CeriBell, Inc. (CBLL) Earnings

Management highlights

### Core Seizure Monitoring Market Growth - Q1 delivered record net new hospital account additions (33 net new accounts) for a total of 680 active hospitals using CeriBell's system, the highest quarterly account growth since the company became public. Management remains confident 2026 full-year new account additions will exceed 2025 levels. - The 2024 Q4 sales organization expansion is delivering strong productivity: over 85% of new sales hires with at least 12 months of tenure have contributed to the active account base, and 100% have generated purchase orders. Management expects further productivity acceleration as new hires mature in 2026 and 2027. - Same-store utilization reached a record high in Q1, driven by the TAM team's focus on departmental expansion, cross-shift provider engagement, and protocol development. Top-performing accounts utilizing the company's best practices monitor approximately 3x more patients than average comparable accounts. - Momentum continues in VA hospital penetration, with 170 VA hospitals unlocked by 2025's FedRAMP High authorization. A new pilot has been launched at select U.S. military hospitals, representing incremental opportunity and validation of CeriBell's product leadership. - A new dedicated small team focused on top-down regional hospital system engagement has been launched, complementing the existing bottom-up territory manager organization and opening new pathways for system-level adoption. ### New Indication Milestones - Full commercial launch of neonate and pediatric seizure monitoring products has been initiated, following a successful 5-site pilot. All 5 pilot sites have transitioned to full implementation, with strong early clinical feedback from providers and evidence of both clinical and health economic benefits, including reduced unnecessary patient transfers. - First sites for the delirium monitoring pilot were activated in April 2026, marking entry into a $1 billion market where CeriBell holds the only FDA-cleared diagnostic tool. A proposed CMS NTAP rule offers up to $2,171 in incremental reimbursement per patient for delirium monitoring; a final rule is expected in August 2026, with an effective date of October 1, 2026 if approved. Full commercial launch of delirium monitoring is on track for Q4 2026 or Q1 2027. - A collaborative clinical study with Vanderbilt Medical Center is underway to examine the clinical overlap between seizure and delirium in ICU patients, which management expects to highlight the value of combined monitoring. - CeriBell received Breakthrough Device Designation for the LVO stroke indication in January 2026, with clinical programs progressing as planned. ### Operational and Financial Highlights - Cost reduction initiatives in 2025 nearly fully offset elevated tariffs on Chinese-sourced inventory. New Vietnam-based manufacturing is fully operational, with lower-tariff inventory already in-house, expected to flow through to financial results in the back half of 2026. - Total cash, cash equivalents, and marketable securities totaled $141.2 million as of March 31, 2026. Management remains confident in achieving cash flow breakeven with existing cash on hand.

Guidance

- Full year 2026 total revenue guidance was revised upward to a range of $112 million to $116 million, from the prior guidance range of $111 million to $115 million. This represents 26% to 30% year-over-year revenue growth over 2025. - Management expects to maintain full-year gross margins in the high 80% range, with potential upside from the transition to lower-tariff Vietnam-sourced inventory in the back half of 2026. - Management expects sequential moderation of Q2 and Q3 utilization volumes due to typical seasonal declines in ICU census during warmer months, but reaffirmed confidence in full-year 2026 performance despite this normal seasonal pattern. - Elevated IP litigation expenses are expected to peak in Q1 and Q2 2026, then moderate in the second half of the year. - Neonate and pediatric products are expected to have only modest revenue contribution in 2026, with much more meaningful revenue growth starting in 2027 and beyond.

Segment performance

CeriBell reports total revenue of $26.5 million for Q1 2026, a 29% year-over-year increase from $20.5 million in Q1 2025. Product revenue totaled $20.2 million, representing 76.2% of total revenue, and grew 29% year-over-year from $15.6 million. Subscription revenue totaled $6.3 million, representing 23.8% of total revenue, and also grew 29% year-over-year from $4.9 million. Gross margin reached 87% in Q1 2026, compared to 88% in the prior-year quarter. Total operating expenses were $43.9 million, a 36% year-over-year increase, with $5.6 million of the increase attributable to elevated IP litigation costs in G&A. Net loss for the quarter was $19.7 million ($0.52 loss per share), compared to a net loss of $12.8 million ($0.36 loss per share) in Q1 2025. Adjusted EBITDA loss was $11.2 million, compared to an adjusted EBITDA loss of $10.9 million in Q1 2025.

Risks & headwinds

- Forward-looking statements around new product adoption, sales productivity, and revenue growth are subject to material risks and uncertainties that could cause actual results to differ materially from expectations, as detailed in the company's SEC filings. - Ongoing IP litigation has resulted in elevated legal expenses, with peak spending occurring in H1 2026 ahead of the upcoming trial, creating short-term pressure on operating results and net losses. - Sales cycles for new regional hospital system accounts and new product indications are longer than individual hospital accounts, creating uncertainty around the timing of revenue contributions from these new growth channels. - Seasonal volatility in ICU census creates predictable quarterly fluctuations in utilization and revenue, which may lead to quarterly results that differ from Street expectations even if full-year performance remains on track. - Tariff policy and global supply chain dynamics create uncertainty around manufacturing costs, though the transition to Vietnam-based production is expected to mitigate this risk.

Analyst Q&A

• Q: After a modest Q1 revenue beat and a small upward guidance revision, what drove management's confidence to raise full-year guidance, and what caused the higher-than-expected Q1 operating expense? /

  A: Management raised guidance based on strong performance across both core growth drivers: record net new account additions and record same-store utilization. Higher Q1 operating expenses came from three sources: moderate elevated investment in sales (for the new regional hospital team) and R&D (for new product development), and outsized IP litigation costs of $5.6 million. Litigation expenses will peak in Q1 and Q2 2026 as the company prepares for trial, then moderate in the back half of the year. Investment in growth initiatives will continue to drive long-term expansion.

• Q: What early trends have you seen from the new neonate and pediatric commercial launch, and how much revenue contribution do you expect from these products in 2026? /

  A: Early momentum is very positive: all 5 initial pilot sites converted to full implementation, with strong interest from both new and existing accounts. Clinical validation is particularly strong, as the technology fills a large unmet need for this vulnerable patient population where conventional EEG is often unavailable. Revenue contribution from these new products will be modest in 2026, as expanding into new departments and onboarding new accounts takes multiple months, with much more meaningful growth expected in 2027 and beyond.

• Q: What clinical synergy exists between delirium and seizure monitoring, and how will this synergy drive adoption? /

  A: Delirium and seizure are heavily clinically intertwined: patients with altered mental status often present with similar symptoms, and a large share of seizure patients later develop delirium, while many delirium patients have underlying undiagnosed non-convulsive seizures. Current standard of care forces physicians to guess at the underlying cause, and first-line seizure treatment (benzodiazepines) actually worsens delirium. The ongoing Vanderbilt study will generate formal clinical evidence of this overlap, which is expected to highlight the unique value of CeriBell's combined continuous monitoring platform, driving deeper penetration in existing accounts and stronger new account adoption.

• Q: What is the size of the U.S. military hospital opportunity, and how does it compare to the VA opportunity? /

  A: There are approximately 30 U.S. military hospitals, which is a much smaller total opportunity than the 170 VA hospitals CeriBell is targeting. However, the pilot is a meaningful validation of CeriBell's technology, as the company was able to leverage its existing FedRAMP High cybersecurity authorization and VA success to gain entry. Military hospitals face similar unmet clinical needs to VA hospitals, including under-resourced neurologist and EEG technician staff, creating strong potential for adoption if the pilot is successful.

• Q: What is the outlook for delirium pricing, and will it be incremental revenue or just a value-add to the existing platform? /

  A: Both incremental separate revenue and deeper existing account utilization are plausible potential outcomes of the delirium launch. Management has not made a final pricing decision yet, and the pilot program is specifically designed to test price sensitivity, clinical workflow adoption, and the impact of delirium on overall utilization before finalizing the commercial strategy. Pricing and incremental revenue plans will be shared closer to the full commercial launch.