Are the bulk of cost changes complete, or are further incremental efficiency gains expected in the operating structure?

CEO feels good about leadership changes and structure. While significant progress has been made, the new CFO will comprehensively examine additional opportunities for efficiency gains. “I think there's probably still opportunities for us. I think this is where having a new CFO flanking me with just a couple of weeks under his belt So, he and I will have an opportunity to more comprehensively continue to examine where those additional opportunities might exist.”

Will Neurostar session inventory continue to be a headwind? Will existing customers transition to new capital/lease models, or is it primarily for new customers?

Management believes session inventories have normalized and will not be a headwind in H2. While new models broaden reach, the majority of existing session customers are expected to remain due to the comprehensive support provided. The new reporting will be holistic due to revenue mix shifts. “we feel like that the inventories are down about as low as we would expect them to be maintained. So, I don't see any continued inventory reductions in the back half of the year.”

What drove the strong gross margin expansion, especially with Greenbrook's larger mix? Was it pricing improvement in clinics or other execution factors?

Gross margin improvement was durable and seen in both Greenbrook and Neurostar. Greenbrook's improvement was due to better revenue cycle management (patient qualification, cleaner claims, efficient AR) and improved reimbursement rates. Neurostar's improvement was due to mix shift towards capital sales, increasing ASP. “A lot of it has to do with improved revenue cycle management. And that is as we make sure that we're being more disciplined about patient qualification, which is good for the patient as well.”

STIM

Neuronetics (STIM) Q2 FY26 earnings call: guidance and Q&A

Earnings call· Jun 2026 (Q2 FY26)· Health Care· Aug 11, 2026

Source: earnings call transcript

Executive summary

Neuronetics Q2 FY26 — Strong Greenbrook Growth and Neurostar Commercial Model Evolution Drive Profitability Progress

Neuronetics delivered a solid quarter, driven by robust growth in its Greenbrook clinic business and initial positive reception to new Neurostar commercial models. The company demonstrated meaningful progress towards profitability and reduced cash burn, with a focus on operational efficiency and optimizing patient acquisition costs. Management is positioning the company for sustainable growth into 2027 and for future opportunities in interventional psychiatry, including potential psychedelic therapies.

Highlights

Total revenue increased 9.1% year-over-year to $41.6 million.
Greenbrook revenue grew 16.8% year-over-year to $26.9 million, driven by strong provider growth and pricing improvement.
Adjusted EBITDA improved by $5.9 million year-over-year, turning positive at $0.3 million.
Net loss significantly reduced to $3.4 million ($0.05 per share) from $10.1 million ($0.15 per share) in Q2 FY25.
Cash balance increased to $25 million as of June 30th, up from $19 million on March 31st, 2026.

Concerns

Neurostar total revenue decreased 2.7% year-over-year to $14.7 million, with session revenue down double digits.
Second half revenue for Neurostar may be 'a bit choppier' due to mix shifts from new commercial options.

Guidance & targets

Category	Target	Timeline	Confidence
Total Revenue	$160M-$164M high materiality	FY26	High
Gross Margin	48%-50% high materiality	FY26	High
Operating Expenses (OPEX)	$95M-$100M high materiality	FY26	High
Operating Expenses (OPEX) excluding share-based compensation	$91M-$96M medium materiality	FY26	High
Share-based Compensation	$4M low materiality	FY26	High
Cash Flow from Operations and Investing	Negative $10.5M to Negative $14.5M high materiality	FY26	High

Segment performance

Segment	Revenue	YoY	QoQ	Margin
Neurostar New commercial models (outright purchase, lease, a la carte support) introduced. Session revenue reduction partly due to inventory normalization and units no longer active. Utilization up 10% among active accounts. Capital revenue: up double digitsTreatment session revenue: down double digits	$14.7M	-2.7%	—	—
Greenbrook Driven by improved revenue cycle management, better patient qualification, cleaner claims, efficient collections, and improved reimbursement rates. Significant available capacity in clinics. Cash collections growth: faster than revenueAI in insurance authorization: reduced operating costsAvailable capacity: up to 40% unused	$26.9M	16.8%	—	—

Product announcements

Product	Type	Timeline	Details
Neurostar with ANT Neuro neuro navigation technology	milestone	May

Deals & partnerships

ANT Neuro Strategic collaboration to co-promote FDA cleared neuro navigation technology with Neurostar.

Allows Neuronetics to offer enhanced visualization, consistency, and personalization for treatment planning and delivery alongside the Neurostar system.

Compass Pathways Collaboration to prepare for anticipated commercial launch of their psychedelic therapeutic for treatment-resistant depression.

Neuronetics is positioning its Greenbrook clinics as a delivery platform for future psychedelic treatments, leveraging existing infrastructure for in-office drug delivery, monitoring, REMS programs, and prior authorization.

Risks & headwinds

Choppier revenue for Neurostar due to commercial model shifts second half

a bit choppier

Mitigation:the changes position us for renewed and sustainable growth as we enter 2027.

Neurostar session revenue decline Q2 FY26

down double digits

Mitigation:reflects the change in our model, not the demand for the therapy; almost half of the reduction reflected continued normalization of customer inventory, now at the lower levels we'd expect to maintain.

What to watch in Q3 FY26

Neurostar revenue mix shift impact

next quarter

Current Second half revenue may be a bit choppier

Target Evidence of renewed and sustainable growth as company enters 2027

Why it matters

The new commercial models are a significant strategic shift; their impact on overall Neurostar revenue and the mix between capital, consumables, service, and sessions is key to future growth.

Ultimately as we introduce new commercial options and we see some mix shifts, our second half revenue may be a bit choppier, but the changes position us for renewed and sustainable growth as we enter 2027.

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Q&A highlights

How will Greenbrook optimize existing capacity for new therapies like Compass 360 (6-hour observation vs. Spravato's 2-hour)? Will new facilities open or existing ones expand once current capacity is filled?

Management stated significant unused capacity (up to 40%) in existing Greenbrook clinics, which will be prioritized for filling first. Rooms are easily convertible for different therapies. AI is being used for scheduling to optimize utilization. Expansion (new sites/footprints) will be considered after existing capacity is maximized.

“we've talked about having available capacity as much as 40% that's still not consumed. So filling those chairs with patients that can benefit from our therapies is a top priority.”

asked by William Plovanic · answered by Daniel Reuvers

2 min read 6 chapters

Detailed narrative

Neurostar Commercial Model Evolution

Neuronetics introduced new acquisition models for its Neurostar system, including outright purchase and lease-financed options, alongside the traditional treatment session model. This aims to broaden customer reach and compete for business previously out of reach, allowing customers to choose support levels à la carte.

The shift is expected to lead to more value reflected in capital revenue, consumables, and service, and less in session revenue, positioning the company for renewed growth in 2027.

Greenbrook Operational Discipline and Growth

The Greenbrook clinic business showed strong performance with 16.8% year-over-year revenue growth to $26.9 million. This was driven by improved revenue cycle management, better patient qualification, cleaner claims submissions, and more efficient collections. The company also implemented AI in the insurance authorization process to reduce operating costs, contributing to cash collections growing faster than revenue.

Focus on Profitability and Cash Generation

The company made significant progress towards profitability, achieving positive adjusted EBITDA of $0.3 million and reducing net loss. Cash used in operations and investing decreased, and the cash balance increased. The new CFO, Nir Nyor, highlighted his focus on converting the business's strong core into sustained profitability and positive cash flow, with a target of limited net cash utilization in the second half of the year.

Leadership Team Changes

CEO Dan Reuvers implemented changes to the senior leadership team, including reducing executive headcount and flattening the structure. Key appointments include Nir Nyor as CFO, Corey Anderson as EVP and GM of Greenbrook, and Rob Green as SVP of Sales. These changes aim to strengthen execution of the company's strategy and get closer to the details of the business.

Interventional Psychiatry Opportunity (Compass Pathways)

Neuronetics continues its collaboration with Compass Pathways for the anticipated commercial launch of their psychedelic therapeutic for treatment-resistant depression (TRD). The company believes its existing infrastructure, including in-office drug delivery, REMS programs, trained staff, and prior authorization capabilities, positions Greenbrook as an early leader for delivering such therapies safely and at scale.

Neurostar Platform Investment

Neuronetics announced a strategic collaboration with ANT Neuro to co-promote their FDA-cleared neuro navigation technology with Neurostar. This partnership aims to offer providers more visualization, consistency, and personalization in treatment planning and delivery, leveraging Neuronetics' large installed base to scale innovations across the field.

Summary of the company's earnings call; see how call summaries are prepared. Not investment advice.