NRXS — NeurAxis, Inc.

NeurAxis, Inc. (NRXS) Q4 2025 Earnings Call Summary

1. Key Financial Results and Metrics

• Q4 2025 Revenue: $968,000, up 27% from $761,000 in Q4 2024.
• Fiscal Year 2025 Revenue: $3.6 million, a 33% increase from $2.7 million in FY 2024.
• Unit Deliveries: Increased by 35% in Q4 and 44% for the fiscal year.
• Gross Margin: 85.4% in Q4 2025, down from 86.4% in Q4 2024; FY 2025 gross margin at 84.2%, down from 86.5% in FY 2024.
• Operating Loss: $1.7 million in Q4 2025, compared to $1.5 million in Q4 2024; FY 2025 operating loss of $7.8 million, up 9% from FY 2024.
• Net Loss: $1.7 million in Q4 2025, 18% higher than $1.4 million in Q4 2024; FY 2025 net loss of $7.8 million, down 5% from FY 2024.
• Cash Position: $5 million as of December 31, 2025, with an improved liquidity position in 2026 after raising $2.6 million.

2. Strategic Updates and Business Highlights

• Commercialization Strategy: Focus on IV Stem technology for pediatric and adult populations, with a successful execution leading to the acquisition of 45 million covered lives.
• CPT Code: A Category I CPT code effective January 1, 2026, is expected to facilitate broader insurance coverage and adoption.
• Insurance Coverage: Secured policy coverage from a major national health insurer, enhancing access to IV Stem.
• Operational Developments: Increased hiring of experienced personnel to support commercial expansion and patient access.
• Veterans Affairs (VA) Contract: Awarded a Federal Supply Schedule contract, allowing access to the VA healthcare system, which serves nearly 7 million patients annually.

3. Forward Guidance and Outlook

• Growth Expectations: Anticipated continued revenue growth in 2026, driven by expanded insurance coverage and increased patient utilization.
• Commercial Strategy: Plans to scale operations and address gaps in insurance coverage while enhancing the commercial footprint.
• Payer Engagement: Ongoing discussions with major payers to secure additional coverage, with a focus on pediatric markets.

4. Bad News, Challenges, or Points of Concern

• Prior Authorization Challenges: While submission rates for prior authorizations have increased significantly, approval rates remain low, indicating ongoing barriers to access.
• Dependence on Insurance Coverage: The need for written policy coverage remains critical, as payers do not provide coverage based solely on the CPT code.
• Operational Losses: Continued operating and net losses suggest financial pressures, despite revenue growth.
• Market Adoption: Some hospitals have not reached expected utilization levels, indicating potential hurdles in broader adoption.

5. Notable Q&A Insights

• Prior Authorization Rates: In Q1, approximately 20% of revenue came from accounts with prior authorizations, with submission rates up nearly 10x compared to 2025.
• Utilization Trends: Hospitals with strong payer relationships and dedicated IV Stem clinic time are performing well, but many hospitals still face barriers to treatment.
• Future Hiring Plans: Additional hires are expected in Q2 as adoption in the VA system grows, with a focus on integrating sales efforts across children's hospitals and VA facilities.
• Adult Market Strategy: Plans for a randomized controlled trial at the Cleveland Clinic to support future adult insurance coverage, with current adult treatments being cash-based due to lack of insurance coverage.

Overall, NeurAxis is positioned for potential growth in 2026, driven by strategic initiatives and improved payer engagement, but faces challenges related to insurance coverage and operational losses.