Lumexa Imaging — Third Quarter 2026 Earnings Summary

Financial Performance:

• Consolidated revenue reached $272.0 million for the quarter ended September 30, 2026, representing a 5.0% year-over-year increase compared to $258.9 million in the prior year period; system-wide revenue grew 7.7%.
• Net income was $7.2 million for the quarter, a significant improvement from a net loss of $3.5 million in the same period last year.
• Adjusted EBITDA was $62.6 million, up from $59.1 million year-over-year, with an Adjusted EBITDA margin of 23.0% compared to 22.8% in the prior year.
• GAAP EPS was $0.07 per share, while Adjusted EPS was $0.26 per share.
• Total operating expenses increased to $266.7 million from $246.6 million, driven by higher cost of operations ($225.6 million vs. $219.2 million) and increased general and administrative expenses ($30.0 million vs. $17.1 million).
• Interest expense decreased to $15.7 million from $30.6 million year-over-year.
• Cash and cash equivalents increased to $90.0 million as of September 30, 2026, from $58.8 million at December 31, 2025.
• Total debt (current and long-term) stood at $837.1 million as of September 30, 2026, compared to $832.1 million at December 31, 2025.
• Net cash provided by operating activities for the nine months ended September 30, 2026, was $70.5 million, compared to a net cash used of $29,000 in the same period of 2025.

Guidance and Future Outlook:

• Reiterated full-year 2026 consolidated revenue guidance of $1.045 billion to $1.097 billion.
• Narrowed full-year 2026 Adjusted EBITDA guidance range to $236 million to $240 million (midpoint $238 million), down from the prior range of $235 million to $241 million.
• The midpoint of the Adjusted EBITDA guidance includes approximately $7 million of public company costs not incurred in 2025; at this midpoint, Adjusted EBITDA growth for 2026 versus 2025 is estimated at 4%, down from 7% without these costs.
• Raised full-year 2026 Adjusted EPS guidance to $0.86 to $0.90 per share from the previous range of $0.71 to $0.77, driven by a lower assumed effective tax rate.
• Management stated they are on pace to achieve 8–10 new center openings in 2026, with three new de novo centers currently being opened.

Business Segments and Product Lines:

• Advanced outpatient volume grew 7.9% consolidated and 8.1% system-wide year-over-year.
• Same-center advanced outpatient volume growth was 6.6% consolidated and 6.8% system-wide.
• The advanced procedure mix reached 31.8% consolidated and 38.2% system-wide, an increase of 127 basis points and 145 basis points, respectively, compared to the prior year.
• Total consolidated procedures were 631,131, up 3.6% from 609,352 in the prior year.
• System-wide total procedures reached 1,049,491, up 4.0% from 1,009,029 in the prior year.
• The company operates approximately 190 outpatient imaging centers as of September 30, 2026, comprising 87 joint ventures and 103 consolidated centers.
• Management fee and other revenue totaled $60.9 million for the quarter, consisting of $25.9 million in fees for managing joint ventures and $35.0 million in zero-margin pass-throughs of site-level costs.

Market and Competitive Landscape:

• The company describes itself as one of the nation's largest providers of outpatient imaging services.
• Management highlighted a transformation in healthcare focused on delivering high-quality imaging in convenient settings, more quickly and at lower costs through wholly owned centers and health system partnerships.
• Advanced modalities (MRI and CT) reached a record high as a percent of volumes.

Risks and Challenges:

• The press release notes that forward-looking statements are subject to risks and uncertainties, including those detailed in the company's Annual Report on Form 10-K for the year ended December 31, 2025, and subsequent Quarterly Reports on Form 10-Q.
• Specific reconciling items such as transaction costs, severance, and executive recruiting create uncertainty and variability that prevent the company from providing GAAP guidance for future periods.
• The company incurred $7 million in public company costs in 2026 that were not present in 2025, impacting Adjusted EBITDA growth rates.

Management Commentary and Tone:

• CEO Caitlin Zulla stated the company advanced its business in several meaningful ways while executing against its strategy, noting that newer de novo cohorts are ramping on plan.
• Management expressed confidence in their ability to deliver for patients, partners, and shareholders in the fourth quarter.
• The tone reflects progress toward long-term growth plans, with achievements translating into strong, durable cash generation.

Other Key Points:

• The company reported a significant reduction in interest expense year-over-year, dropping from $30.6 million to $15.7 million in the quarter.
• Stock-based compensation for the quarter was $12.3 million, up from $8.3 million in the prior year period.
• Litigation and settlements costs were $3.6 million for the quarter, compared to a net benefit of $14,000 in the prior year.
• Strategic initiatives and implementation costs were $2.4 million for the quarter, up from $1.2 million in the prior year.
• The company has not provided GAAP guidance for the full year 2026 due to the uncertainty of reconciling items like transaction costs and severance.
• A conference call to discuss results was held on November 10, 2026.