What is the strategic value of Paige Predict for QNS samples, and what are the ASP expectations for 2026?

Eric explained Paige Predict's value in generating insights from digitized pathology slides even when sequencing fails, making tests better and faster. Jim detailed ASPs were $1,640 in Q4, with over $500 upside potential driven by xT CDx migration to FDA-approved version, xF liquid biopsy FDA submission (2027 impact), and commercial payer improvements. “Being able to digitize the pathology slide and render insights even when sequencing fails just makes our tests a little better than somebody else. The fact that we can also render those results in hours, makes us a little faster to deliver those insights.”

Where does the foundation model stand, has the Q1 version launched, and what are the volume growth assumptions for Oncology and Hereditary in the 2026 guide?

Eric confirmed hitting Q1 benchmarks for the AstraZeneca foundation model and procuring a second, larger cluster of GB200 GPUs for internal models. Jim stated Oncology volume growth (29% in Q4) is off to a good start in Q1, while Hereditary (23% in Q4) is expected to moderate to high teens in 2026 with some lumpiness. “The foundation model had a deliverable in Q1 where we had to hit certain benchmarks that AstraZeneca had established. We think we've hit all those benchmarks. We've submitted all that to AZ. They're testing the model now, but we feel great about the model's performance.”

Is the interpretation correct that only 5% of the sales force sold MRD in Q4, and is the 20x higher potential an aspirational long-term outlook?

Eric clarified that the 20x higher potential is a hypothetical to highlight the strength of their MRD offering (4,700 tests, 56% QoQ growth) despite a highly constrained sales effort. He confirmed a very small percentage of the sales force is currently selling MRD and that they intend to ungate it over time, expecting to become a very large supplier. “We were simply highlighting the really unbelievable strength of our MRD offering on -- the main vector being we ran 4,700 tests. It's 56% quarter-over-quarter, not year-over-year, but quarter-over-quarter growth, and we are highly constraining this effort.”

TEM

Tempus AI (TEM) Q4 FY25 earnings call: guidance and Q&A

Earnings call· Dec 2025 (Q4 FY25)· Health Care· Feb 24, 2026

Source: earnings call transcript

Executive summary

Tempus AI Q4 FY25 — Strong Growth in Diagnostics and Data, Driven by AI Advantage

Tempus AI delivered exceptional Q4 FY25 results, with both its Diagnostics and Data businesses growing rapidly, fueled by its proprietary data and AI advantages. The company is uniquely positioned with extensive multimodal data and broad distribution, enabling it to generate and deliver insights in real-time clinical care. Strong bookings provide significant visibility into 2026 revenue, and the company is doubling down on foundation model development to further accelerate growth and enhance product offerings.

Highlights

Total core business revenue up over 33% YoY.
Oncology unit growth of 29% YoY, accelerating throughout the year.
MRD unit growth of 56% QoQ, despite highly constrained sales effort.
Data licensing business up 69% in Q4 (including one-time impact), with 126% net revenue retention.
Total contract value (TCV) greater than $1.1 billion, rising faster than revenue.

Concerns

Hereditary unit growth expected to moderate to high teens in 2026 due to lapping prior share gains, with potential lumpiness.
MolDX reimbursement timing for the first-gen CRC assay is uncertain, impacting broader MRD market entry.
Small CRO business is being deemphasized and not contributing to growth.

Guidance & targets

Category	Target	Timeline	Confidence
Full Year 2026 Total Revenue	$1.59 billion high materiality	FY26	High
Full Year 2026 Adjusted EBITDA	approximately $65 million positive high materiality	FY26	High
Q1 2026 Data Licensing Growth	roughly 40% growth medium materiality	Q1 · FY26	High
Full Year 2026 Hereditary Growth Rate	high teens medium materiality	FY26	Medium
xT CDx FDA-Approved Version Transition	vast majority of volume on FDA-approved version high materiality	by end of 2026 · FY26	High
xH Whole Genome Heme Offering Launch	goes live this year medium materiality	FY26	High

Segment performance

Segment	Revenue	YoY	QoQ	Margin
Diagnostics - Oncology Unit growth has been accelerating throughout the year. Unit Growth: 29% YoY	—	29%	—	—
Diagnostics - MRD Extraordinary growth despite highly constrained sales effort. Unit Growth: 56% QoQTests Performed: 4,700	—	—	56%	—
Diagnostics - Hereditary Held up well. Expected to moderate to high teens in 2026. Unit Growth: 23%	—	23%	—	—
Data - Licensing (Insights) Includes one-time impact of AstraZeneca warrant.	—	69%	—	—

TEM operating KPIs by quarter

TEM operating KPIs stated on its earnings calls, by fiscal quarter
KPI	This call Dec 2025 Q4 FY25	Mar 2026 Q1 FY26	Jun 2026 Q2 FY26	Change vs prior quarter
Average selling price (ASP) Diagnostics	~$1,640 And then in response to the ASP question, so ASPs in Q4 were around $1,640. Source: earnings call transcript	~$1,740 I do -- we do believe that ASPs are likely to rise years by virtue back that our current ASP sits at around 1740 or something like that, somewhere in that range, 720. Source: earnings call transcript	—	—
Procedures MRD	4,700 We were simply highlighting the really unbelievable strength of our MRD offering on -- the main vector being we ran 4,700 tests. Source: earnings call transcript	6,500 I mean our MRD assay grew 500%, but it was only 6,500 a test. Source: earnings call transcript	~9,000 Even with that, we are delivering growth rates that have exceeded our expectations, running approximately 6,500 tests in Q1 and approximately 9,000 tests in Q2, growing 38% quarter-over-quarter. Source: earnings call transcript	—

Operating figures the company stated on at least two of the calls shown, checked against each call's transcript. Click a figure to read the sentence. A dash means it was not stated that quarter.

Product announcements

Product	Type	Timeline
Paige Predict	launch	1Q
xF Liquid Biopsy	milestone	—
xH Whole Genome Heme Offering	launch	FY26

Deals & partnerships

Ambry Broadened comprehensive nature of testing compendium, particularly hereditary profiling.

Acquired to offer a comprehensive solution to clients, enabling management of risk, treatment, and monitoring of cancer patients.

AstraZeneca Collaboration on an Oncology foundation model.

Tempus hit Q1 benchmarks for the foundation model, which AstraZeneca is currently testing.

Risks & headwinds

Hereditary growth moderation and lumpiness FY26, with potential lumpiness in Q1.

Expected to moderate from 23% in Q4 FY25 to high teens in 2026.

Mitigation:Anticipated slowdown due to lapping prior share gains.

MolDX reimbursement uncertainty for first-gen CRC assay Near-term.

Not quantified, but resolution timing is unknown.

Mitigation:Engaged in discussions with MolDX; current MRD offering is largely tumor-informed (95%) and not reliant on this specific assay for market penetration.

Competition in tumor-naive MRD market Ongoing.

Not quantified.

Mitigation:Developing a second-generation tumor-naive assay; currently focused on tumor-informed product where tissue is prevalent (e.g., CRC).

What to watch in Q1 FY26

Hereditary Growth Rate

Q1 FY26 and throughout FY26

Current 23% in Q4 FY25

Target high teens

Why it matters

To assess if the anticipated moderation and lumpiness in Hereditary growth aligns with management's expectations.

On the Hereditary side, volume growth was 23% in Q4. As we've talked about previously and what we highlighted in the letter is we do anticipate that continuing to moderate as we lap some of the share gains that they had. There likely will also be some lumpiness in the Hereditary growth rates in 2026.

Find out whether TEM delivers this. Inve re-checks your case every morning.

Q&A highlights

How is Tempus protected from traditional AI players entering healthcare, why do pharma clients return, and are they seeing success from Tempus's data?

Eric emphasized Tempus's unique position with proprietary data (450 petabytes multimodal) and distribution (5,500 hospitals, 8,500 oncologists). He highlighted that clients use Tempus's data to refine discovery, design trials, and accelerate drug approval, leading to 126% net revenue retention and accelerating data business growth.

“The most interesting business models, I believe, surrounding AI, in particular, large language or large multimodal models, really center around access to proprietary data to train models and proprietary distribution once you have a model that generates insight.”

asked by Kallum Titchmarsh · answered by Eric Lefkofsky

2 min read 6 chapters

Detailed narrative

AI Strategy and Data Advantage

Tempus AI's business model centers on proprietary data to train models and proprietary distribution for insights. The company possesses over 450 petabytes of connected multimodal data, flowing from its Diagnostic business, which includes real-time insights, longitudinal patient tracking, and rich molecular and imaging data. This unique dataset and distribution network across 5,500 hospitals and 8,500 oncologists are difficult to replicate, providing a significant competitive moat.

Product Innovation and Technology Stacking

The company's growth is driven by a technology advantage that provides physicians with greater insights. Examples include Paige Predict, which digitizes pathology slides to predict mutations, and the Immune Profile Score, which refines traditional biomarkers using multimodal data. These insights stack up to make Tempus's tests 'better' and 'faster' than competitors, a trend expected to accelerate with foundation model efforts.

Foundation Model Development

Tempus has hit key benchmarks for its Q1 foundation model deliverable with AstraZeneca, which focused on oncology. The company has also procured a second, larger cluster of GB200 GPUs to run additional internal models across various data types (radiology, pathology, cardiology, neuropsych), expecting these models to be catalytic for both diagnostic and data businesses.

Ambry Acquisition Rationale

The primary reason for acquiring Ambry was to broaden Tempus's testing compendium, particularly in hereditary profiling, to offer a comprehensive solution to clients. This aligns with the belief that providers increasingly seek a single platform for managing risk, treating, and monitoring cancer patients, similar to e-commerce platforms.

MRD Market Strategy

Tempus's current MRD offering is largely tumor-informed (95%) and in partnership with Personalis. While a first-gen CRC assay is awaiting MolDX reimbursement, its impact is not expected to be a 'needle mover' due to the evolving landscape where tumor-naive products need continuous improvement.

The company is developing a second-generation tumor-naive assay and plans to ungate its highly constrained MRD sales effort when reimbursement and timing are appropriate, expecting to become a very large MRD supplier given its extensive oncology market penetration.

Gross Margin Philosophy

The company balances gross margin maximization with providing the broadest possible panels to the market. While ASP increases would lead to gross margin increases, Tempus is less reliant on maximizing gross profit in Diagnostics due to its dual business model, allowing for reinvestment in broader panels and downstream implications.

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