NeuroPace, Inc. Q4 FY2025 earnings call

Joel Becker started with an overview of fourth quarter results, noting strong revenue growth driven by R&S business. He provided updates on clinical and product development initiatives, including submission of PMA supplement for IgE indication, progress on seizure ID, RNS remote care, and foundation model development. Patrick Williams reviewed financials, discussing revenue growth, gross margin, operating expenses, and introduced adjusted EBITDA. They also discussed strategic investments in commercial organization, clinical and product development.

Fourth quarter 2025 revenue was $26.6 million, up 24% year-over-year. R&S system revenue was $22.4 million, up 26% year-over-year. Gross margin was greater than 77%, up roughly 200 basis points year over year, with R&S gross margin greater than 80%. Full year 2025 revenue was $100 million, up 25% year-over-year. Full year gross margin was 77.2%, with R&S gross margin 81.9%.

Reiterated full year 2026 revenue guidance of $98 million to $100 million, assuming 20% to 22% core RNS growth in current adult focal epilepsy indication. First quarter 2026 revenue expected to be in range of $21 million to $22 million. Operating expense guidance on non-GAAP basis, expecting adjusted EBITDA to be a loss in range of $9 million to $10 million, with first half likely more negative and second half improving.

Q: Frank Ticanin asked about translating IgE approval into revenue and generalized opportunity size.

A: Need to extend coverage in private payers, do initial training and scaling. Generalized opportunity could be meaningful.

Q: Mike Kretke asked about pricing impact on R&S growth and Project CARE.

A: Consistent low to mid single digit pricing increases, growth from initial implants in level four centers. Project CARE contributes to referral community growth.

Q: Priya Secdeva asked about capacity dynamics and seizure IDE.

A: Neurosurgeon capacity is sufficient, nurse navigators are being invested in. Seizure IDE is software capability provided to customers for efficiency.

Q: Eduardo asked about pediatrics NEST collaboration.

A: Focus on pediatric focal population, working with NEST and FDA, ongoing activity but no specific submission time