This article first appeared on GuruFocus .
-
Total Revenue:$41.6 million, up 9.1% year-over-year.
-
NeuroStar Revenue:$14.7 million, down 2.7% year-over-year.
-
Greenbrook Revenue:$26.9 million, up 16.8% year-over-year.
-
Gross Margin:51.1%, up from 46.6% in the prior year.
-
Operational Expenses:$22.7 million, down 12% year-over-year.
-
Net Loss:$3.4 million, or $0.05 per share, compared to a net loss of $10.1 million, or $0.15 per share, in the prior year.
-
Adjusted EBITDA:Positive $0.3 million, compared to negative $5.6 million in the prior year.
-
Cash Position:Total cash of $25 million as of June 30, 2026.
-
Cash Used in Operations and Investing:$1.4 million in Q2 2026, compared to $3.8 million in Q2 2025.
-
Full-Year Revenue Guidance:Narrowed to $160 million to $164 million.
-
Full-Year Gross Margin Guidance:Raised to 48% to 50%.
-
Full-Year OpEx Guidance (excluding share-based compensation):$91 million to $96 million.
-
Full-Year Cash Flow Guidance (operations and investing):Negative $10.5 million to negative $14.5 million.
Release Date: August 11, 2026
For the complete transcript of the earnings call, please refer to the full earnings call transcript .
Positive Points
-
Total revenue increased 9.1% year-over-year to $41.6 million, driven by strong Greenbrook growth.
-
Greenbrook revenue grew 16.8% to $26.9 million, with cash collections growing faster than revenue due to improved revenue cycle management.
-
Gross margin improved to 51.1% from 46.6% in the prior year, driven by better payer contracting and revenue cycle management.
-
Net loss narrowed significantly to $3.4 million from $10.1 million, and adjusted EBITDA turned positive at $0.3 million.
-
Cash burn reduced substantially, with cash used in operations and investing down to $1.4 million from $3.8 million in Q2 2025, and total cash increased to $25 million.
Negative Points
-
NeuroStar total revenue declined 2.7% year-over-year, with treatment session revenue down double digits due to model changes and customer inventory normalization.
-
The shift to new commercial models (capital purchases, leases) may cause revenue to be 'choppier' in the second half of 2026.
-
The company reduced executive headcount and flattened structure, indicating potential organizational disruption.
-
Cash flow guidance remains negative for the full year, with expected cash use of $10.5 million to $14.5 million.
-
The company's reliance on the success of the new go-to-market pilot and the potential for existing customers to transition away from the high-touch session model introduces uncertainty.
Q & A Highlights
Q: As you lean into the service offering for new psychedelics coming to market, how many rooms are typically available per Greenbrook site, and could we expect you to start opening more facilities or expanding existing ones as you become more cash-generating? A: Dan Reuvers (CEO): There is significant runway in improving the capacity available within our existing sites, with as much as 40% of capacity still not consumed. Filling those chairs is a top priority. Rooms used for Spravato can be easily converted to administer psychedelics like COMP360. We are using AI for scheduling to optimize how we deliver varying treatments (TMS, Spravato, and longer-duration psychedelics). Once we get closer to full capacity, expanding footprints or opening more sites is within our roadmap, but the immediate focus is on utilizing existing unused capacity.
Q: Are you through the bulk of the cost structure changes, or should we think about further opportunities for efficiency gains in the operating structure? A: Dan Reuvers (CEO): We have made significant progress in the leadership ranks, adding good talent and redistributing assignments to capable internal folks. Organizationally, we feel well-positioned. However, with the new CFO, Nir Naor, we will continue to comprehensively examine where additional opportunities might exist, so there are likely still opportunities for further efficiency gains.
Q: Should we expect the NeuroStar treatment session inventory normalization to continue through the rest of the year, and do you expect a larger portion of existing customers to transition to the new capital models? A: Dan Reuvers (CEO): Inventories have largely equilibrated to normal sustainable levels after the second quarter, so we don't see continued inventory reductions as a headwind in the back half. We expect the majority of existing session-model customers will continue with the comprehensive support model, as our chairs perform almost twice as many treatments per chair as the competitive landscape. However, we are offering more options to let customers decide how they want to pay for value. If a new customer chooses the capital route, they will still pay for service, consumables, and training, which is why we are reporting NeuroStar on a more holistic basis.
Q: What drove the strong gross margin expansion, especially with clinic revenue making up a larger mix of sales? A: Dan Reuvers (CEO): The gross margin strength was seen on both the Greenbrook and NeuroStar sides. On the Greenbrook side, it was driven by improved revenue cycle management, including better patient qualification, cleaner claims submissions, and more efficient accounts receivable, along with improved reimbursement rates through more effective payer contracting. On the NeuroStar side, as the mix shifts more toward capital sales, the average selling price is going up, which is a sustainable positive for gross margins. These considerations are embedded in our updated guidance.
Q: Can you parse out the underlying trends on the Spravato side versus the TMS side of the Greenbrook business, and how is your model best set up to offer Spravato, TMS, and psilocybin? A: Dan Reuvers (CEO): We saw a bit more strength from Spravato than TMS, but overall growth reflects Greenbrook becoming a destination of choice for referral sources. Spravato is more durable as patients stay active longer. Regarding Compass and psilocybin, we are poised to be a first-mover benefactor due to our close collaboration and existing infrastructure, including REMS certification, room setups, and available capacity. We aim to be the destination of choice for referral sources for whatever intervention is best suited for the patient, and our model of not doing medical management and psychotherapy gives referral sources confidence they will get their patients back.
Q: Are there certain KPIs you will be tracking as you evaluate efficiently getting more patients through the door with different sales methods? A: Dan Reuvers (CEO): Internally, patient acquisition cost is a key metric we are scrutinizing. Account managers supporting the Greenbrook community are proving to be a very effective source for referral generation. We are evaluating the balance of spend between our field team, direct-to-consumer ad spend, and peer-to-peer education events, and we will rebalance spend toward the most effective paths. The ultimate goal is finding the most efficient way to get the right patient who can benefit from our therapies into a chair.
Q: Can you provide more color on the second-quarter financial results and the updated guidance? A: Nir Naor (CFO): Total revenue was $41.6 million, up 9.1% year-over-year, driven primarily by Greenbrook revenue of $26.9 million, up 16.8%. NeuroStar revenue was $14.7 million, down 2.7%, with capital sales up double digits and session revenue down double digits. Gross margin was 51.1%, up from 46.6%, due to mix and improved revenue cycle management. Operating expenses decreased 12% to $22.7 million. Net loss improved to $3.4 million from $10.1 million, and adjusted EBITDA was positive $0.3 million versus negative $5.6 million. We are narrowing total revenue guidance to $160-$164 million, raising gross margin guidance to 48%-50%, and lowering OpEx guidance to $91-$96 million excluding share-based compensation.
Q: What is the status of the collaboration with Compass Pathways and the potential for psychedelic therapeutics? A: Dan Reuvers (CEO): We continued our collaboration with Compass Pathways to prepare for the anticipated commercial launch of their psychedelic therapeutic for treatment-resistant depression. With their recent Phase 3 extended durability data readout, our enthusiasm for the opportunity continues to grow. When these therapies come to market, they will require the kind of delivery platform we already operate, including in-office drug delivery, REMS programs, trained clinical staff, and prior authorization infrastructure. Greenbrook's experience, scale, and available capacity positions us as an early leader in that space.
Q: How should we think about the cash flow guidance and the company's path to profitability? A: Nir Naor (CFO): We are updating our cash flow guidance to include both cash flow from operations and investing, estimating it to be in the range of negative $10.5 million to negative $14.5 million for the full year. We continue to target limited net cash utilization for operations and investing in the second half of the year. Our focus is on converting progress into sustained profitability and positive operating cash flow. During the quarter, we raised $7.6 million in net proceeds through our at-the
For the complete transcript of the earnings call, please refer to the full earnings call transcript .
