating a robust pipeline of potential partners, with multiple ongoing conversations at various stages.

Speaker #3: When it comes to M&A tokens, we are continuously evaluating accretive opportunities and will remain very disciplined in our approach. At the end of the fourth quarter, we completed one small token acquisition of a new facility in North Carolina, an extension of our strong partnership with Atrium.

I'd like to highlight a recent example that illustrates the power of our approach to joint ventures.

Caitlin Zulla: Through this, we're working with UPMC to help them achieve their goals of providing access to lower cost, high quality, and more convenient imaging. At the same time, we are broadening our own footprint to include Pennsylvania, expanding our reach to 14 states. It's early on in our partnership, but we are actively advancing site location planning. We are energized to have been chosen as a partner by this results-oriented and forward-thinking health system. When it comes to M&A tuck-ins, we are continuously evaluating accretive opportunities and will remain very disciplined in our approach. At the end of Q4, we completed one small tuck-in acquisition of a new facility in North Carolina, an extension of our strong partnership with Atrium Health. Another strategic priority for 2026 involves offering new strategic service lines to drive acuity mix and achieve efficiencies through innovation.

In the back half of last year, we entered into a new partnership with University of Pittsburgh Medical Center.

Through this, we're working with UPMC to help them achieve their goals of providing access to lower-cost, high-quality, and more convenient imaging.

Speaker #3: Another strategic priority for 2026 involves offering new strategic service lines to drive acuity mix and achieve efficiencies through innovation. Two areas I'd like to highlight as examples are mammography with cardiac screening, known as breast arterial calcification, and PET.

At the same time we are broadening our own footprint to include Pennsylvania expanding our reach to 14 States.

It's early on in our partnership, but we are actively advancing site location planning.

We are. Energized have been chosen as a partner by this results-oriented and forward-thinking health system.

Speaker #3: We recently launched breast arterial calcification, or BAC, screenings as a cash add-on assessment for cardiac health at our mammography locations in South Jersey. Cardiovascular disease is one of the leading causes of death for women, with over 60 million women in the U.S.

When it comes to M&A tuck-ins, we are continuously evaluating creative opportunities and will remain very disciplined in our approach.

Speaker #3: living with some form of heart disease. As noted in a study published in the Journal of the American College of Cardiology, BAC can be used as a biomarker to evaluate calcium buildup in the breast artery, which may indicate increased cardiovascular risk.

At the end of the fourth quarter, we completed one small tuck-in acquisition of a new facility in North Carolina, and an extension of our strong partnership with Atrium.

Caitlin Zulla: Two areas I'd like to highlight as examples are mammography with cardiac screening, known as breast arterial calcification, and PET. We recently launched breast arterial calcification or BAC screenings as a cash add-on assessment for cardiac health at our mammography locations in South Jersey. Cardiovascular disease is one of the leading causes of death for women, with over 60 million women in the US living with some form of heart disease. As noted in a study published in the Journal of the American College of Cardiology, BAC can be used as a biomarker to evaluate calcium buildup in the breast arteries, which may indicate increased cardiovascular risk. Acceptance of this add-on has been strong since inception. PET is another strategic area of focus for us and was a contributor to our growth and increase in acuity mix in 2025.

Another strategic priority for 2026 involves offering new strategic service lines to drive it mix and Achieve efficiencies through innovation.

Speaker #3: Acceptance of this add-on has been strong since inception. PET is another strategic area of focus for us and was a contributor to our growth and increase in acuity mix in 2025.

2 areas, I'd like to highlight as examples are mamography with cardiac screening known as breast arterial, calcification and pets.

Speaker #3: Our Lumexa Alzheimer's Center of Excellence helps identify patients who may benefit from emerging onset dementia therapies with amyloid PET exams. Patients who receive this therapy need up to five MRIs for side effect monitoring.

We recently launched breast arterial calcification or BAC screenings as a cache add-on assessment for cardiac health at our mammography locations in South Jersey.

Cardiovascular disease is one of the leading causes of death for women, with over 60 million women in the U.S. living with some form of heart disease.

Speaker #3: Improved PET access is a valuable way we can enable their care. Our full-year PET volumes increased mid-teens on both a consolidated and system-wide basis.

As noted in a study published in the Journal of the American College of Cardiology, BAC can be used as a biomarker to evaluate calcium buildup in the breast arteries, which may indicate increased cardiovascular risk.

Speaker #3: BAC and PET drive both volume and rate for us, and we're in the process of expanding these strategic service lines to other geographies. I'd like to take a moment to speak about our approach to innovation.

Acceptance of this add-on has been strong since inception.

Caitlin Zulla: Our Lumexa Alzheimer's Center of Excellence helps identify patients who may benefit from emerging onset dementia therapies with amyloid PET exams. Patients who receive this therapy need up to five MRIs for side effect monitoring. Improved PET access is a valuable way we can enable their care. Our full-year PET volumes increased mid-teens on both a consolidated and system-wide basis. BAC and PET drive both volume and rate for us, and we're in the process of expanding these strategic service lines to other geographies. I'd like to take a moment to speak about our approach to innovation. At Lumexa, we take a partnering approach to leveraging technology and incorporating artificial intelligence across our business. We believe this approach allows us to accelerate adoption, benefit from reduced capital intensity, and enjoy the flexibility to leverage the best proven solutions as they rapidly come to market.

Speaker #3: At Lumexa, we take a partnering approach to leveraging technology and incorporating artificial intelligence across our business. We believe this approach allows us to accelerate adoption, benefit from reduced capital intensity, and enjoy the flexibility to leverage the best-proven solutions as they rapidly come to market.

PET is another strategic area of focus for us and was a contributor to our growth and increase in acute mix in 2025.

Our Lumexa Alzheimer's Center of Excellence helps identify patients who may benefit from emerging onset dementia therapies with Omalo PET exam.

Patients who received this therapy need up to five MRIs for side effect monitoring.

Improved pet access is a valuable way. We can enable their care.

Speaker #3: In the fourth quarter, we reached an agreement to partner with Farim Health, a leading AI convener. Simply put, Farim acts as an AI clinical imaging app store, providing us access to FDA-cleared apps through a single integrated pathway.

Our full year PET volumes increased mid-teens on both the consolidated and systemwide basis.

BAC and PET drive both volume and rate for us, and we're in the process of expanding these strategic service lines to other geographies.

Speaker #3: Through this partnership, we can quickly turn on, evaluate, and measure the effectiveness of hundreds of AI applications that we can implement across modalities and workflows.

I'd like to take a moment to speak about our approach to innovation.

Speaker #3: While protecting our data and our insights. We're driving best-of-breed technology across our entire company. Our centralized back office teams are also participating in this push for innovation as well, using emerging agentic and generative AI functions to increase efficiencies.

At Lumexa, we take a partnering approach to leveraging technology and incorporating artificial intelligence across our business.

We believe this approach allows us to accelerate adoption.

Caitlin Zulla: In Q4, we reached an agreement to partner with Ferrum Health, a leading AI convener. Simply put, Ferrum acts as an AI clinical imaging app store, providing us access to FDA-cleared apps through a single integrated pathway. Through this partnership, we can quickly turn on, evaluate, and measure the effectiveness of hundreds of AI applications that we can implement across modalities and workflows while protecting our data and our insights. We're driving best-of-breed technology across our entire company. Our centralized back office teams are also participating in this push for innovation as well, using emerging agentic and generative AI functions to increase efficiencies. Wrapping up, I'm pleased with our Q4 results, and our team is energized by the success to deliver on our strategic priorities for the year to come.

Benefit from reduced Capital intensity and enjoy the flexibility to leverage. The best proven Solutions as a rapidly come to Market.

In the fourth quarter, we reached an agreement to partner with FAM Health, a leading AI convener.

Speaker #3: Wrapping up, I'm pleased with our Q4 results and our team is energized by the success to deliver on our strategic priorities for the year to come.

Simply put, FM acts as an AI clinical imaging app store, providing us access to FDA-cleared apps through a single, integrated pathway.

Speaker #3: We believe we're in the early stages of capitalizing on the significant opportunity ahead of us and that Lumexa is well positioned to deliver profitable growth this year and beyond.

Through this partnership, we can quickly turn on, evaluate, and measure the effectiveness of hundreds of AI applications that we can implement across modalities and workflows.

Speaker #3: I want to say a huge thank you to our dedicated team members and our radiologists. Our accomplishments are a direct result of their hard work and commitment to providing the highest quality imaging experience for our patients who rely on us.

While protecting our data and our insights.

We're driving best-of-breed technology across our entire company. Our centralized back-office teams are also participating in this push for innovation, as well as using emerging agentic and generative AI functions to increase efficiencies.

Speaker #3: I'll now turn the call over to Tony, to review our fourth quarter in more detail. Tony? Thank you, Caitlin, and thank you all for joining us today to discuss our results.

Caitlin Zulla: We believe we're in the early stages of capitalizing on the significant opportunity ahead of us. That Lumexa is well positioned to deliver profitable growth this year and beyond. I want to say a huge thank you to our dedicated team members and our radiologists. Our accomplishments are a direct result of their hard work and commitment to providing the highest quality imaging experience for our patients who rely on us. I'll now turn the call over to Tony to review our Q4 in more detail. Tony?

Wrapping up, I'm pleased with our Q4 results and our team is energized by the success to deliver on our strategic priorities for the year to come.

Speaker #3: On today's call, I'll review the financial results and speak to some key drivers of our performance at the quarter. I will then provide our outlook for full year 2026.

We believe we’re in the early stages of capitalizing on the significant opportunity ahead of us, and that Lumexa is well positioned to deliver profitable growth this year and beyond.

Speaker #3: To supplement my review of our gap financials on today's call, I will cite some system-wide metrics to help you better understand our overall performance and the breadth of our business.

I want to say a huge thank you to our dedicated team members and our radiologists.

Speaker #3: System-wide metrics include all centers that we operate, including the 102 that we wholly own, as well as the 86 centers that we operate and our eight joint ventures with health systems.

are a direct result of their hard work and commitment to providing the highest quality imaging experience for our patients who rely on us.

Tony Martin: Thank you, Caitlin, and thank you all for joining us today to discuss our results. On today's call, I'll review the financial results and speak to some key drivers of our performance this quarter. I will then provide our outlook for full year 2026. To supplement my review of our GAAP financials on today's call, I will cite some system-wide metrics to help you better understand our overall performance and the breadth of our business. System-wide metrics include all centers that we operate, including the 102 that we wholly own, as well as the 86 centers that we operate in our eight joint ventures with health systems. Our health system JV centers' revenues and expenses are not included in our GAAP revenues and expenses due to our minority ownership position.

I'll now turn the call over to Tony to review our fourth quarter in more detail. Tony?

Speaker #3: Our health system JV centers revenues and expenses are not included in our gap revenues and expenses due to our minority ownership position, but they're important drivers of our performance because we do record our pro-rata ownership share of their net income and their cash flows in hours.

Thank you, Caitlyn, and thank you all for joining us today to discuss our results.

On today's call, I'll review the financial results and speak to some key drivers of our performance this quarter.

I will then provide our outlook for 4 years, 2026.

Speaker #3: And we pick up our pro-rata share of their EBITDA in our adjusted EBITDA. Details of our JV financial performance are included in our quarterly financial statement disclosures.

The supplement, my review of our gaap financials. On today's call, I will cite some systemwide metrics to help you better understand or overall performance and the breadth of our business.

Speaker #3: We ended 2025 with a strong Q4 performance, one that exemplified our long-term growth algorithm and our focus on advanced modalities including MRI, CT, and PET.

Systemwide metrics include all centers that we operate, including the 102 that we wholly own, as well as the 86 centers that we operate in our 8 joint ventures.

Ventures with Health Systems.

Speaker #3: Consolidated revenues for the full year of $1.023 billion increased 7.8% compared to 2024. System-wide revenues increased 8.2% compared to 2024. We also delivered adjusted EBITDA of $230.2 million, which increased 14.6% compared to 2024.

Tony Martin: They're important drivers of our performance because we do record our pro rata ownership share of their net income and their cash flows in ours, and we pick up our pro rata share of their EBITDA and our adjusted EBITDA. Details of our JV financial performance are included in our quarterly financial statement disclosures. We ended 2025 with a strong Q4 performance, one that exemplified our long-term growth algorithm and our focus on advanced modalities, including MRI, CT, and PET. Consolidated revenues for the full year of $1.023 billion increased 7.8% compared to 2024. System-wide revenues increased 8.2% compared to 2024. We also delivered adjusted EBITDA of $230.2 million, which increased 14.6% compared to 2024, representing an adjusted EBITDA margin of 22.5%.

Our health system, JB centers, revenues and expenses are not included in our GAAP revenues and expenses due to our minority ownership position. But they're important drivers of our performance because we do record our pro rata ownership share of their net income and their cash flows in ours.

And we pick up our pro. Radish are of their IBA and our adjusted IBAA.

Speaker #3: Representing an adjusted EBITDA margin of 22.5%. Our cash flows were strong and delivered a more than half-turn reduction in leverage ratio, during a year in which we opened a record nine new centers.

Details of our JP financial performance are included in our quarterly financial statement disclosures.

We ended 2025 with a strong Q4 performance—one that exemplified our long-term growth algorithm and our focus on advanced modalities including MRI, CT, and PET.

Speaker #3: The leverage coming down an additional two turns to three and a half times levered in December, as a result of our IPO and related debt refinancing.

Consolidated revenues for the full year of 1.023 billion increased 7.8% compared to 2024

Speaker #3: Turning to our fourth quarter financials, starting with revenues, in the fourth quarter, consolidated revenues came in at $267.7 million. An increase of 7.9% compared to the same period last year.

Systemwide revenues increased 8.2% compared to 2024.

We also delivered adjusted EVA of $230.2 million, which increased 14.6% compared to 2024.

Tony Martin: Our cash flows were strong and delivered a more than half-year reduction in leverage ratio during a year in which we opened a record nine new centers. The leverage coming down an additional two turns to 3.5x levered EBITDA in December as a result of our IPO and related debt refinancing. Turning to our Q4 financials, starting with revenues. In the Q4, consolidated revenues came in at $267.7 million, an increase of 7.9% compared to the same period last year. This growth was most heavily driven by our return in-network with a large payer in New Jersey. We also saw an increase in the volume of procedures in other locations, and a continued mix shift toward advanced imaging, which has higher rates.

Speaker #3: This growth was most heavily driven by our return in network with a large payer in New Jersey. We also saw an increase in the volume of procedures in other locations, and a continued mix shift toward advanced imaging, which has higher rates.

Representing an adjusted EVA margin of 22.5%.

Our cash flows were strong and delivered a more than half-term reduction in leverage ratio during a year in which we opened a record 9 News centers.

Speaker #3: We experienced strong system-wide performance across all of our outpatient sites, both wholly owned and in JVs. As shown in our financial tables, system-wide revenue growth was 10.6% in the quarter.

The Leverage coming down an additional 2, turns to 3 and a half times leopard. In the end of December as a result of our IPO and related debt. Refinancing

Turning to our fourth quarter financials, starting with revenues.

Speaker #3: Revenue per unit, which includes both scan and read revenue, also benefited from modest increases in contracted rates with payers. We appreciate our lower price point compared to hospital-based services.

And the fourth quarter Consolidated, revenues came in at 2 6 7. 7 0.

million, an increase of 7.9% compared to the same period last year.

This growth was most heavily driven by our return in network with a large payer in New Jersey.

Speaker #3: Our outpatient revenues also grew as we ramped four sites added in 2024 and the nine new sites we opened across 2025. Additionally, our professional fee revenues, which comprise our second operating segment, were $66.8 million, reflecting growth of 10.6%.

Tony Martin: We experienced strong system-wide performance across all of our outpatient sites, both wholly owned and in JVs. As shown in our financial tables, system-wide revenue growth was 10.6% end of quarter. Revenue per unit, which includes both scan and read revenue, also benefited from modest increases in contracted rates with payers who appreciate our lower price point compared to hospital-based services. Our outpatient revenues also grew as we ramped 4 sites added in 2024, and the 9 new sites we opened across 2025. Additionally, our professional fee revenues, which comprise our second operating segment, were $66.8 million, reflecting growth of 10.6%. Finally, management fee and other revenues were $57.2 million. These revenues consist of two primary components.

We also saw an increase in the volume of procedures in other locations, and a continued mixed shift toward Advanced Imaging, which has higher rates.

We experienced strong systemwide performance across all of our outpatient sites, both wholly owned and in JVS.

Speaker #3: Finally, management fee and other revenues were $57.2 million. These revenues consist of two primary components. First, we're paid a management fee by each of our health system JVs to operate the outpatient centers in those JV structures.

As shown in our financial tables. Systemwide Revenue growth was 10.6% and a quarter.

Revenue per unit which includes both scan and read Revenue. Also benefited from Modest increases in contracted rates with payers who appreciate our lower price point compared to hospital-based services.

Speaker #3: Second, we employ center employees, and directly pay for certain IT and other services on behalf of the JV sites and essentially lease them back to the JV without an associated margin.

Our outpatient revenues also grew, as we ramped four sites added in 2024 and the nine new sites we opened across 2025.

Speaker #3: We call these pass-through revenues. We disclose the amount of pass-through revenues in a table accompanying our quarterly earnings release. Expenses related to the refinancing of our debt and other transaction costs in our IPO year resulted in a gap net loss of $28.7 million for the quarter.

Finally, management fee and other revenues for $57.2 million.

Tony Martin: First, we're paid a management fee by each of our health system JVs to operate the outpatient centers in those JV structures. Second, we employ center employees and directly pay for certain IT and other services on behalf of the JV sites and essentially lease them back to the JV without an associated margin. We call these pass-through revenues. We disclose the amount of pass-through revenues in a table accompanying our quarterly earnings release. Expenses related to the refinancing of our debt and other transaction costs in our IPO year resulted in a GAAP net loss of $28.7 million for the quarter, compared to a net loss of $25.1 million in the Q4 of last year.

These revenues consist of two primary components,

Speaker #3: Compared to a net loss of $25.1 million, in the fourth quarter of last year. Adjusted EBITDA for the fourth quarter was $63.8 million, compared to $53.7 million in the same period last year.

First, we're paid a management fee by each of our health system JVS to operate the outpatient centers in those JV structures.

Speaker #3: Representing an increase of 18.6%. Adjusted EBITDA margin was a healthy 23.8%, up 150 basis points from the prior year fourth quarter. Underscoring the scalability of our operating model and strong execution of margin expansion initiatives.

Second, we employ Center employees and directly pay for certain IT and other services on behalf of the JB sites, and essentially lease them back to the JB without an associated margin,

We call these pass through rebates.

We just closed the amount of pass-through revenues in a table, accompanying our quarterly earnings release.

Speaker #3: I'll remind everyone that adjusted EBITDA reflects our pro-rata ownership share of EBITDA of all our centers, both the ones we wholly own and those in health system JVs.

Expenses related to the refinancing of our debt, and other transaction costs. And our IPO year resulted in a GAAP net loss of $28.7 million for the quarter.

Tony Martin: Adjusted EBITDA for Q4 was $63.8 million, compared to $53.7 million in the same period last year, representing an increase of 18.6%. Adjusted EBITDA margin was a healthy 23.8%, up 150 basis points from the prior year Q4, underscoring the scalability of our operating model and strong execution of margin expansion initiatives. I'll remind everyone that adjusted EBITDA reflects our pro rata ownership share of EBITDA of all our centers, both the ones we wholly own and those in health system JVs. A quick note on stock-based compensation. Our stock-based comp can be viewed in two components. First is the expensing of shares that were issued as part of the purchase price for some businesses we acquired during 2020 and 2021. These costs will be fully amortized during 2026.

Compared to a net loss of 25.1 million in the fourth quarter of last year.

Speaker #3: A quick note on stock-based compensation. Our stock-based comp can be viewed in two components. First is the expensing of shares that were issued as part of the purchase price for some businesses we acquired during 2020 and 2021.

The fourth quarter was $63.8 million compared to $53.7 million, an increase of 18.6%.

Speaker #3: These costs will be fully amortized during 2026. Second, is the expensing of equity instruments granted to management and employees. Which is expected to continue to be part of stock comp beyond 2026.

Adjusted EVA, Dawn, margin was a healthy 23.8%, up 150 basis points from the prior year fourth quarter.

Underscoring the scalability of our operating model and strong execution of margin expansion initiatives.

Speaker #3: Turning to the balance sheet, we ended the quarter with $58.8 million of cash and cash equivalents, compared to $26.1 million at the end of 2024.

I'll remind everyone that adjusted evaa reflects our Pro rata ownership share of IBA of all our centres. Both the ones we wholly owned and those in health system JBS

A quick note on stock-based compensation.

Speaker #3: We've materially strengthened our balance sheet. As I described earlier, we de-levered over half a turn simply through the operation of the business during 2025, despite opening a record nine de novos.

Our stock based comp can be viewed in 2 components.

First is the expensing of shares that were issued as part of the purchase price for some businesses we acquired during 2020 and 2021.

Tony Martin: Second is the expensing of equity instruments granted to management and employees, which is expected to continue to be part of stock comp beyond 2026. Turning to the balance sheet, we ended the quarter with $58.8 million of cash and cash equivalents compared to $26.1 million at the end of 2024. We've materially strengthened our balance sheet. As I described earlier, we delevered over half a turn simply through the operation of the business during 2025, despite opening a record 9 de novos. In December, we used $406 million of net IPO proceeds to pay down debt, which reduced our leverage ratio by two more turns. In December, we also received improved credit ratings from both S&P and Moody's to B+ and B2 respectively, and we refinanced our term loan at a more favorable interest rate.

Speaker #3: Then in December, we used $406 million of net IPO proceeds to pay down debt. Which reduced our leverage ratio by two more turns. In December, we also received improved credit ratings from both S&P and Moody's to B+ and B2, respectively.

These costs will be fully advertised during 2026.

Second is the expensing of equity instruments granted to management and employees.

Which is expected to continue to be part of stock comp beyond 2026.

Speaker #3: And we refinanced our term loan at a more favorable interest rate. The result of this balance sheet strengthening activity is an anticipated annual cash savings of more than $50 million.

Turning to the balance sheet, we ended the quarter with 58.8 million of cash and cash equivalents compared to 26.1 million at the end of 2024.

We've materially strengthened our balance sheet.

Speaker #3: Sometimes people ask about the debt of our unconsolidated health system JVs. We'll always disclose that figure in our quarterly reporting. But I'll note here that the total at year-end was $69 million.

As I described earlier, we deliberate over half a turn simply through the operation of the business during 2025, despite opening a record 9 dozen.

Then in December, we used $406 million of net IPO proceeds to pay down debt.

Speaker #3: Attributed mainly to financing of equipment purchases at the centers. That number is not included in our balance sheet or our computation of leverage ratios for lenders but if we were to include our pro-rata ownership share of this debt, our leverage ratio would only increase by about 0.15 times.

Which reduced our leverage ratio by two more terms?

In December. We also received improved credit ratings from both S&P and movies to B+ and B2 respectively.

Tony Martin: The result of this balance sheet strengthening activity is an anticipated annual cash savings of more than $50 million. Sometimes people ask about the debt of our unconsolidated health system JVs. We'll always disclose that figure in our quarterly reporting, but I'll note here that the total at year-end was $69 million, attributed mainly to financing of equipment purchases at the centers. That number is not included in our balance sheet or our computation of leverage ratios for lenders. If we were to include our pro rata ownership share of this debt, our leverage ratio would only increase by about 0.15 times. We consider our JVs to be capital-efficient business models that support our growth objectives and generate significant cash flows for us and our health system partners. Our business continues to generate strong cash flow.

And we refinanced our term loan at a more favorable interest rate.

The result of this balance sheet strengthening activity is

Speaker #3: We consider our JVs to be capital-efficient business models that support our growth objectives. And generate significant cash flows for us and our health system partners.

Anticipated annual cash savings of more than $50 million.

Sometimes people ask about the debt of our unconsolidated health system, JBS.

We'll always disclose that figure in our quarterly reporting.

Speaker #3: Our business continues to generate strong cash flow. Before moving to guidance, I want to reiterate our three capital allocation priorities. First, we plan to fund de novo facility growth, equipment upgrades, and investments in strategic service lines.

But I'll note here that the total at year-end was $69 million.

Attributed mainly to financing of equipment purchases at the centers.

That number is not included in our balance sheet, or our computation of leverage ratios for lenders.

Speaker #3: Second, we may make carefully chosen strategic tuck-in acquisitions. While these are part of our growth matrix, our 2026 guidance is not dependent on future M&A.

But if we were to include our pro rata ownership share of this debt, our leverage ratio would only increase by about 0.15 times.

Speaker #3: And third, over the longer term, we aim to reduce our leverage profile to below three times. Given the durable cash generation of our business, we believe we're well positioned to execute on these three priorities.

We consider our JBS to be capital-efficient business models that support our growth objectives and generate significant cash flows for us and our health system partners.

Tony Martin: Before moving to guidance, I want to reiterate our three capital allocation priorities. First, we plan to fund de novo facility growth, equipment upgrades, and investments in strategic service lines. Second, we may make carefully chosen strategic tuck-in acquisitions. While these are part of our growth matrix, our 2026 guidance is not dependent on future M&A. Third, over the longer term, we aim to reduce our leverage profile to below three times. Given the durable cash generation of our business, we believe we're well-positioned to execute on these three priorities. Put another way, we believe our business provides the flexibility to naturally delever even while fully funding our ongoing capital needs and growth strategy. Now turning to our outlook for full year 2026.

Speaker #3: Put another way, we believe our business provides the flexibility to naturally de-lever, even while fully and growth strategy. Now, turning to our outlook for full year 2026.

Our business continues to generate strong cash flow. Before moving to guidance, I want to reiterate our three capital allocation priorities.

First, we plan to fund, de novo, facility growth, equipment, upgrades, and investments in strategic service lines.

Second, we may make carefully chosen, strategic tuck-in acquisitions.

Speaker #3: Unchanged from our pre-announcement earlier this month, we continue to expect revenue to be in the range of $1.045 billion, to $1.097 billion. And adjusted EBITDA to be in the range of $234 million, to $242 million.

While these are part of our growth matrix, our 2026 guidance is not dependent on future M&A.

At third, over the longer term, we aim to reduce our leverage profile to below 3 times.

Speaker #3: Which includes approximately $7 million of public company costs that were not incurred in 2025. At the midpoint, the adjusted EBITDA growth rate excluding the addition of these costs in our first full year of operations as a public company would be 7%.

Given the durable cash generation of our business, we believe we’re well positioned to execute on these three priorities.

Put another way, we believe our business provides the flexibility to naturally deliver, even while fully funding our ongoing capital needs and growth strategy.

Tony Martin: Unchanged from our pre-announcement earlier this month, we continue to expect revenue to be in the range of $1.045 billion to $1.097 billion. Adjusted EBITDA to be in the range of $234 million to $242 million, which includes approximately $7 million of public company costs that were not incurred in 2025. At the midpoint, the adjusted EBITDA growth rate, excluding the addition of these costs in our first full year of operation as a public company, would be 7%. Today, we're adding guidance for adjusted EPS, which we expect to be between $0.71 and $0.77 per share. We expect continued growth in volumes with advanced modalities growing faster and representing an increasing share of the mix. This is important as advanced imaging drives higher revenue per procedure and higher margins.

Now, turning to our outlook for full year 2026,

Speaker #3: And EPS. Which we expect to be between 71 and 77 cents per share. We expect to continued growth in volumes, with advanced modalities growing faster and representing an increasing share of the mix.

Unchanged from our pre-announcement earlier this month, we continue to expect revenue to be in the range of $1.045 billion.

To 1.097 billion.

Speaker #3: This is important as advanced imaging drives higher revenue per procedure and higher margins. Other modalities impact our profits, but some drive profit more than others and our marketing efforts reflect that.

Adjust and adjust the DIVA to be in the range of $234 million to $242 million.

Which includes approximately $7 million of public company costs that were not.

Heard in 2025.

Speaker #3: For example, X-ray volumes were 15% of our system-wide volumes in 2025, but only 5% of our revenues. We do not provide quarterly guidance, but as we think about Q1, I'd want to share some additional color that may be helpful in framing expectations.

At the midpoint, the adjusted EBA dog growth rate—excluding the addition of these costs and our first full year of operations as a public company—would be 7%.

And today, we're adding guidance for adjusted EPS, which we expect to be between $0.71 and $0.77 per share.

Speaker #3: From a seasonality perspective, the first quarter is typically our lowest for revenue and adjusted EBITDA. And then our results ramp throughout the year, with the fourth quarter consistently being our strongest.

Tony Martin: Other modalities impact our profits, but some drive profit more than others, and our marketing efforts reflect that. For example, X-ray volumes were 15% of our system-wide volumes in 2025, but only 5% of our revenues. We do not provide quarterly guidance, but as we think about Q1, I'd want to share some additional color that may be helpful in framing expectations. From a seasonality perspective, Q1 is typically our lowest for revenue and adjusted EBITDA, and then our results ramp throughout the year, with Q4 consistently being our strongest, driven by patients seeking care ahead of annual deductible resets. With Q1 2026 largely behind us, we want to note some atypical timing dynamics. First, we believe our strong Q4 performance was in part due to some pull forward of volumes from January into December.

This is important, as Advanced Imaging drives higher revenue per procedure and higher margins.

Speaker #3: Driven by patience seeking care ahead of annual deductible resets. With Q1 2026 largely behind us, we want to note some atypical timing dynamics. First, we believe our strong Q4 performance was in part due to some pull-forward volumes from January into December.

Other modalities impact our profits, but some drive profit more than others, and our marketing efforts reflect that.

For example, X-ray volumes account for 15% of our systemwide volumes in 2025, but only 5% of our revenues.

We do not provide quarterly guidance, but as we think about Q1,

I want to share some additional colors that may be helpful in framing expectations.

Speaker #3: Second, New Jersey Texas and three other southern states were impacted in Q1 by storms, causing some impact to volumes. While we were able to recover a portion of these volumes within the quarter, we anticipate these dynamics to result in Q1 adjusted EBITDA being approximately flat compared to Q1 of 2025.

From a seasonality perspective, the first quarter is typically our lowest for revenue and adjusted IBA.

And then our results ramp throughout the year, with the fourth quarter consistently being our strongest.

Driven by patients seeking care ahead of annual deductible resets.

Speaker #3: We believe we can make up the remaining lost volume throughout the course of 2026, and we remain confident in our full-year guidance. As we set our sights on the longer term, in alignment with the discussions we had at the time of our IPO, we believe we're building a durable growth engine, fueled by de novo growth, same center sales expansion, and expanding strategic service lines.

Tony Martin: Second, New Jersey, Texas, and three other southern states were impacted in Q1 by storms, causing some impact to volumes. While we were able to recover a portion of these volumes within the quarter, we anticipate these dynamics to result in Q1 adjusted EBITDA being approximately flat compared to Q1 of 2025. We believe we can make up the remaining lost volume throughout the course of 2026, and we remain confident in our full year guidance.

With Q1 2026 largely behind us, we want to note some atypical timing dynamics. First, we believe our strong Q4 performance was in part due to some pull forward of volumes from January into December.

Second.

New Jersey, Texas, and three other southern states were impacted in Q1 by storms, causing some impact to volumes.

Speaker #3: We're in the early days of implementing our growth initiatives. And as new centers ramp and acuity mix shifts, with industry tailwinds supporting our growth, we believe we can consistently deliver revenue growth at least in line with that of the market.

While we were able to recover a portion of these volumes within the quarter,

We anticipate these dynamics to result in Q1 adjusted EBITDA being approximately flat compared to Q1 of 2025.

Speaker #3: Further, our attractive unit economics give us confidence we can consistently grow our adjusted EBITDA at a rate higher than our revenue growth. Wrapping up my review of our financials, 2025 was an exciting year of milestones and profitable growth.

We believe we can make up the remaining lost volume throughout the course of 2026, and we remain confident in our full-year guidance.

Tony Martin: As we set our sights on the longer term, in alignment with the discussions we had at the time of our IPO, we believe we're building a durable growth engine fueled by de novo growth, same-center sales expansion, and expanding strategic service lines. We're in the early days of implementing our growth initiatives, and as new centers ramp and acuity mix shifts with industry tailwinds supporting our growth, we believe we can consistently deliver revenue growth at least in line with that of the market. Further, our attractive unit economics give us confidence we can consistently grow our adjusted EBITDA at a rate higher than our revenue growth. Wrapping up my review of our financials, 2025 was an exciting year of milestones and profitable growth, and we put the building blocks in place for long-term shareholder value creation.

As we set our sights on the longer term,

In alignment with the discussions we had at the time of our IPO,

Speaker #3: And we put the building blocks in place for long-term shareholder value creation. Echoing Caitlin, I'm pleased with our performance in the quarter ending the year on strong footing.

We believe we’re building a durable growth engine fueled by de novo growth, same-center sales expansion, and expanding strategic service lines.

We're in the early days of implementing our growth initiatives.

Speaker #3: I also want to recognize that none of it would have been possible without the hard work of our dedicated team. Operator, would you please open the call to questions?

And as new centers ramp and Acuity, mixed shifts with industry tailwinds supporting our growth, we believe we can consistently deliver revenue growth at least in line with that of the market.

Speaker #1: Thank you. We will now begin the question and answer session. To ask a question, you will need to press star when one of your telephone keypad.

Further, our attractive unit economics give us confidence we can consistently grow our adjusted EBITDA at a rate higher than our revenue growth.

Speaker #1: We ask that you please limit yourself to one question. Our first question comes from the line of John Ransom. We're Raymond James, your line is now open.

Wrapping up my review of our financials, 2025 was an exciting year of milestones and profitable growth.

Tony Martin: Echoing Caitlin, I'm pleased with our performance in the quarter, ending the year on strong footing. I also want to recognize that none of it would have been possible without the hard work of our dedicated team. Operator, would you please open the call to questions?

And we put the building blocks in place for long-term shareholder value creation.

Speaker #2: Hey, good morning. Can you hear me?

Speaker #3: We can.

Speaker #2: Yes, we can.

Speaker #3: Great. So as we think about 2026, how do we think about the growth and advanced imaging versus routine? Does it look like 2025? I know there was a distortion from the Blue Cross tuck-in.

Echo and Caitlyn, I'm pleased with our performance in the quarter, ending the year on strong footing.

I also want to recognize that none of it would have been possible without the hard work of our dedicated team.

Operator, would you please open the call to questions?

Operator: Thank you. We will now begin the question and answer session. To ask a question, you will need to press star one one on your telephone keypad. We ask that you please limit yourself to one question. Our first question comes from the line of John Ransom with Raymond James. Your line is now open.

Speaker #3: And then as you think about the rhythm of opening your new centers, how do we think about the quarterly rhythm of that as we move through the year?

Thank you. We will now begin the question and answer session. To ask a question, you will need to press star 1 on your telephone keypad.

Speaker #3: Thank you.

Speaker #1: Thanks so much, Don. Yeah, so we remain focused on continuing the growth of our advanced imaging. We are incredibly proud of the strength that we were able to show in fourth quarter and throughout the year.

We ask that you please limit yourself to one question.

Our first question comes from the line of John Ransom with Raymond James. The line is now open.

John Ransom: Hey, good morning. Can you hear me?

Caitlin Zulla: We can.

Tony Martin: Yes, we can.

Hey, good morning. Can you hear me?

John Ransom: Great. As we think about 2026, how do we think about the growth in advanced imaging versus routine? Does it look like 2025? I know there was a distortion from the Blue Cross tuck-in. As you think about the rhythm of opening your new centers, how do we think about the quarterly rhythm of that, as we move through the year? Thank you.

Speaker #1: As we said in our prepare remarks throughout the year, advanced imaging grew 8% on the same center basis, 7.1% on excuse me, on the consolidated basis and 7.1% system-wide.

We can, yes, we can.

Great. Um, so as we think about 2026,

How do we think about the growth in Advanced Imaging versus routine? Does it look like

Speaker #1: We will continue to see that growth at a rate higher than our routine. When we think about routine, it really is combined of three different modalities.

Speaker #1: You have your ultrasound, your mammography, and your X-ray. X-ray, just by the nature of the speed and the accessibility, it is the largest end.

Caitlin Zulla: Thanks so much, John. Yes. We remain focused on continuing the growth of our advanced imaging. We are incredibly proud of the strength that we were able to show in Q4 and throughout the year. As we said in our prepared remarks, throughout the year, advanced imaging grew 8% on a same center basis, 7.1% on a consolidated basis, and 7.1% system-wide. We will continue to see that growth at a rate higher than our routine. When we think about routine, it really is combined of three different modalities. You have your ultrasound, your mammography, and your X-ray. X-ray, just by the nature of the speed and, you know, the accessibility, it is the largest end.

In 2025, I know there was a distortion from the, uh, Blue Cross tuck-in, and then, as you think about the rhythm of opening your new centers, how should we think about the quarterly rhythm of that as we move through the year? Thank you.

Speaker #1: It's the biggest number. It's the biggest piece. And obviously, we provide that for strategic reasons. But as Tony shared in his prepared remarks, it is not correlated to the overall performance of the business.

Speaker #1: And you focus on the strength of advanced and excited to see that continue to grow. And then answering your questions about de novos, thrilled to say that we've already opened up one this year.

Speaker #1: On track to deliver that 8 to 10. We've got really good visibility in terms of pacing. Expect it to be more second half of the year weighted with more of the openings, but we will have some additional openings in the first half as well.

Thank you so much, Don. Yes. So, uh, we remain focused on, uh, continuing the growth of our Advanced Imaging. We are incredibly proud of the strength that we're able to show in the fourth quarter. And throughout the year, as we said in our prepared remarks, uh, throughout the year, Advanced Imaging grew 8% on the same-center basis, 7.1%—um, on, uh, excuse me, on the consolidated basis of 7.1% system-wide. We will continue to see that growth at a rate higher than our routine. When we think about routine, it really is combined of, uh, three different modalities. You have your ultrasound, your mammography, and your X-ray.

Caitlin Zulla: It's the biggest number, it's the biggest piece, and obviously, we provide that for strategic reasons. As you know, Tony shared in his prepared remarks, it is not correlated to the overall performance of the business, and you saw that in Q4. We'll continue to focus on the strength of advanced and excited to see that continue to grow. Then answering your questions about de novos. Thrilled to say that we've already opened up one this year. On track to deliver that 8 to 10. We've got really good visibility. In terms of pacing, expect it to be more H2 weighted with more of the openings, but we will have some additional openings in the H1 as well. Thanks so much, John.

Speaker #1: Thanks so much, Don.

Speaker #3: Okay, thank you.

Speaker #1: Thank you. Our next question comes from the line of Whit Mayo with Lee Rink Partners. Your line is now open.

Speaker #4: Hey, thanks. Good morning. Tony, any help on cash flow and CapEx for the year? And then how much of the CapEx is expected to be the equipment upgrades?

X-ray, just by the nature of the speed and, um, you know, the accessibility, it is the largest end. It's the biggest number. It's the biggest piece that—obviously, we provide that for strategic reasons. But as you know, Tony Sheridan and his prepared remarks—it is not correlated to the overall performance of the business.

And you saw that in Q4. So we'll continue to focus on the strengths of Advanced and

To grow.

Speaker #4: Just any thoughts would be helpful.

Speaker #5: Sure. Yeah, as I've discussed in the prepared remarks and previously, it's a strong cash-generating business. Thankfully, we're able to carry out all of our growth initiatives while delivering each year.

That 8 to 10, we've got really good visibility in terms of pacing. Expect it to be more second half of the year weighted, with more of the openings, but we will have some additional openings in the first half as well.

John Ransom: Okay. Thank you.

So, it's John.

Operator: Thank you. Our next question comes from the line of Whit Mayo with Leerink Partners. Your line is now open.

Okay, thank you.

Speaker #5: And that really sets us up, especially after the IPO, bringing down our debt and generating even more cash to be used in the future to kind of continue that delivering.

Whit Mayo: Hey, thanks. Good morning. Tony, any help on cash flow and CapEx for the year, and then how much of the CapEx is expected to be the equipment upgrades? Just any thoughts would be helpful.

Thank you. Our next question comes from the line of With Mayo with Lee Rink Partners. Your line is now open.

Speaker #5: As to how that's played out in 2025, we will be filing our 31st, which will have more details on how what the spend consists of.

Tony Martin: Sure, Whit. Yeah, as I've discussed in the prepared remarks and previously, you know, it's a strong cash generating business, thankfully. We're able to carry out all of our growth initiatives while delevering each year. You know, that really sets us up, especially after the IPO, you know, bringing down our debt and generating even more cash to be used in the future to kind of continue that delevering. As to how that's played out in 2025, we will be filing our Form 10-K not later than 31 March, which will have more details on how this, what the spend consists of.

Uh, hey, thanks. Good morning. Um, Tony, any help on cash flow and capex for the year, and then how much did the capex—uh, is it, and is it expected to be the equipment upgrades? Just any thoughts would be, uh, helpful?

Speaker #5: But we do remain heavily focused on the de novos as a huge chunk of that spend, investing in the existing centers for growth, and then there is a maintenance component that is kind of the minority of the spend.

Speaker #5: But is necessary to ensure that we continue to have what we need at the existing sites.

Sure what um, yeah. As as uh, as I've discussed the in the prepared remarks and, and, and previously, you know, it's a strong cash generating business. Thank you. We're, we're able to carry out all of our growth initiatives while de-levering each year. And, you know, that, that really sets us up especially after the, the IPO, you know, bringing down our debt and generating, even more cash to be used in the future to kind of continue that that de-levering.

Speaker #4: Okay. Well, just back on the cash flow this year, just trying to think about the bridge from '25 to '26, would it be just simplistically easy to look at just the EBITDA growth and then adding back the $50 million of interest savings to get to a reasonable number?

Tony Martin: You know, we do remain heavily focused on the de novos as a huge chunk of that spend, investing in the existing centers for growth. Then there is a maintenance component that is kind of the minority of the spend, but is necessary to ensure that we continue to have what we need at the existing sites.

Um, as to how how that's, uh, played out in, in 2025. I mean, we, we will be filing our, our 10K, not later than March 31st, which will have have more details on on how this this what what the spend consists of

Uh, but you know, we—we do remain heavily focused on.

Speaker #4: Are there any other variables or considerations that we should think about?

the denovos as a huge chunk of that's been

Speaker #5: At this point, we're not really guiding on cash flow. And so I'll caveat whatever I say about that, at least for the moment, in our young or early journey as a public company.

Investing in the existing centers for growth. Uh, and then there is a maintenance, uh, component that is kind of the minority of the spend, but is necessary to ensure that we continue to have what we need at the existing sites.

Whit Mayo: Okay. Well, just back on the cash flow this year, just trying to think about the bridge from 2025 to 2026. Would it be just simplistically easy to look at just the EBITDA growth and then adding back the $50 million of interest savings to get to a reasonable number? Or are there any other variables or considerations that we should think about?

Speaker #5: But yes, high-level, the company is experiencing the EBITDA growth you described. A lot of interest savings. 2026 will continue to be kind of a high capital spend year just because of the continuation of what we did in 2025 in terms of the growth CapEx and ensuring that the fleet is fully up to current needs for us.

Tony Martin: At this point, we're not really guiding on cash flow, and so I'll caveat whatever I say about that, at least for the moment, in our young, early journey as a public company. Yes, high level, the company, you know, is experiencing the EBITDA growth you described, a lot of interest savings. With 2026 will continue to be kind of a high capital spend year just because of the continuation of what we did in 2025 in terms of the growth CapEx and ensuring that, you know, the fleet is fully up to current needs for us. We'd spend a little more on maintenance than usual, and we'll probably continue to do that in 2026.

Okay, well, just back on the the cash flow that you're just trying to think about the bridge from, uh, 25 to 26. Would it be just simplistically uh, easy to look at just the ebit dog growth and then adding back the $50 million of um uh interest savings to get to a reasonable number or there any other variables or considerations that we should um think about

Speaker #5: So we've spent a little more on maintenance than usual. And we'll probably continue to do that in 2026. But directionally, you're thinking about it the right way.

Um, at this point, we're not really guiding on cash flow and so I'll caveat whatever I say about that, at least for the moment, um, and our young, early journey as a public company.

Speaker #4: Okay. Thanks. Appreciate it.

Speaker #1: Thanks a lot. Our next question comes from the line of Benjamin Rossi with JPMorgan. Your line is now open.

Uh, but yes, high level, the company, you know, is experiencing the EBITDA growth. You described a lot of interest in savings.

Speaker #6: Hey, good morning. Thanks for taking my question here. Just on the rate side within your 2026 guidance, what do you factor in for pricing in 2026?

um, but 2026 will continue to be kind of a high Capital spend year just because of the continuation of of

Speaker #6: And how are you thinking about expectations for rate growth across your main books for commercial, Medicare, and Medicaid payers this year?

Speaker #3: Thank you so much, Ben. Yeah, Tony, maybe I'll let you talk a little bit about how we assume our growth algorithm.

Tony Martin: You know, directionally, you're thinking about it the right way.

Speaker #5: Sure. Sure. Over time, our growth is driven about two-thirds by volume. And a third by rate. And that kind of drives the kind of 7 percentish same-site growth that we have in the outpatient segment.

Whit Mayo: Okay. Thanks. Appreciate it.

What we did in 2025, in terms of the growth capex and ensuring that, you know, the the fleet is fully up to up to, uh, current needs for us. Uh, so we've spent a little more on maintenance than than usual, will probably continue to do that in 2026 but you know directionally you're thinking about it the right way.

Caitlin Zulla: Thanks, Whit.

Okay, thanks. Appreciate it.

Operator: Our next question comes from the line of Benjamin Rossi with JP Morgan. Your line is now open.

Operator: Our next question comes from the line of Benjamin Rossi with J.P. Morgan. Your line is now open.

Thanks.

Benjamin Rossi: Hey, good morning. Thanks for taking my question here. Just on the rate side within your 2026 guidance, what are you factoring for pricing in 2026, and how are you thinking about expectations for rate growth across your main books for commercial, Medicare, and Medicaid payers this year?

Our next question comes from the line of Benjamin Rossi with JP Morgan. Your line is now open

Hey, good morning. Thanks for taking my question here.

Speaker #5: If you look at our consolidated financials, we show top-line revenue growth a little bit less than that because we do have a second segment, which is a lot smaller than the outpatient segment.

Speaker #5: And it grows a little bit less, more like 5%. And we've talked about how that fits into our overall strategy to drive that business.

Caitlin Zulla: Thank you so much, Ben. Yeah. Tony, maybe I'll let you talk a little bit about how we assume our growth algorithm.

Just on the right side within your 2026 guidance, what are you factoring for pricing in 2026? And how are you thinking about expectations for rate growth across your main books for commercial, Medicare, and Medicaid payers this year?

Tony Martin: Sure. Sure. Over time, our growth is driven, you know, about two-thirds by volume and a third by rate. You know, that kind of drives the kind of 7%-ish same-site growth that we have in the outpatient segment. You know, if you look at our consolidated financials, we show top line revenue growth a little bit less than that because we do have a second segment, which is a lot smaller than the outpatient segment, and it grows a little bit less, more like 5%. We've talked about, you know, how that fits into our overall strategy to drive that business. That creates a kind of a blended growth rate of more like 6%, 5% to 6% top line.

Thank you so much, Ben. Yeah, Tony, maybe I'll let you talk a little bit about how we assume our growth algorithm.

Speaker #5: So that creates a kind of a blended growth rate of more like 6%, 5 to 6 percent top line. But that outpatient business is more like 7%.

Sure. Sure, over time. Um, our, our growth is driven, you know, about 2/3 by volume and and the third by rate

Speaker #5: Two-thirds of it by volume heavily by growth in advanced modalities. So the growth in the advanced kind of is represents about half of what we experience in terms of rate increase because those just reimburse higher, three to four times higher.

You know, that kind of drives the kind of 7% growth that we have in the outpatient segment. You know, if you look at our Consolidated financials, we show Topline Revenue growth, a little bit less than that. Because we do have a second

Segment which is a lot smaller than the outpatient segment and it it grows a little bit less more like 5%.

Speaker #5: So as we have more business in that, it generates some rate growth. And then the kind of the remaining half of what we call rate growth is driven just by escalators in the contracted rates.

Tony Martin: That outpatient business is more like 7%, two-thirds of it by volume, heavily by growth in advanced modalities. The growth in the advanced kind of represents about half of what we experience in terms of rate increase, you know, because those just reimburse higher, 3 to 4 times higher. As we have more business in that, it generates some rate growth. Then, you know, kind of the remaining half of what we call rate growth is driven just by escalators in contracted rates in the commercial book. That's, we believe, we're actually kind of thinking of that very conservatively at this point.

Speaker #5: And the commercial book. And that's, we believe, we're actually kind of thinking of that very conservatively at this point.

And we, we've talked about, you know, how that fits into our overall strategy, to drive that business. So that that creates a kind of a blended growth rate of more like 6% 5 to 6%, Top Line. Uh, but that outpatient business is, is more like 7% 2 thirds of it by volume heavily by growth in advanced modalities.

Speaker #4: Great. Thanks for the comments.

so, the growth in the advanced kind of

Speaker #1: Thanks, Ben. Our next question comes from the line of Andrew Mok with Barclays. Your line is now open.

Speaker #6: Hi, good morning. Just wanted to follow up on the cash flow and CapEx. Can you give us a sense for total system-wide CapEx expected for 2026?

Speaker #6: And help us understand how that's expected to flow through the P&L and cash flow statement, especially on the non-consolidated portion. Thanks.

Is represents us about half of what we experience in terms of rate increase, you know, because those just reimburse, higher 3 to 4 times higher. So as we have more business in that, it it, uh, it, it generates some, some rate growth and then the, you know, kind of the remaining.

Of what we call rate growth is driven just by escalators in in the contract.

Speaker #5: Sure. We're not at this point putting a number out there. In terms of how much that's going to be numerically, I think it does flow through a combination of ways on our cash flow statement.

Rates and the commercial book and that's uh we we believe we're actually kind of thinking of that very conservatively at this point.

Benjamin Rossi: Great. Thanks for the comments.

Caitlin Zulla: Thanks, Ben.

Great, thanks for the comments.

Operator: Our next question comes from the line of Andrew Mok with Barclays. Your line is now open.

Thanks friends. Our next question comes from the line of Andrew mock with Berkeley. She'll let us know open

Speaker #5: For our consolidated sites, it's in our investing activities. To the degree we use our own cash, there's also a supplemental disclosure that talks about CapEx that we fund just by capital leasing those assets.

Andrew Mok: Hi, good morning. Just wanted to follow up on the cash flow and CapEx. Can you give us a sense for total system-wide CapEx expected for 2026 and help us understand how that's expected to flow through the P&L and cash flow statement, especially on the non-consolidated portion? Thanks.

Hi, good morning.

Speaker #5: Which involves no cash outlay. So you'll see that in our 10K when we file in terms of what the 2025 numbers are. The amounts we spend on the health system JVs are burden the cash distribution that we get from them.

Just wanted to follow up on the cash flow and capex. Can you give us a sense for total systemwide capex expected for 2026 and help us? Understand how that is expected to flow through the pnl and cash flow statement especially on the non Consolidated portion, thanks?

Tony Martin: Sure. We're not at this point putting a number out there, in terms of, you know, how much that's gonna be numerically. I think it does flow through a combination of ways on our cash flow statement. For our consolidated sites, it's in our investing activities, to the degree we use our own cash. There's also a supplemental disclosure that talks about CapEx that we fund just by capital leasing those assets, but, you know, which involves no cash outlay. You'll see that in our 10-K when we file in terms of what the 2025 numbers are. The amounts we spend on the health system JVs are, you know, burden the cash distribution that we get from them.

Sure. Um, we're not at this point, putting a a number out there. Uh, in terms of of, you know,

How much that going to be numerically?

Speaker #5: So that's something we'll talk about more as we get a little bit more mature as a company. We're keeping our guidance metrics pretty limited at the moment.

Speaker #5: But we're going to be happy to show more about that in the future.

Speaker #6: If you're not giving 2026, can you share where total system-wide CapEx landed for 2025?

Speaker #5: I believe I don't know that that's going to be in our 10K explicitly. But I think in our talks during the going public process, system-wide, we were spending something north of $100 million.

I think it, it does flow through a combination of ways on our, on our cash flow statement for our Consolidated sites. It's in our investing activities, uh, to the degree, we use our own cash. There's also a supplemental disclosure that talks about capex that we fund just by capital, leasing those assets but you know, which involves no cash outlay. So, you'll see that in our in our 10K, when we file in terms of what the 2025 numbers are the uh,

Tony Martin: That's something we'll talk about more as we get, you know, a little bit more mature as a company. We're keeping our guidance metrics pretty limited at the moment, but we're gonna be happy to show more about that in the future.

Speaker #5: With our pro rata share of that being significantly less because for the part we spend in the health system JVs, we split it pro rata with our health system partner.

The myth, the amounts we spend on the health system babies are, are, you know, burden the cash distribution that we get from that. Uh, so that that's something, we'll, we'll talk about more as we get, you know, a little bit more mature as a company. Uh, we're keeping keeping our, our guidance metrics, pretty Limited at the moment.

But we're we're going to be happy happy to show uh more.

That in the future.

Andrew Mok: If you're not giving 2026, can you share where total system-wide CapEx landed for 2025?

Speaker #6: Great. Thank you.

If if you're not giving 2026, can you share where total system like that? That's landed for 2025.

Speaker #1: Thank you. Our next question comes from the line of Ryan Daniels with William Blair. Your line is now open.

Tony Martin: I believe I don't know that that's gonna be in our 10-K explicitly. But I think in our you know talks during our going public process system-wide, we were spending you know something north of $100 million with our pro rata share of that you know being significantly less 'cause you know for the part we spend in the health system JVs, we split it pro rata with our health system partner.

Tony Martin: I believe I don't know that that's gonna be in our 10-K explicitly. I think in our you know talks during our going public process system-wide, we were spending you know something north of $100 million with our pro rata share of that you know being significantly less 'cause you know for the part we spend in the health system JVs, we split it pro rata with our health system partner.

uh,

I believe, I don't know if that's going to be in our 10K explicitly.

Speaker #7: Hello. This is Matthew Mardula on for Ryan. Thank you for taking the questions. So in your prepared remarks, you touched up on this regarding Q4 results.

um, but I think in our, you know, talks during the

Speaker #7: But since a majority of patients come from referring physicians, how is the team positioned for this year to increase patient referrals to your imaging centers?

Speaker #7: And are you planning to do any more initiatives or changes to build as well as increase physician relationships for this year?

During our going public process systemwide. We were spending, you know, something north of a hundred million dollars with our Pro radish here that you know being significantly less. Because you know, for the for the part we we spend in the health system JVS, we split it pro rata with our our health system partner

Andrew Mok: Great. Thank you.

Great. Thank you.

Operator: Thank you. Our next question comes from the line of Ryan Daniels with William Blair. Your line is now open.

Speaker #3: Yes, Matt. Thank you so much. So we have a strong engagement strategy with our referring physicians. We have over 120 sales reps that are embedded in our markets that engage with over 100,000 referring physicians.

Thank you. Our next question comes from the line of Ryan Daniels with William Blair. Your line is now open.

Matthew Mardula: Hello, this is Matthew Mardula on for Ryan. Thank you for taking the questions. In your prepared remarks, you touched up on this regarding Q4 results. Since a majority of patients come from referring physicians, how is the team positioned for this year to increase patient referrals to your imaging centers? Are you planning to do any more initiatives or changes to build as well as increase physician relationships for this year?

Hello, this is Matthew, mullah on for Ryan. Thank you for taking the questions.

Speaker #3: So incredibly engaged. When we think about we first focus on our highest referring specialties, your ortho, your neuro, your ENT, your pain, your urology, and your gastro.

Speaker #3: We highlighted a specific campaign we did on orthopedics in Q4 in our prepared remarks. Very much because that is their busy season as well.

Speaker #3: And so orthopedics need imaging. And we were able to provide that for them. We also have marketing efforts specifically as we think through women who cancel their mammograms during the snow days.

Caitlin Zulla: Yes, Matt. Thank you so much. We have a strong engagement strategy with our referring physicians. We have over 120 sales reps that are embedded in our markets that engage with over 100,000 referring physicians, so incredibly engaged. When we think about, we first focus on our highest referring specialties, your ortho, your neuro, your ENT, your pain, your urology, and your gastro. We highlighted a specific campaign we did on orthopedics in Q4 in our prepared remarks, very much because that is their busy season as well. Orthopedics need imaging, and we were able to provide that for them.

So in your prepared remarks, you touched up on this regarding Q4 results but since a majority of patients come from referring Physicians, how is the team position for this year to increase? Patient referrals to your imaging centers and are you planning to do any more initiatives or changes to build, as well as increase physician relationships for this year?

Speaker #3: In Q1. And so very targeted outreach to make sure that we are rescheduling and getting our patients back on the schedule to get their mammogram.

Speaker #3: So we'll continue to have a high level of engagement with our referring physicians and making sure we've got targeted messaging and strategies to meet their needs.

Speaker #3: Thanks so much, Matt.

Speaker #7: Great. Thank you.

Speaker #1: Our next question comes from the line of Stephen Baxter with Wells Fargo. Your line is now open.

Caitlin Zulla: We also have marketing efforts, specifically as we think through women who canceled their mammograms, you know, during the snow days in Q1, and so very targeted outreach to make sure that we are rescheduling and getting our patients back on the schedule to get their mammograms. We'll continue to have a high level of engagement with our referring physicians, making sure we've got targeted messaging and strategies to meet their needs. Thanks so much, Matt.

Speaker #8: Yeah. Hi. Thanks for the color on Q1. That's helpful. It would be great to potentially understand how you're thinking about it on potential volume impact or maybe same-store revenue impact from the weather and kind of pull-forward dynamics.

Speaker #8: And then as you're thinking about the balance of the year outside of Q1, any sense of how much you're assuming of the volumes that you have in recovered yet that you might actually get versus what kind of just leaks out and doesn't ultimately occur?

Yes, Matt, thank you so much. So we uh have a strong engagement strategy with our referring Physicians. We have over 120 sales reps that are embedded in our markets that engage with over 100 um thousand referring Physicians. So incredibly engaged, when we think about uh we first focused on our highest referring, Specialties your ortho, your neuro, your entt, your pain, your Urology, and your gastro. We highlighted, a specific campaign. We did on Orthopedics in Q4 and our prepared remarks, uh, very much because that is their busy season as well. And so Orthopedics need Imaging and we were able to provide that for them. Um, we also have marketing efforts, uh specifically as we think through um women who cancel their mammograms, you know, during the snow days uh, in q1 and so very targeted Outreach to make sure that we are rescheduling and getting our patients back on back on the schedule to get their mammogram. So we'll continue to have a high level of Engagement with

They're referring physicians and making sure we've got targeted messaging and strategies to meet their needs.

Matthew Mardula: Great. Thank you.

Thanks so much, Matt.

Speaker #8: Thanks.

Operator: Our next question comes from the line of Stephen Baxter with Wells Fargo. Your line is now open.

Speaker #3: Yeah. Thanks so much, Stephen. I appreciate the question. As we said in a bit in the prepared remarks and obviously saw at SCA and USCI, Q4 was always our highest quarter related to deductible reset.

Great. Thank you.

Our next question comes from the line of Stephen Baxter with Wells. Fargo, your line is now open.

Stephen Baxter: Yeah, hi. Thanks for the color on Q1. That's helpful. It would be great to potentially understand how you're thinking about it on, you know, potential volume impact or maybe same-store revenue impact from the weather and kind of pull-forward dynamics. Then as you're thinking about the balance of the year outside of Q1, any sense of, you know, how much you're assuming of the volumes that you haven't recovered yet that you might actually get versus what kind of just leaks out and doesn't ultimately occur? Thanks.

Speaker #3: And so really proud of the efforts that the team put in to drive strength in Q4 and obviously will be replicating that as we think about 2026.

Speaker #3: When we think about kind of the impact in Q1, about 50/50 kind of 50% acceleration in Q4 and then about 50% of it being about weather impact.

Caitlin Zulla: Yeah, thanks so much, Stephen. I appreciate the question. You know, as we said in the bit in the prepared remarks and obviously saw at SCA and USPI, you know, Q4 was always our highest quarter related to deductible reset, and so really proud of the efforts that the team put in to drive strength in Q4. You know, obviously we'll be replicating that as we think about 2026. When we think about kind of the impact in Q1, you know, about 50/50, kinda 50% acceleration in Q4 and then about 50% of it being about weather impact. Team is actively engaging. You know, certainly we know any patients that had scans on the schedule and our centralized call center is reaching out to reschedule them.

Speaker #3: Team is actively engaging certainly, we know any patients that had scans on the schedule and were our call center centralized call centers reaching out to reschedule them.

Yeah. Hi, uh, thanks for the the color on q1. Uh, that's helpful. It would be great to potentially understand how you're thinking about it on, you know, Central volume impact or maybe same store Revenue impact from the weather and kind of pull forward Dynamics. And then, as you're thinking about the balance of the Year, outside of q1, any sense of, you know, how much you're assuming of the volumes that you haven't recovered yet that you might actually get versus what kind of just leaks out and and doesn't ultimately occur. Thanks.

Speaker #3: And then we have our sales team engaging with referring physicians who also had a backlog. So we feel really confident that we'll be able to continue to drive the volume growth.

Speaker #3: We're seeing strength post-storm, especially in the advanced mod growth. And the combination of our strong sales efforts as well as just the operational strength of our team feel confident in the full-year guidance.

Marks and obviously saw um at Sea and usci Q4 was always our highest quarter uh related to deductible reset and so really proud of the efforts that the team put in to drive strength in Q4. And, you know, obviously, we'll be replicating that as we think about 2026. When we think about kind of the impact in q1, you know about 5050. Um, kind of 50% acceleration in Q4 and and then about 50% of it being about whether impact,

Speaker #7: Great. Yeah. That's very helpful. And then maybe also if you could, potentially provide a comment on maybe some of the current macro conditions. Obviously, people are watching closely when it comes to things like oil prices and gas prices and things of that nature.

The team is actively engaging—you know, certainly we know, uh, any patients that had, uh—

Caitlin Zulla: Then we have our sales team engaging with referring physicians who also had a backlog. We feel really confident that we'll be able to continue to drive the volume growth. We're seeing, you know, strength post-storm, especially in the advanced mod growth and, you know, the combination of our strong sales efforts as well as just the operational strength of our team. We feel confident in the full year guidance.

Speaker #7: I guess how are you thinking about that? Is there any exposure within your own P&L that we need to be mindful of? And then as you think about the money you're spending on capital, I guess how are you thinking about potential downstream impacts to the capital projects that you might have?

Speaker #7: Thanks.

Speaker #3: Yes. Thank you so much, Stephen. We are very much keeping an eye on all things macro. And all things within our supply chain and right now, we see no risk at all to Lumexa Imaging.

Stephen Baxter: Great. Yeah, that's very helpful. And then maybe also if you could, you know, potentially provide a comment on, you know, maybe some of the current macro conditions. Obviously, people are watching closely when it comes to things like oil prices, gas prices, and things of that nature. I guess, how are you thinking about that? Like, is there any exposure within your own P&L that we need to be mindful of? And then as you think about the money you're spending on capital, I guess, how are you thinking about potential downstream impacts to the capital projects that you might have? Thanks.

Scans on the schedule and were our call center centralized call centers, reaching out to reschedule them and then we have our sales team, engaging with referring Physicians who also had a backlog. So we feel really confident that we'll be able to continue to, um, Drive the volume growth. We're seeing, you know, strength, uh, post storm, especially in the advanced mod growth and, um, you know, the combination of our strong sales efforts, as well as, um, you know, just the operational strength of our team, feel confident in the full year guidance.

Speaker #3: We've specifically received some questions regarding helium. Just as an example, helium has actually been in shortage for several years. And we have strong service contracts with our original equipment manufacturers that give us fair pricing.

Speaker #3: We also have a number of secondary sources. And all of those have fixed rates. Same with gadolinium. And just in terms of context, some of the newer MRs require actually less helium than older models.

Great. Yeah, that's very helpful. Um, and then maybe also, if you could, you know, potentially provide a comment on, you know, maybe some of the, the current macro conditions, obviously, people are watching closely, uh, when it comes to things like oil, play, prices and gas prices and and things of that nature, I guess. How are you thinking about that? Like, is there any exposure within your own p&l? Do? We need to be mindful of? And then as you think about the money, you're spending on Capital, I guess, are you thinking about 10?

Caitlin Zulla: Yes. Thank you so much, Stephen. We are very much keeping an eye on all things macro and all things within our supply chain. Right now we see no risk at all to Lumexa Imaging. You know, we've specifically received some questions regarding helium. You know, just as an example, helium has actually been in shortage for several years, and we have strong service contracts with our original equipment manufacturers that give us fair pricing. We also have a number of secondary sources, and all of those have fixed rates. Same with gadolinium. You know, just in terms of context, some of the newer MRs require actually less helium than older models, and so the equipment refreshes that we've been doing intentionally over the last few years provide us further security.

Speaker #3: And so the equipment refreshes that we've been doing intentionally over the last few years provide us further security. So no concerns at this time that you need to be thinking of.

Speaker #1: Thank you. As a reminder, to ask a question at this time, please press star 11 on your telephone. Our next question comes from the line of Brian Tinklett with Jefferies.

Speaker #1: Your line is now open.

Speaker #9: Hey. Good morning. You got Jack Slevin on for Brian. Thanks for taking the question. Caitlin, I wanted to ask some really interesting commentary around your rollout of FastScan and other throughput initiatives.

Central Downstream impacts to the capital projects that you might have. Thanks. Yes. Thank you so much, Stephen. We are very much keeping an eye on all things, macro and all things within our supply chain. And, uh, right now we see no risk at all till the next, the Imaging, you know, we've specifically received some questions, uh, regarding helium. You know, just as an example. Uh, helium has actually been in in shortage for several years and we have strong service contracts with our original equipment manufacturers that give us fair pricing. We also have a number of secondary sources and all of those have fixed rates same with Catalina.

Speaker #9: Can you maybe talk a little bit about I heard the progression of we're going to get to two-thirds by the end of this year.

Speaker #9: But are there any early reads on sort of what that means from an efficiency standpoint or sort of the volume inflection you've been able to see as you've rolled that out across the first half of the portfolio?

Uh, and just in terms of context, some of the newer MRIs require actually less helium than older models. And so, the equipment refreshes that we've been doing intentionally over the last few years—

Caitlin Zulla: No concerns at this time that you need to be thinking of.

Provide us further security, so no concerns at this time that you need to be thinking of.

Operator: Thank you. As a reminder, to ask a question at this time, please press star one one on your telephone. Our next question comes from the line of Brian Tanquilut with Jefferies. Your line is now open.

Speaker #9: Thanks.

Speaker #3: Yes. Thanks so much, Jack. Appreciate the question. So we are very excited about FastScan. It's an initiative that we have been working on over years.

Speaker #3: Proud to be at 50% of our MRI fleet with FastScan at the end of last year. Very simply, FastScan truncates the amount of time it takes to do an exam.

Jack Lebow: Hey, good morning. You got Jack Lebow for Brian. Thanks for taking the question. Caitlin, I wanted to ask some really interesting commentary around your rollout of Fast Scan and other throughput initiatives. Can you maybe talk a little bit about, you know, I heard the progression of we're gonna get to two-thirds by the end of this year, but are there any early reads on sort of what that means from an efficiency standpoint or sort of the volume inflection you've been able to see as you've rolled that out across the first half of the portfolio? Thanks.

[Analyst] (Jefferies): Hey, good morning. You got Zach Levin for Brian. Thanks for taking the question. Caitlin, I wanted to ask some really interesting commentary around your rollout of Fast Scan and other throughput initiatives. Can you maybe talk a little bit about, you know, I heard the progression of we're gonna get to two-thirds by the end of this year, but are there any early reads on sort of what that means from an efficiency standpoint or sort of the volume inflection you've been able to see as you've rolled that out across the first half of the portfolio? Thanks.

Thank you as a reminder to ask a question at this time. Please press star 1, 1, 1 on your telephone. Our next question comes from the line of Brian tinklin with Jeffries. Your line is now open.

Speaker #3: So for an ankle MRI on a Siemens, it takes it from 22 minutes down to 8. It is better for the radiologist because the image is a higher quality.

Hey, good morning, you got Jax 11 on for Brian, thanks for taking the question. Um, Kaitlin I wanted to ask some some really interesting commentary around your roll out of fast, scan and other throughput initiatives. Can you maybe talk a little bit about

Speaker #3: And then it is better for the patient because they have to spend less time in the claustrophobic MRI tube. And then, of course, it's better for us because it opens up additional scheduling capacity typically about 40%.

Caitlin Zulla: Yes. Thanks so much, Jack. Appreciate the question. We are very excited about Fast Scan. It's an initiative that we have been working on over years. Proud to be at 50% of our MRI fleet with Fast Scan at the end of last year. You know, very simply, Fast Scan truncates the amount of time it takes to do an exam. For an ankle MRI on a Siemens, it takes it from 22 minutes down to 8. It is better for the radiologist because the image is higher quality, and then it is better for the patient because they have to spend less time in the claustrophobic MRI tube. Of course, it's better for us because it opens up additional scheduling capacity, you know, typically about 40%. We are very measured in all capital deployment, including Fast Scan.

Caitlin Zulla: Yes. Thanks so much, Zach. Appreciate the question. We are very excited about Fast Scan. It's an initiative that we have been working on over years. Proud to be at 50% of our MRI fleet with Fast Scan at the end of last year. You know, very simply, Fast Scan truncates the amount of time it takes to do an exam. For an ankle MRI on a Siemens, it takes it from 22 minutes down to 8. It is better for the radiologist because the image is higher quality, and then it is better for the patient because they have to spend less time in the claustrophobic MRI tube. Of course, it's better for us because it opens up additional scheduling capacity, you know, typically about 40%. We are very measured in all capital deployment, including Fast Scan.

You know, I heard the progression of we're going to get to two-thirds by the end of this year, but can you—are there any early reads on sort of what that means from an efficiency standpoint, or sort of the volume inflection you've been able to see as you've rolled that out across the first half of the portfolio? Thanks.

Speaker #3: We are very measured in all capital deployment. And including FastScan, we can get FastScan capabilities either by acquiring a new machine or by providing bolt-on software.

Speaker #3: It's about $150,000. So obviously, meaningfully lower price point. And we always want to make sure that we will be able to drive a strong IRR that will meet our investment thresholds.

Speaker #3: So we make sure we have that business case approved before we roll it out. So excited for the continued growth. And that's a big part of giving us the confidence that we'll be able to drive the same-site growth in 2026 and beyond that we've shared in our growth algorithm.

Speaker #1: Thank you. Our next question comes from the line of Pito Chickering with Deutsche Bank. Your line is now open.

Caitlin Zulla: You know, we can get Fast Scan capabilities either by acquiring a new machine or by providing bolt-on software. It's about $150,000, so obviously a meaningfully lower price point. We always wanna make sure that we will be able to drive a strong IRR, that it will meet our investment thresholds. We make sure we have that business case approved before we roll it out. Excited for the continued growth, and that's a big part of giving us the confidence that we'll be able to drive the same site growth in 2026 and beyond, that we've shared in our growth algorithm.

Speaker #10: Hey. Good morning, guys. And thanks for taking my question. I guess going back to sort of one cue, you got to just sort of flat EBITDA year over year.

Speaker #10: But your guidance was maintained for the year. So originally remodeling quarterly guidance, quarterly EBITDA growth, about 6.7% in the midpoint of the range excluding the 7 million public costs.

Yes, thanks so much Jack, appreciate the question. So we are uh, very excited about fast. Scan its initiative that we have been working on over years, proud to be at 50% of our MRI Fleet, uh, with fast scan at the end of last year. You know, very simply fast and chunky the amount of time it takes to do an exam. So for an ankle MRI on a Siemens, it takes it from 22 minutes. Down to 8, it is better for the Radiologists because the image is higher quality and then it is better for the patient because they have to spend less time in the claustrophobic MRI too. And then of course it's better for us because it uh, opens up additional scheduling capacity. You typically about 40% we are very measured in all capital deployments and including fast scan, you know, we can get fast, scan capabilities, either by acquiring a new machine or by providing bolt-on software, it's about 150,000. So obviously meaningfully lower price point and we always want to make sure that we will be able to drive a strong irr. That

They'll meet our investment thresholds so we make sure we have that business case approved before we roll it out, so excited for uh the continued growth. And

Part of giving.

Speaker #10: For every quarter this year, now with first quarter is flat. So it's mathematically we should be modeling sort of 9% quarterly EBITDA growth from 2Q to 4Q and just sort of curious what it seems like a big step up for the rest of the year with a flat first quarter.

Insight growth in 2026 and beyond, uh, that we've shared in our growth algorithm.

Operator: Thank you. Our next question comes from the line of Pito Chickering with Deutsche Bank. Your line is now open.

Pito Chickering: Hey, good morning, guys, and thanks for taking my question. I guess, going back to sort of Q1, you guys were flat EBITDA year over year, but your guidance was maintained for the year. Originally modeling, you know, quarterly guidance, you know, quarterly EBITDA growth about, you know, 6.7% in the midpoint of range, excluding the $7 million of PubCo costs for every quarter this year. Now with Q1 is flat, so it's mathematically we should be modeling sort of 9% quarterly EBITDA growth from Q2 to Q4. Just so curious, you know, it seems like a big stark step up for the rest of the year with a flat Q1.

Thank you. Our next question comes from the line of pedo churring with Deutsche Bank, your line is now open,

Speaker #10: I guess what gives you guys conviction of EBITDA growing at 9% for the rest of the year? Thanks.

Speaker #3: Sure. I think Peto, thank you for the question. I think broadly, we have great momentum in the business. So we have strength of our advanced mods.

Hey, good morning guys and thank you for taking my question. Uh I guess going back to sort of 1 Q. Uh you got to just reflect even a year but your guidance was maintained for the year. So originally remodeling

Speaker #3: We have the record year of de novo openings in 2025 that are ramping well. The pacing of last year was more first weighted than second half.

You know, quarterly guidance, you know, according to the EV growth of about, you know, 6 6 6 7 in the midpoint of the range, excluding the 7 million of public costs.

Speaker #3: And we already have the one open in 2026. We also have multiple ongoing GV conversations at various stages. It gives us confidence in the broader need for our service and our model.

Pito Chickering: I guess, what gives you guys conviction of EBITDA growing at, you know, 9% for the rest of the year? Thanks.

Speaker #3: And then we have the tuck-in acquisition that we shared in December. And we're building a pipeline of acquisition opportunities. And then on top of that, we've got conviction and proof points in advancing our strategic service lines like our breast arterial calcification.

I want to follow up and just curious what you know—it seems like a big step up for the rest of the year with a flat first quarter. I guess, what gives you guys conviction of EBITDA growing at, you know, 9% for the rest of the year? Thanks.

Caitlin Zulla: Sure. I think, Pito, thank you for the question. I think broadly, you know, we have great momentum in the business. We have strength of our advanced mods. We have the record year of de novo openings in 2025, that are ramping well. You know, the pacing of last year was more front weighted than H2. We already have the one open in 2026. We also have multiple ongoing JV conversations at various stages, it gives us confidence in the broader need for our service and our model. You know, we have the tuck-in acquisition that we shared, in December, and we're building a pipeline of acquisition opportunities.

Speaker #3: Great uptake in New Jersey. And great clinical results for our patients first and foremost. And so we'll be thinking about how we expand that as well.

Speaker #3: Tony, anything else you'd add about how we think about pacing throughout the quarters?

Speaker #11: Yes. As we discussed, it is a seasonal business and ramps. And it happens in kind of different rates year to year depending on things like weather and depending on how significant deductible reset-driven behavior is.

Caitlin Zulla: On top of that, we've got conviction and proof points in advancing our strategic service lines, like our breast arterial calcification, you know, great uptake in New Jersey and great clinical results for our patients first and foremost. We'll be thinking about how we expand that as well. Tony, anything else you'd add about how we think about pacing throughout the quarters?

Speaker #11: So that will change but we do ramp up every year quarter by quarter. And weather events and other disruptions in individual sites happen. With referring physicians being closed down for a couple of days or us being closed down for a couple of days.

Tony Martin: Yes, you know, as we discussed, it is a seasonal business and it ramps, and it happens in kind of different rates year to year, depending on things like weather and depending on, you know, how a significant deductible reset, you know, driven behavior is. So, you know, that will change, but we do ramp up every year quarter by quarter. You know, weather events and other disruptions at individual sites happen, you know, with referring physicians, you know, being out, closed down for a couple days or us being closed down for a couple days. So, you know, we have a playbook that we use to get that volume back. It's, you know, it's part of doing business in this space.

Speaker #11: So we have a playbook that we use to get that volume back. It's part of doing business in this space. All healthcare services providers have those playbooks and we certainly do.

Sure. Uh, I think, you know, thank you for the question. I think, broadly, you know, we have great momentum in the business. So we have strength of our Advanced mods, we have the record year of denovo openings in 2025, uh, that are ramping. Well, you know, the pacing of last year was more first weighted than than second half, uh, and we already have the the 1 open in 2026. We also have multiple ongoing JV conversations at various stages. Uh, it gives us confidence in the broader, need for our service and our model. And then, you know, we have the tuck in acquisition that we shared, um, in December, and we're building a pipeline of acquisition opportunities. And then on top of that, we've got, uh, conviction and proof points and advancing our strategic service lines like our breast arterial calcification, you have great uptake in New Jersey and great clinical results for our patients first and foremost. And so we'll be thinking about how we expand that as well. Um Tony anything else, you'd add about how we think about pacing throughout the quarters. Yes, uh, you know, as we discussed it, it it

Speaker #11: And put them to work. So we do expect to kind of pull that rest of that volume in at some point. And then that adds to our conviction and our annual guidance.

Speaker #10: Great. Thanks so much.

Speaker #1: Thank you. Our last question is a follow-up from the line of John Ransom with Raymond James. Your line is now open.

The seasonal business, and, and ramps, and it, it happens and kind of different rates year to year, depending on things like weather and depending on on, you know, how how, how significant deductible reset. You know, driven behavior is, um, so, you know, that that will change but we do ramp up, uh, every year quarter by quarter and you know, whether events and other disruptions in individual sites happen, you know, with referring Physicians, uh, you know,

Speaker #12: Hey there. Just a couple more for me. What was the professional fee revenue in the fourth quarter and for the full year?

Tony Martin: All healthcare services providers, you know, have those playbooks and we certainly do and put them to work. You know, we do expect to, you know, kind of pull that rest of that volume in at some point. That adds to our conviction and, you know, our annual guidance.

Speaker #11: For the fourth quarter, it was 66.8 million.

Speaker #12: Okay.

Speaker #11: And the full-year figure, I think I put in my prepared remarks but I certainly have it.

being, you know, closed down for a couple days or us being closed down for a couple days. So, you know, we have a Playbook that we use to get that volume back. It's uh, you know, it's part of doing business in in this space all Healthcare Services providers, you know, have those playbooks and and we certainly do and and put them put them to work, you know? So we we we do expect to, you know, kind of pull, pull, pull that rest of that volume in at some point and then and that that adds to our our conviction and, you know, our annual guidance

Pito Chickering: Great. Thanks so much.

Operator: Thank you. Our last question is a follow-up from the line of John Ransom from Raymond James. Your line is now open.

Great. Thanks so much.

Speaker #12: I didn't I can get that. I mean, I can get that offline.

John Ransom: Hey there. Just a couple more for me. What was the professional fee revenue in the Q4 and for the full year?

Thank you. Our last question, is a follow-up from the line of John ransom for Raymond James. Your line is now open.

Speaker #3: Yeah. We just wanted to.

Speaker #12: Okay.

Speaker #11: Yeah. And that'll certainly be under 10K. We're going to be filing that not later than the 31st. But yeah, we can certainly get that.

Hey there. Uh, just a couple more for me. Um, what was the professional fee revenue in the fourth quarter and for the full year?

Tony Martin: For the Q4, it was $66.8 million.

Speaker #12: And then my other and then what was the professional fee last year, fourth quarter professional fee?

John Ransom: Okay.

Uh, for the fourth quarter, it was 66.8 Million.

Tony Martin: The full year figure, I think I put in my prepared remarks, but I certainly have it.

Okay.

Tony Martin: The full year figure, I think I put in my prepared remarks, but I certainly have it.

Speaker #11: Yeah. The growth rate was 10.6% year over year. So I'll answer your question that way.

The full-year figure, I think I

I put it in my prepared remarks, but I certainly have it. Um,

Speaker #12: That's professional grew that much?

Speaker #11: Yes.

Speaker #12: Okay. All right. Thank you. And then secondly, we've kind of been back and forth on how to manage or excuse me, how to model management fee plus pass-through.

John Ransom: I can get that. I mean, I can get that offline.

Tony Martin: Yeah.

Caitlin Zulla: Yeah.

John Ransom: million. Okay.

Tony Martin: Yeah, that'll certainly be in our 10-K. We're gonna be filing that-

Speaker #12: So in your disclosure, the we had thought about management fees as being 10% of the revenue of your unconsolidated. So it looks like management fees are higher than that.

John Ransom: Yeah.

Tony Martin: You know, not later than the 31st. Yeah, we can certainly get that.

John Ransom: What was the professional fee last year, Q4?

I don't I can get that. I mean I can get that offline so yeah we can. Okay. Yeah that that'll and that will certainly be under 10k. We're going to be filing that. Yeah you know not later than 31st but yeah we can still get that.

John Ransom: What was the professional fee last year, Q4?

Speaker #12: And that probably includes some stuff in your other revenue segments. But how do we think about managing excuse me, modeling management fees? And what kind of margin does that business generate?

Tony Martin: Yeah. It, the growth rate was 10.6% year over year. I'll answer your question that way.

And then, and then my other—and then, what was the professional fee last year? Fourth quarter?

John Ransom: That's professional. Grew that much?

Speaker #12: Because I know you don't break out the costs. But just help us model that versus the pass-through in 2026.

Yeah, it, uh, we—the growth rate was 10.6% year-over-year, so I'll answer your question that way.

Tony Martin: Yes.

John Ransom: Okay. All right. Thank you. And then secondly, you know, we've kind of been back and forth on how to model management fee plus pass through. So in your disclosure, we had thought about management fees as being 10% of the revenue of your unconsolidated. So it looks like management fees are higher than that, and that probably includes some stuff in your other revenue segments. But how do we think about modeling management fees, and what kind of margin does that business generate? 'Cause I know you don't break out the costs, but just help us model that versus the pass through in 2026.

That's professional group that much.

Yes.

Speaker #11: Yes. Good question. And I'm glad we're able to highlight the pass-throughs because that's a big chunk of revenues that doesn't really drive anything in EBITDA standpoint.

Okay, all right, thank you. Um, and then secondly, you know, we've

Speaker #11: So your question about what to focus on in terms of modeling us makes a lot of sense to me. I think what you've seen in recent in the recent trend is the best indicator of the future on that.

Speaker #11: It is, from a pure management fee standpoint, driven by a percentage of the revenues of the underlying JVs. Which you can see the growth rates that are happening at that level.

Kind of been back and forth on how to manage or excuse me, how to model management fee plus pass through. So in your disclosure, the we had thought about management fees as being 10% of the revenue of your unconsolidated. So it looks like management fees are higher than that and and that probably includes some stuff in your other Revenue segments. But how do we think about managing ma, excuse me, modeling management fees and what kind of margin does that business generate? Because I

Tony Martin: Yes. Good question. You know, I'm glad we're able to highlight the pass-throughs, you know, 'cause that's a big chunk of revenues that doesn't really drive anything in the EBITDA standpoint. You know, your question about, you know, what to focus on in terms of modeling us makes a lot of sense to me. I think what you've seen in the recent trend is the best indicator of the future on that. It is from a pure management fee standpoint, you know, driven by a percentage of the revenues of the underlying, you know, JVs, which, you know, you can see the growth rates that are happening at that level.

You don't break out the costs, but just help us model that versus the pass-through in 2026.

Speaker #11: There is a little bit of other revenue in that as well for some other services we provide. So I think that combination is not likely to change a whole lot in terms of how it's growing and how you're looking at it.

Yes, uh good, good question. And and, you know, I'm glad we're able to highlight the pass throughs, you know? Because that's a big chunk of revenues that doesn't really Drive anything in EA standpoint. So I

You know, your question about, you know, what to focus on in terms of modeling as—

Speaker #12: So grow it sort of in line with consolidated revenue growth? Or I'm sorry, with system-wide revenue growth?

I think, I think what you've seen in in recent in the recent trend is the best indicator of the future on that, it is. It is

Speaker #11: I think generally speaking, that's how we look at it. Yeah.

Speaker #12: Okay. Thanks.

Tony Martin: There is a little bit of other revenue in that as well, for some, you know, other services we provide. I, you know, I think that combination is not likely to change a whole lot in terms of how it's growing and how you're looking at it.

From a pure management fee standpoint you know driven by a percentage of the revenues of the underlying, you know, JBS which you know you you can see the growth rates that are happening at that level.

Speaker #1: Thank you. I would now like to hand the call back over to Caitlin Zulla for closing remarks.

Speaker #3: Thank you for the questions today. And thank you for your continued interest in Lumexa Imaging. As you've heard throughout the call, we are entering 2026 with strong momentum.

it it is there is a little bit of other revenue and and that as well for some, you know, other other services we provide

Speaker #3: A clear strategy and deep confidence in our ability to execute. A true team remains focused on delivering exceptional patient care, expanding access to high-quality imaging, and driving disciplined, profitable growth.

John Ransom: grow it sort of in line with consolidated revenue growth? Or I'm sorry, with, system-wide revenue growth?

You know, I think that that combination is not not likely to change a whole lot in terms of how, it's how it's growing and how you're looking at it.

John Ransom: grow it sort of in line with consolidated revenue growth? Or I'm sorry, with, system-wide revenue growth?

so grow, it sort of in line with Consolidated Revenue growth

Or, I'm sorry, with a systemwide revenue growth.

Tony Martin: I think generally speaking, that that's how we look at it. Yeah.

Speaker #3: I want to close once again by thanking our dedicated team members and our radiologists. Their commitment to our mission and to the patients and the communities we serve continues to be the foundation of our success.

I, I think generally speaking.

That's how we look at it.

John Ransom: Okay, thanks.

Operator: Thank you. I would now like to hand the call back over to Caitlin Zulla for closing remarks.

Okay, thanks.

Speaker #3: We appreciate your time today and look forward to updating you on our progress in the quarters ahead. Thank you.

Thank you. I would now like to hand the call back over to Caitlyn Zula for closing remarks.

Caitlin Zulla: Thank you for the questions today, and thank you for your continued interest in Lumexa Imaging. As you've heard throughout the call, we are entering 2026 with strong momentum, a clear strategy, and deep confidence in our ability to execute. Our team remains focused on delivering exceptional patient care, expanding access to high-quality imaging, and driving disciplined, profitable growth. I wanna close once again by thanking our dedicated team members and our radiologists. Their commitment to our mission and to the patients and the communities we serve continues to be the foundation of our success. We appreciate your time today and look forward to updating you on our progress in the quarters ahead. Thank you.

Thank you for the question today.

The Imaging, as you've heard throughout the call, we are entering 2026 with strong momentum, a clear strategy and deep confidence in our ability, to execute a t. Team remains focused on, delivering exceptional patient care, expanding, access to high-quality Imaging and driving disciplined profitable growth.

I want to close once again by thanking our dedicated team members and our Radiologists.

Their commitment to our mission and to the patients and the communities. We serve continues to be the foundation of our success.

Operator: This concludes today's conference. Thank you for your participation. You may now disconnect.

We appreciate your time today and look forward to updating you on our progress. In the quarters ahead. Thank you, this concludes today's conference. Thank you for your participation. You may now disconnect

Q4 2025 Lumexa Imaging Holdings Inc Earnings Call

Request TrialDemo

Lumexa Imaging Holdings

Earnings