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    LMRI
    Earnings call· Jun 2026(Q2 FY26)

    Lumexa Imaging Holdings Q2 FY26 earnings call LMRI

    Aug 12, 2026 Source

    Executive summary

    Lumexa Imaging Holdings, Inc. Q2 FY26 — Record Advanced Modality Volume and Strong Cash Flow

    Lumexa Imaging delivered a strong second quarter, marked by record advanced modality volumes and robust free cash flow generation, reflecting the benefits of debt paydown and strategic investments. The company reaffirmed its full-year guidance, driven by successful de novo center ramps and a growing pipeline of health system partnerships, particularly with the new HSS joint venture. Management remains confident in its outpatient imaging model, which is further validated by proposed site-neutral payment rules.

    Highlights

    5

    • Advanced modalities grew to a record 37.4% of total volume, up 111 basis points year-over-year.

    • System-wide revenue growth was 6% in the quarter, powered by strong growth in advanced modalities.

    • Free cash flow reached a record $23.1 million in Q2 FY26, a $25.6 million improvement year-over-year, with a 41% adjusted EBITDA conversion.

    • Net leverage improved to 3.6x as of June 30, 2026, compared to 5.7x a year ago.

    • Announced a significant joint venture with Hospital for Special Surgery (HSS), expanding presence in the New York City metro area.

    Concerns

    3

    • Adjusted EBITDA margin decreased to 21.4% in Q2 FY26 from 22.4% in Q2 FY25, partly due to $1.5 million in public company costs.

    • G&A expenses increased by $5.7 million year-over-year, driven by $5.9 million higher expenses from pubco costs and stock-based compensation.

    • Routine scans were somewhat tempered, although mammography volumes improved after a slower start to the year.

    Guidance & targets

    12
    CategoryTargetConfidence
    Adjusted EBITDA
    $235 million to $241 million
    high materiality
    High
    Consolidated Revenue
    $1.045 billion to $1.097 billion
    high materiality
    High
    Adjusted EPS
    $0.71 to $0.77 per share
    high materiality
    High
    Free cash flow conversion
    approximately 25% to 30% of adjusted EBITDA
    medium materiality
    High
    Public company costs
    approximately $7 million
    low materiality
    High
    Stock-based compensation
    approximately $50 million
    low materiality
    High
    Stock-based compensation
    approximately $20 million to $28 million
    low materiality
    Medium
    Cash CapEx
    approximately $5 million to $7 million
    medium materiality
    High
    Government reimbursement rates
    approximately flat
    medium materiality
    High
    Commercial payor rates
    1% increase
    medium materiality
    High
    De novo openings
    8 to 10 annually
    medium materiality
    High
    Free cash flow
    $60 million to $70 million
    high materiality
    High

    Segment performance

    3
    SegmentRevenueYoYQoQMargin
    Outpatient net patient service revenues
    Grew on healthy same-site growth.
    		$143.7 million3.5%——
    Professional fee net patient service revenues
    Reflecting growth in line with the company's model. Corrected from $60.0 million (sic) in transcript.
    		$64.2 million5%——
    Management fee and other revenues
    Includes management fees earned from operating health system JVs and zero-margin pass-through costs.
    Management fees from JVs: $26 millionZero-margin pass-through of employee, IT and site level costs: $34 million
    		$60.4 million———

    Operational metrics

    33
    Consolidated revenues
    $264.2 millionup 5.1% YoY
    Q2 FY26

    Explicitly requested, typically omitted as a GAAP statement line.

    System-wide revenue growth
    6%YoY
    Q2 FY26

    Includes all sites operated, both wholly owned and joint ventures.

    Revenue per scan
    2.2%increase YoY
    Q2 FY26

    Driven by advanced modalities representing a larger share and modest increases in contracted payor rates, partially offset by payer mix shifts.

    System-wide volume growth
    3.1%YoY
    Q2 FY26

    Includes both wholly owned and JV sites.

    Advanced modality volumes growth
    6.3%YoY
    Q2 FY26

    Generally reimbursed 3x to 4x higher than routine modalities.

    Advanced modality volumes growth
    6.8%YoY
    Q2 FY26

    Reflects growth in majority-owned centers.

    Advanced modalities as % of total volume
    37.4%111 bps higher YoY
    Q2 FY26

    Record high for the company.

    Routine scans
    somewhat tempered
    Q2 FY26

    Impact earnings less than advanced modalities.

    Mammography volumes growth
    2.6%YoY
    Q2 FY26

    Improved after starting the year slower than expected.

    PET volumes growth
    23.2%YoY
    Q2 FY26

    Before 2 new PET machines opened in July. Expected to go higher in Q3.

    G&A expenses
    $24.4 millionup $5.7 million YoY
    Q2 FY26

    Increase was expected and driven by specific components.

    Public company costs
    $1.5 million
    Q2 FY26

    Ongoing expenses related to being a public company.

    Stock-based compensation
    $12.7 millionvs $8.3 million in Q2 FY25
    Q2 FY26

    Reflects one-time resetting of legacy equity comp plans as part of IPO.

    Equity in earnings of unconsolidated affiliates
    $18.6 million$2.1 million higher YoY
    Q2 FY26

    Reflects pro rata ownership share of net income from JV sites, showing particular strength this quarter.

    Interest expense
    $16.2 million$14 million less than Q2 FY25
    Q2 FY26

    Reflects use of IPO proceeds to pay down debt.

    Pretax income
    $5.8 millioncompared to a pretax loss of $2.4 million in Q2 '25
    Q2 FY26

    Explicitly requested, typically omitted as a GAAP statement line.

    Net income
    $2.7 millioncompared to a net loss of $7.2 million in the prior year period
    Q2 FY26

    After a tax provision of about $3 million.

    GAAP EPS
    $0.03
    Q2 FY26

    Explicitly requested, typically omitted as a GAAP statement line.

    Adjusted EPS
    $0.20
    Q2 FY26

    Supplemental measure.

    Adjusted EBITDA
    $56.4 millioncompared with $56.3 million a year ago
    Q2 FY26

    Includes adjusted EBITDA from wholly owned centers and pro rata share from JV centers.

    Adjusted EBITDA margin
    21.4%compared to 22.4% in Q2 FY25
    Q2 FY26

    Partly due to $1.5 million step-up in public company costs.

    Adjusted EBITDA margin
    110 bpsincreased sequentially from Q1
    Q2 FY26

    Sequential improvement.

    Cash flows from operating activities
    $32.8 million$31 million higher than Q2 FY25
    Q2 FY26

    Reflective of lower senior credit facility debt and related interest payments.

    Free cash flow conversion
    41%
    Q2 FY26

    Record high conversion of adjusted EBITDA.

    Capital spend
    $9.7 million
    Q2 FY26

    Reflects a busy quarter of investment activity, not a change in underlying spending plan.

    Cash and cash equivalents
    $69.7 millionup from $58.8 million at the start of the quarter
    as of June 30, 2026

    Explicitly requested, typically omitted as a GAAP statement line. Corrected from $51.2 million (sic) to $58.8 million as per transcript.

    Net leverage
    3.6xcompared to 5.7x a year ago
    as of June 30, 2026

    Improved leverage ratio.

    Term loan repricing interest savings
    $4 million
    per year

    Generated by repricing term loan to SOFR plus 250 basis points.

    First half earnings percentage
    45.3%
    H1 FY26

    Percentage of full year earnings, slightly ahead of 45% expectation.

    MRI growth
    7.2%QoQ
    Q2 FY26

    Reflects strength in acuity.

    PET machines
    8
    current

    2 of 3 targeted new PET machines opened in July.

    Commercial mix
    59%same as last year
    Q2 FY26

    Very slight downward tick in a few markets, but nothing significant or durable.

    Operating expenses
    5%up YoY
    Q2 FY26

    Related to labor, considered good in inflationary environment.

    Industry KPIs

    5
    MetricValueDetails
    Utilization trends6.3%%
    Same facility volumes3.1%%
    Payer mix supplemental payments59%%
    Segment revenue operating income$143.7 millionUSD
    Adjusted EPS EBITDA leverage guidance$56.4 millionUSD

    Deals & partnerships

    2
    Hospital for Special Surgery (HSS)Strategic partnership to expand outpatient imaging services in the New York City metro area.

    Ninth health system joint venture, focusing on a de novo approach in targeted markets. Represents a significant validation of Lumexa's joint venture approach.

    UPMCPartnership for outpatient imaging services.

    First site with the UPMC joint venture was completed this quarter. This is the second new health system collaboration in the last 12 months following UPMC.

    Risks & headwinds

    4
    Public company costsQ2 FY26

    $1.5 million in Q2 FY26

    Mitigation: Expected to be approximately $7 million for full year 2026, absorbed into reported growth.

    Increased stock-based compensationQ2 FY26

    $12.7 million in Q2 FY26 (up from $8.3 million in Q2 FY25)

    Mitigation: Due to one-time resetting of legacy equity comp plans as part of IPO. Expected to be approximately $50 million for FY26, then $20 million to $28 million for FY27 as historic M&A related amortization ends.

    Data breachQ2 FY26

    Minimal impact, no material costs identified

    Mitigation: Related to a vendor, not Lumexa's systems. Company is transparent about the event and monitoring for impact.

    Labor tightness and inflationary environmentQ2 FY26

    Operating expenses for labor up 5% YoY

    Mitigation: Managed through Technologist Advancement Academy, virtual MRI solutions (allowing one tech to run multiple machines), and a 3-pronged radiologist model (Connexia telerad, third-party, affiliated physician groups) to support capacity.

    What to watch in Q3 FY26

    5

    De novo center ramp-up

    Second half of the year (Q3 and Q4 FY26)
    Current2024 and 2025 cohorts tracking in line with expectations
    TargetContinued momentum and profitability contribution from 2025 de novos

    Why it matters

    De novo centers are a key growth driver, and their successful ramp to profitability is essential for overall financial performance.

    The 2025 ones are going to gain a lot more momentum in the second half of the year. They are doing very well against expectations.

    Q&A highlights

    7

    What are the expectations for seasonality in H2 and what drivers will contribute to sequential ramp?

    Management expects natural seasonality with 55% of earnings in H2, driven by sequential volume ramping and maturation of 2024/2025 de novo cohorts. Advanced imaging strength and new facilities also contribute.

    “As we reported last quarter, we expected 45% of our earnings in the first half of the year and 55% in the back half, and we're right on that. That comes from the seasonal ramping of volume and the ramping of our de novos.”

    asked by Brett Grulkowsk · answered by J. Martin

    2 min read6 chapters

    Detailed Narrative

    01

    Strategic Priorities & Execution

    Lumexa continues to execute on strategic priorities including driving strong same-center growth with an expanding mix of advanced modalities, successful ramp of new de novo centers, accelerating high-impact strategic service lines, and expanding its geographic footprint through disciplined, capital-efficient growth. These efforts are supported by strong employee engagement, with record scores achieved in the annual employee engagement survey, reflecting a team aligned and energized by the company's vision.

    02

    Market Opportunity & Value Proposition

    The company operates in a large and growing market, benefiting from durable long-term tailwinds such as aging populations with complex conditions, new treatment paradigms requiring advanced imaging, rising preventative screening rates, and a sustained shift from hospital-based to outpatient sites of care. Lumexa's model helps health systems improve access, retain patients, and enhance their bottom line by delivering high-quality, lower-cost imaging in more convenient settings, reflected in Net Promoter Scores consistently exceeding 90.

    03

    Regulatory Environment

    CMS's proposed 2027 Hospital Outpatient Prospective Payment System (OPPS) rule, if finalized, would reduce the reimbursement advantage associated with hospital outpatient departments, further strengthening the rationale for health systems to expand lower-cost freestanding imaging capacity. This site-neutral shift is viewed as a multi-year structural growth driver. The 2027 Medicare Physician Fee Schedule proposed rule is consistent with the company's planning assumption for approximately flat government reimbursement rates.

    04

    Joint Venture Expansion

    Lumexa announced its ninth health system joint venture, a strategic partnership with Hospital for Special Surgery (HSS), a world-renowned leader in musculoskeletal health. This partnership, following UPMC, represents a significant validation of Lumexa's joint venture approach and expands its presence in the New York City metro area, targeting de novo sites. The company's recent market review identified a substantial pipeline of close to 100 health systems where its model can address outpatient imaging needs.

    05

    Operational Enhancements & Technology

    The company is implementing programs to drive same-center growth and expand access, particularly for advanced modalities. PET volumes grew 23.2% in Q2, with 2 of 3 targeted new PET machines opened in July, and expansion into new tracers like FES. Lumexa Connect, an operating platform built on leading technologies, supports rapid integration of innovations, efficient onboarding of partners, and scalable growth. FastScan deployment across two-thirds of centers by year-end and AI-powered dictation tools are enhancing efficiency and capacity.

    06

    Talent Development

    Lumexa's Technologist Advancement Academy graduated its 100th technologist in Q2, spanning advanced modalities and mammography, including technologists from across all geographies. This initiative supports talent development and retention, helping make Lumexa a great place for clinical team members and addressing broader labor tightness in the industry.

    AI-generated summary of the company’s earnings call. Not investment advice.