Inspire Medical Systems, Inc. Q1 FY2026 earnings call

Timothy P. Herbert highlighted team execution in first quarter despite coding/reimbursement and WISER program challenges. Progress on coding/reimbursement for Inspire V, including Medicare C-code and MAC actions. WISER program impact on revenue. Revised outlook and focus on projects to drive growth. Upcoming SLEEP conference presentations. Matthew Osberg reviewed first quarter financials and revised 2026 outlook with revenue range, profitability metrics, and cash flow/balance sheet details. Strategic territory management and hiring of field clinical reps.

Revenue increased 1.6% to $204.6 million. Operating margin and adjusted operating margin improved due to higher sales mix of Inspire V systems. Operating cash flow was $12.8 million. Balance sheet remains strong with no debt and $400 million in cash and investments. U.S. territories and field clinical representatives counts are as mentioned with strategic territory management.

Revised full year revenue outlook to $825 million to $875 million. Revenue impact from coding/reimbursement and WISER program estimated at $120 million to $150 million. Adjusted operating margin range, diluted EPS range. Expect revenue decline in 2026, adjusted operating loss in Q2, sequential improvement in back half. Focus on disciplined spending and revenue-generating activities.

Coding and reimbursement uncertainty, WISER program delays, impact of GLP-1s on revenue, variability in coding policies across payers, potential changes in MAC modifier policies affecting reimbursement.

Q: Walk through thinking behind updated guidance range and reimbursement assumptions.

A: Timothy P. Herbert and Matthew Osberg discussed impact of coding/reimbursement and WISER on revenue, lag in prior authorization.

Q: On $120M to $150M impact from reimbursement headwinds, where do revenues go.

A: Timothy P. Herbert talked about working with centers to keep hot leads.

Q: Revised outlook entirely related to reimbursement and WISER.

A: Matthew Osberg said main revenue takedown due to reimbursement headwinds.

Q: Current state of salesforce.

A: Timothy P. Herbert discussed intentional territory realignment and field team experience.

Q: WISER and CPT codes ambiguity.

A: Timothy P. Herbert talked about WISER process and CPT coding policies.

Q: $20M impact math and commercial billing.

A: Matthew Osberg and Timothy P. Herbert discussed revenue impact estimation and commercial billing.

Q: Technical coding and reimbursement question.

A: Timothy P. Herbert explained coding variance between Medicare and commercial.

Q: Inspire IV versus V mix.

A: Timothy P. Herbert and Matthew Osberg talked about inventory and mix.

Q: Return to growth before 2028.

A: Timothy P. Herbert discussed focus on coding/reimbursement and WISER to drive growth.

Q: Prioritizing revenue-generating activities.

A: Timothy P. Herbert said focus on existing centers and new centers.

Q: Account comfort with billing/coding.

A: Timothy P. Herbert and Matthew Osberg talked about experience and proactive reviews.

Q: Competitive landscape impact.

A: Timothy P. Herbert said focus on coding/reimbursement and WISER.

Q: Centers getting comfortable with billing/coding.

A: Timothy P. Herbert discussed experience and methodology.

Q: Rest-of-year cadence sensitivity.

A: Matthew Osberg and Timothy P. Herbert talked about impact of coding/reimbursement resolution speed