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    TEM
    Earnings call· Dec 2025(Q4 FY25)

    Tempus AI Q4 FY25 earnings call TEM

    Feb 24, 2026 Source

    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

    5
    • 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

    3
    • 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

    6
    CategoryTargetConfidence
    Full Year 2026 Total Revenue
    $1.59 billion
    high materiality
    High
    Full Year 2026 Adjusted EBITDA
    approximately $65 million positive
    high materiality
    High
    Q1 2026 Data Licensing Growth
    roughly 40% growth
    medium materiality
    High
    Full Year 2026 Hereditary Growth Rate
    high teens
    medium materiality
    Medium
    xT CDx FDA-Approved Version Transition
    vast majority of volume on FDA-approved version
    high materiality
    High
    xH Whole Genome Heme Offering Launch
    goes live this year
    medium materiality
    High

    Segment performance

    4
    SegmentRevenueYoYQoQMargin
    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%

    Operational metrics

    14
    Total Contract Value (TCV)
    $1.1 billionrising faster than revenue over the past several quarters
    Q4 FY25

    Greater than $1.1 billion.

    Net Revenue Retention
    126%super strong
    Q4 FY25

    On average, clients are ordering significantly more year after year.

    Petabytes of Data
    450
    Q4 FY25

    Data flows from Diagnostic business, includes real-time insights, outcome/response, longitudinal tracking, molecular, and imaging data.

    Connected Hospitals
    5,500
    Q4 FY25

    More than 5,500 hospitals.

    Ordering Oncologists
    8,500
    Q4 FY25

    More than 8,500 regularly ordering oncologists and thousands of other physicians.

    Average Selling Price (ASP)
    $1,640up about $40 quarter-over-quarter
    Q4 FY25

    ASPs in Q4 were around $1,640.

    Potential ASP Upside
    greater than $500
    coming years

    Based on current mix, with xT CDx being the biggest driver playing out over 2026.

    H200 GPU Cluster Size
    over 1,000
    Q1 FY26

    Dedicated to the AstraZeneca partnership.

    GB200 GPU Cluster Size
    more than 500greater than the first cluster in terms of actual compute power
    Q1 FY26

    For additional models not just in oncology, but across radiology, pathology, cardiology, neuropsych data.

    CRO Business Revenue
    $20 million
    annual

    Relatively small, deemphasized, and not growing.

    Core Business Growth Rate
    30-plus percent
    FY26

    Implied growth rate after accounting for slower-growing Hereditary and deemphasized businesses.

    MRD Sales Force Penetration
    very small percentage
    Q4 FY25

    Currently selling MRD, indicating significant untapped potential if unblocked.

    MRD Tumor-Informed Share
    95%
    Q4 FY25

    In partnership with Personalis.

    TCV tied to 2026 revenue
    $350 million
    FY26

    Amount of current Total Contract Value already committed for 2026 revenue, providing high visibility.

    Industry KPIs

    5
    MetricValueDetails
    Revenue EPS guidance$1.59 billion revenue; $65 million adjusted EBITDAUSD
    Pricing price realization$1,640USD
    Diagnostics testing demand29% Oncology unit growth; 56% MRD unit growth QoQ; 23% Hereditary unit growth%
    Segment organic revenue growth29% Oncology; 23% Hereditary; 69% Data Licensing%
    Organic core revenue growth by end market33%%

    Product announcements

    3
    ProductTypeDetails
    Paige Predictlaunch
    xF Liquid Biopsymilestone
    xH Whole Genome Heme Offeringlaunch

    Deals & partnerships

    2
    AmbryBroadened 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.

    AstraZenecaCollaboration on an Oncology foundation model.

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

    Risks & headwinds

    3
    Hereditary growth moderation and lumpinessFY26, 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 assayNear-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 marketOngoing.

    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

    5

    Hereditary Growth Rate

    Q1 FY26 and throughout FY26
    Current23% in Q4 FY25
    Targethigh 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.

    Q&A highlights

    6

    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 read6 chapters

    Detailed Narrative

    01

    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.

    02

    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.

    03

    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.

    04

    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.

    05

    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.

    06

    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.

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