Operator
Good morning, and welcome to the NeoGenomics Fourth Quarter and Full Year 2025 Financial Results Call. Please be advised that today's conference is being recorded.
I will now turn the call over to Kendra Webster with NeoGenomics. The floor is yours.
Kendra Webster
Thank you, Kelly, and good morning, everyone. Welcome to the NeoGenomics fourth quarter and full year 2025 financial results call.
With me today to discuss the results are Tony Zook, Chief Executive Officer; Jeff Sherman, Chief Financial Officer; and Abhishek Jain, EVP of Finance. Additional members of the management team will be available for the Q&A portion of our call.
This call is being simultaneously webcast. For reference, concurrent with today's call, we posted a short slide presentation to the Investors tab on our website at ir.neogenomics.com.
During this call, we will make forward-looking statements regarding our future financial and business performance, business strategy, the timing and outcome of reimbursement decisions, and financial guidance. We caution you that the actual events or results could differ materially from those expressed or implied by the forward-looking statements.
These forward-looking statements made during the call speak only as of the original date of the call, and we undertake no obligation to update or revise any of these statements. Please refer to the information disclosed on the safe harbor statements slide in the deck posted on our website, as well as the information under the heading Risk Factors in our most recent Forms 10-K, 10-Q, and 8-K that we filed with the SEC to identify important risks and other factors that may cause our actual results to differ materially from the forward-looking statements.
These documents can be found in the Investors section of our website or on the SEC's website. During this call, we also refer to certain non-GAAP financial measures that include adjustments to GAAP results.
The non-GAAP financial measures presented should not be considered an alternative to the financial measures required by GAAP, should not be considered measures of liquidity, and are unlikely to be comparable to non-GAAP financial measures provided by other companies. Any non-GAAP financial measures referenced on this call are reconciled to the most directly comparable GAAP financial measures in a table available in the press release we issued this morning and in the slide deck available in the Investors section of our website.
I will now turn the call over to Tony.
Tony Zook
Thanks, Kendra. Good morning, everyone.
Thank you for joining us today. As has been our practice, I'll begin with a discussion of Q4 highlights and key business growth drivers before turning the call over to Jeff for a deep dive into our 2025 financial results.
Our new EVP and incoming CFO, Abhishek Jain, will then introduce our 2026 guidance. Afterwards, we'll open up the call for your questions.
Our mission and vision guided us through 2025 to deliver improving results throughout the year. Let's get into the recent highlights.
As we covered in our preannouncement, during the fourth quarter of 2025, we delivered record revenues while making meaningful progress advancing our NGS and MRD long-term growth initiatives, including preparing for a full clinical launch of our RaDaR ST MRD assay this month. I'll cover these initiatives in more detail shortly.
Total revenue for Q4 was $190 million, representing double-digit growth of 11% year-over-year. Our clinical business continued its robust growth, with revenue increasing 16% year-over-year.
The clinical performance was driven by effective execution of our key commercial strategy, enabling volume and share gains in key segments. In the fourth quarter, we again saw sequential improvement in AUP, continued growth in test volumes, and NGS revenue growth of 23%, well ahead of NGS market growth rate.
The five NGS products launched in 2023 contributed 23% of clinical revenue in the quarter. We continued to see demand for our non-NGS modalities as well, with all modalities continuing to grow at above-market growth.
Our full year total revenue was $727 million, which represents 10% growth over full year 2024. We ended the year with significant momentum, and I attribute this to several factors.
One, we're a pure-play oncology solutions provider driving rapid dissemination and adoption of innovation through our best-in-class commercial organization in the community setting. Studies have shown that as much as 80% of all cancer care is now delivered in the community setting, which has historically lagged NCI-designated cancer centers when it comes to introducing the latest in cancer testing innovation.
How are we winning in the community? We believe community oncologists are guideline-driven and focused on certainty, not possibility, and they choose partners that remove friction and enable confident treatment decisions under operational, economic, and time pressures.
Reimbursement coverage also is critical. The results of several meetings of our Scientific Advisory Board, as well as independent market research that we commissioned, reveal several reasons why community oncologists look to us.
NeoGenomics offers ease of ordering, simple-to-interpret test reports, fast and consistent test turnaround times, access to medical expertise, and most importantly, our comprehensive test menu spanning diagnosis, therapy selection, and MRD. Our Net Promoter Score of 79 reflects strong physician satisfaction among our current customer base, with our NPS score continuing to improve in '25, even with record test volumes.
Two, we enjoy a leadership position in the hematology testing market, with greater than 25% share across diagnostics and therapy selection. As pathologists and oncologists consolidate the number of vendors they use, we are successfully leveraging this heme leadership position to create enhanced test demand, particularly in high-value areas such as therapy selection and MRD.
In fact, in 2025, we saw 14% growth in the total number of pathologists and oncologists ordering five or more tests from Neo. On top of that, we estimate that approximately 40% of all active pathologists and oncologists have ordered five or more tests of ours during the year.
While we're proud of that reach, it also means that over half the practicing providers are still available to us to bring over to Neo. Three, we've built a geographically balanced lab network that allows us to be responsive to customer needs, including offering some of the fastest test turnaround times in the industry, when faster, more accurate treatment decisions can have a material impact on patient outcomes.
This network was further strengthened by our acquisition of New Jersey-based Pathline last year, which gives us a meaningful presence in the number three cancer market in the country. We're on track to capture operational efficiencies and synergies from the Pathline acquisition that we anticipate will be accretive to profitability beginning this year.
Four, we have one of the broadest cancer test menus in the industry, spanning diagnosis to therapy selection to MRD, for both heme and solid tumor cancers, including over 300 commercial payer contracts, which enables us to be the partner of choice among community hospitals and community oncologists. We're highly differentiated from both large reference labs as well as specialty oncology labs, and this optimally positions us to address underpenetrated markets in therapy selection and MRD in excess of $30 billion, while potentially improving outcomes for patients as they advance along the cancer care journey.
We're enabling precision oncology in the community setting. Turning now to RaDaR ST.
In November, we presented new research for the RaDaR ST assay for circulating tumor DNA detection across solid tumor types. The data from this bridging study showed that RaDaR ST demonstrated 97% concordance and maintained equivalent sensitivity with RaDaR 1.0.
This bridging study was used to secure MolDX reimbursement in the two previously approved indications: HPV-negative head and neck cancer and a subset of breast cancers. This decision paves the way for us to broadly commercialize RaDaR ST, formerly RaDaR 1.1.
To that end, we're on track to execute a full clinical launch of RaDaR ST by the end of this month. As part of our go-to-market strategy, we're expanding our sales force to help us penetrate the head and neck market.
We believe adding feet on the ground will help us penetrate this market with the only MolDX-approved HPV-negative test currently available to patients. To ensure that we're well positioned to capture more of this large and rapidly growing MRD market, we have also submitted two additional solid tumor cancer indications for MolDX for approval.
While we're not disclosing these cancer types yet for competitive reasons, we believe that upon securing coverage, we will effectively double the market opportunity of patients eligible for RaDaR ST testing. To expand our reach as we secure additional MolDX approvals, we expect to add more than 25 oncology sales specialists, or OSSs, by the third quarter.
From a financial perspective, we believe 2026 will see modest revenue contributions from RaDaR ST as adoption ramps and we gain reimbursement approval in the additional indications. We expect revenue growth to accelerate in '27 and beyond.
In parallel with our RaDaR ST launch preparedness activities and efforts to gain coverage for additional indications, we also continue to focus our R&D investment in next-generation MRD. This assay will be an ultra-sensitive, whole genome solution for lower-shedding cancer types.
We're working on product development now, with data generation and MolDX submissions slated for next year and a potential clinical launch as early as 2028. Turning now to our PanTracer portfolio of products for solid tumor therapy selection.
PanTracer is designed for solid and liquid to work together, empowering oncologists with actionable genomic insights for confident, real-time treatment decisions. The tests can be ordered independently or as complementary tests, depending on a patient's individual needs.
PanTracer LBx is a non-invasive, blood-based test that analyzes circulating tumor DNA to identify key genomic alterations that inform treatment decisions in patients with advanced-stage solid tumors. Importantly, PanTracer LBx fills a gap in our portfolio that providers have been asking for, allowing them to further consolidate the number of labs they use.
We have submitted to MolDX for clinical reimbursement coverage of the LBx test and are awaiting a decision. Assuming a favorable decision, we anticipate that LBx will contribute modestly to revenue in 2026 as adoption ramps throughout the year.
Another product in the PanTracer family, PanTracer Tissue, had strong growth throughout 2025. We doubled the volume of tests ordered from '23 to '24 and then nearly doubled again from '24 to '25, while continuing to grow AUPs.
This represents another proof point of our ability to pull higher-value tests through our community channel, leveraging our heme leadership position. 75% of community oncologists who were new to Neo in 2025 ordered five or more tests, a strong leading indicator of our continued growth and success penetrating the community channel.
I'm pleased to share today that PanTracer portfolio is growing. Last week, we launched PanTracer Pro as part of the expanded solid tumor therapy selection portfolio.
The test integrates broad genomic profiling with diagnosis-directed IHC and ancillary testing, intelligently selected based on tumor type and clinical context, to provide oncologists with actionable insights for therapy selection in a single order. PanTracer Pro rounds out the portfolio, and it will help streamline the ordering and testing process, delivering timely, relevant results, helping clinicians personalize treatment strategies and improve patient outcomes.
At the end of 2024 and moving into 2025, we invested in our commercial organization, specifically our oncology sales specialists. We added 35 people to this group who target community oncologists.
As these individuals mature in their roles, we're seeing a continued uptake in NGS testing accounting for a larger portion of our total clinical revenue as we increase our reach and frequency. This penetration speaks to the strength of our commercial channel as well.
We have launched five NGS products since March of 2023. Even though we were later to market than some of our peers with these products, we're still seeing very good uptake.
PanTracer Tissue, highlighted earlier, was one of the five products, which reflects the breadth and strength of our menu and our ability to capture market share when we introduce new products. With the success of our NGS products, we now have the opportunity to be more selective with the volumes that we prioritize.
We are intentionally shifting testing capacity towards more therapy-guided and higher-value testing, which is expected to make AUP expansion a more significant driver of revenue growth relative to volume. With that, I'll hand it over to Jeff to further discuss our results for the quarter and full year.
Jeff Sherman
Thanks, Tony, and good morning. Fourth quarter total revenue increased by 11% over prior year to $190 million.
Total clinical revenue continued with strong double-digit growth and increased 16% from prior year. As expected, non-clinical revenue declined by over 25% in the fourth quarter.
Adjusted gross profit improved by $5.8 million, or 7% over prior year, and adjusted EBITDA was $13.4 million, up 10%. Q4 was the 10th consecutive quarter of positive earnings, with adjusted EBITDA and margins improving sequentially each quarter in 2025.
Clinical volumes and revenues continued with robust growth in the quarter. Total test volumes increased by 11% in the fourth quarter, with AUP growth of 5%.
Same-store revenue without Pathline was $170 million, representing growth of 14%, driven by a 6% increase in test volumes and a 7% increase in AUP. Volumes were negatively impacted in the fourth quarter as we intentionally rationalized our exposure to higher-volume, lower-value test clients.
We are continuing to see strength across our portfolio, with above-market growth rates across modalities we offer. NGS revenues grew by 23% over prior year in the quarter and accounted for around a third of total clinical revenue.
Average revenue per clinical test increased sequentially from Q3 by $12, or 3%, and was up 5% from prior year. Excluding Pathline, AUP increased by $15, or 3%, from Q3 and was up 7% over prior year.
A larger percentage of higher-value tests, including NGS, as well as recent managed care pricing increases and RCM initiatives, are helping to drive higher AUP. Total operating expenses in the quarter were $97 million, an increase of $1 million, or 1% over prior year.
Cash flow from operations was a positive $1 million in the quarter, and we ended the quarter with total cash of $160 million, down slightly from Q3. Our balance sheet and expected cash flow will enable us to continue to invest in our business to drive organic growth through new product development and sales force expansion, while also increasing operating efficiencies through investments in technology and automation.
Turning to full year 2025 results, revenue was up 10% versus prior year to $727 million, driven by deeper penetration into the community setting, a continuing shift to higher-margin modalities, and execution of revenue cycle management initiatives. Total clinical revenue increased 15%, and growth was 13% excluding Pathline.
Non-clinical revenue declined 24% for the year, in line with our revised expectations. Adjusted gross profit increased $23 million, or 8%, to $335 million.
This represented an adjusted gross margin of 46%, or a decline of 111 basis points, mostly driven by Pathline, the decline in non-clinical revenue, and the operating costs of the clinical liquid biopsy launch. Cash flow from operations was positive $5 million in 2025, with free cash flow improving by over 35% as compared to 2024.
Adjusted EBITDA increased by $4 million to positive $43.4 million, an improvement of 9% over prior year. Now I'll hand it over to Abhishek to introduce our 2026 guidance.
Abhishek Jain
Thank you, Jeff. I would like to begin by thanking my colleagues at Neo for their warm welcome.
Over the past month, I spent time with investors and analysts, attended our global sales meeting, visited our labs, and gained deeper insights into our strategies and the opportunities ahead. It has been a productive and energizing first month.
With that context, let me share our 2026 guidance. For the full year, we expect revenues of $793 million to $801 million.
The midpoint of our 2026 revenue guidance assumes RaDaR ST revenue in mid-single-digit millions for all approved indications, a modest revenue contribution from PanTracer Liquid, and sustained softness in non-clinical through the year, exiting 2026 down low to mid-single digits. While we do not provide quarterly guidance, let me provide some color on quarterly cadence that is impacted by the Pathline acquisition and revenue assumptions for RaDaR ST and PanTracer Liquid, which are weighted towards the back half of the year.
I suggest modeling approximately 10% year-over-year growth in the first quarter, 8% to 9% in the second, 9% to 10% in the third, and slightly above 10% in the fourth quarter of 2026. Regarding the extreme weather throughout the country so far this year, we know some providers had to close their offices and appointments have been rescheduled.
As a result, there will be some impact on volumes and revenue for Q1. This has been contemplated in our full year 2026 guide and cadence by quarter.
We expect adjusted EBITDA to be in the range of $55 million to $57 million for 2026, representing year-over-year growth of approximately 27% to 31%. We expect adjusted EBITDA to grow by low 20s percent year-over-year in the first and the second quarter, and low 30s percent year-over-year in the third and the fourth quarter, respectively.
We will continue to take a balanced approach to investments, strategically increasing sales and marketing and R&D spend for new product initiatives and clinical programs that support payer reimbursement and drive top-line growth, while improving liquidity with the goal of becoming free cash flow positive this year. Now let me turn the call back to Tony.
Tony Zook
Thanks, Abhishek, and welcome to the team. To recap, during the fourth quarter, we again delivered very strong clinical volumes and revenue, while advancing NGS and MRD initiatives that we believe will contribute to accelerating our growth for years to come.
Looking forward into 2026, in our clinical business, the focus is on strategic, profitable growth driven by continued expansion of NGS revenues and market penetration for the PanTracer family and RaDaR ST. Simultaneously, we're implementing tools and solutions we believe will enhance the productivity of the entire sales organization and working to enhance customer workflows through solutions like our Epic Aura integrations.
In parallel with our product and service offerings to grow revenue, we are making targeted investments to drive top-line growth and margin expansion. There's a very strong financial discipline embedded throughout the organization, and we're going to build on that as we continue to grow revenue and improve operating efficiencies and margins.
Thank you for your continued interest in NeoGenomics. Operator, this concludes our prepared remarks, please open the line for questions.
Operator
Certainly. The floor is now open for questions.
If you have any questions or comments, please press *1 on your phone at this time. We ask that while posing your question, you please pick up your handset if listening on a speakerphone to provide optimum sound quality.
Please hold just a few moments while we poll for questions. Your first question is coming from David Westenberg with Piper Sandler.
Please pose your question, your line is live.
David Westenberg
Hi. Thank you so much, and good morning.
I'll just ask one question, but it will be kind of on the longer side, and I'll just ask it upfront. You talked about the imminent launch of RaDaR ST.
Can you provide a little bit more specifics? You mentioned submissions to MolDX.
Can you give us more specific timing? I get that this is trying to predict government, but is this end of the year, is this potentially dragged into the next year, et cetera?
Then you mentioned also 25 sales reps. I just want a clarification, that is specific to MRD or esoteric tests in general?
Then on those sales reps, do you plan on just going after the head and neck, the sub-indications of breast, or are you actually, in fact, thinking about some of those future MolDX submissions that you have there? Then lastly, I get this is really long, but just talk about the complementarity with PanTracer Liquid.
Thanks so much.
Tony Zook
Dave, there's a lot to unpack there. I'll try and start it, and kick us off, and then look to Warren to address perhaps follow-up questions six, seven, and eight, okay, Warren?
Get ready for that. Relative to RaDaR ST, Dave, you are right that the intention is we go out the end of this month for our full launch.
Relative to focus, it will be focused, Dave, on the initial indications of head and neck and the subsets of breast that we have articulated: HPV-negative and the HR, HER2-negative breast. That will remain the focal point for the initial launch activities.
That was one of your questions. As far as additional indications go, as you say, all we can do is submit and put the best packages forward that we believe are possible for MolDX to work their way through.
For our own assumptions, we believe, Dave, that those additional indications would be available in the latter half of this year for us. Still possible to potentially generate some revenue from those in this year, but that would be upside against our guide, Dave.
We are not counting on those, and certainly will help fuel additional robust growth going into 2027. Relative to the actual field force expansion, I'm going to turn that over to Warren because what we wanted to do, Dave, was do two things.
First and foremost, we wanted to take advantage of the HPV-negative indication because we believe we'll be the only MolDX-approved product for HPV-negative, and it's a very specialized group of physicians that account for that bulk of that business, and there's a fairly clear roadmap to how we can get to those. Warren's team is initially now expanding to cover that group, and then he will build the additional reps over time for the added indications that we have.
Yes, Dave, they are intended to be complementary to MRD and NGS. They won't be specific only to MRD.
Warren, maybe a little bit more color on the coverage aspect.
Warren Stone
Absolutely. Thanks, Tony, and morning, Dave.
The expansion is taking place. There's an initial expansion happening sort of as we speak.
That is to really address the RaDaR ST launch, and particularly head and neck HPV-negative. The reason why we felt we needed to do a small initial expansion there is one of the primary call points for head and neck HPV-negative is the ENT, and that hasn't been a traditional call point for us up until now.
We're actually are investing in a small team dedicated towards ENTs, and they will be almost exclusively focused on the RaDaR head and neck indication. They will have an option to represent other parts of the portfolio, but we feel that their focus would be largely focused on the RaDaR ST.
As we've done in the past, and very successfully I might add, as we expect new products, and in this case new indications, to come to market, we do expand our sales force because we want to increase reach and frequency. We will be doing that in quarter two and in quarter three in anticipation of the additional indications that we expect from MolDX.
Again, these team members will be oncology sales specialists. They will be responsible for selling our oncology portfolio, which is therapy selection for heme and solid tumor, as well as MRD.
It's probably a bundle of about 12 or 14 tests if you really look at it, but we see a 100% call point overlap between our portfolio for therapy selection as well as MRD. Today, based on our size of our sales team, we feel we get more value by consolidating sales activities within one resource versus having specialized sales teams, although we will get some good lessons from our dedicated ENT group that we're establishing as we speak.
Tony Zook
Thanks, Dave.
David Westenberg
All right. Thank you, guys.
Operator
Your next question is coming from Bill Bonello with Craig-Hallum. Please pose your question, your line is live.
Bill Bonello
Thanks, guys. Hoping to sneak in a couple, but the first would be just on the clinical volume.
Any chance you could quantify the impact of exiting the low-value business and then maybe clarify whether there's more business that you will still be exiting in future quarters, we can have some sense of how to think about volume growth as we progress through the year?
Tony Zook
Sure, Bill. I'll kick that off, and again I'll look to Abhishek or Jeff to add in any additional color.
Bill, if you just step back and you look at us historically, right, and if you look at how the revenue models were built, volume represented for us typically, this upper to single digits growth, and AUP was more in the low single-digit growth. There's two factors that are driving our thinking now.
First of those is this constant and purposeful penetration into therapy selection and MRD. With that, we will be the beneficiaries of higher AUPs, and therefore a better impact on our margins and business overall.
That's point number one. We expect our AUPs to continue to grow.
Then the second point, Bill, was this idea we want to make sure we secure the right volume. We want to be a business that's growing our revenue as well as our margins over time.
You recall that we talked about a contract throughout last year that was a high-volume, low-value-added opportunity for us. The AUPs, Bill, in that were in the low $200 range.
We entered into that with the potential opportunity to secure longer-term growth into higher-value tests, but if they don't materialize, we had to look at it in a macro sense. For us, we believe the better course and judgment here was to say our resources are better used and focused in the areas where we're seeing higher-margin opportunities and higher growth.
The model now kind of inverts a little bit. What you should be expecting is AUP now in the upper single-digit range, with volume in the low to mid-single-digit range.
That being said, I just want to make sure we clarify this, Bill, because it's an important point. We're still growing all the right volumes, right?
We're going to continue to grow by modality. We have no desire to pull back in that area.
We continue to expect NGS to have robust growth as well. That is going to continue.
We saw robust NGS volume and AUP growth in 2025. We would expect similar results in 2026, and so the right volume will come through.
On that NGS business, again, it's now over a third of our clinical business, and an interesting fact, Bill, is that that third of our clinical revenue, it's actually being supported with only 9% to 10% of our volume. It's the right volume that's generating these kinds of growth numbers.
I would expect most of this to be evident through Q1 and Q2, and then from that point on we'll be back to kind of normal growth trends. Does that help, Bill?
Bill Bonello
It does, and should we think even a bit lower, perhaps, as we get into Q2 and Q3 just then on the volume growth? It sounds like maybe a little to still come, or is this pretty good proxy?
Warren Stone
Let me take that one, Bill. For example, what you have seen in Q4 results, our sequential volume growth was slightly down.
We are anticipating, as we kind of go in Q1, our numbers will be sequentially down in similar vein as we kind of start to focus on these high-margin, high-value tests. This is very intentional from our strategy standpoint, and that's the reason we are moving in that direction.
As we get into Q2, we'll basically be year-over-year flattish, and that's where we will start to grow our volumes in Q3 and Q4 on a year-over-year as well as on a sequential basis.
Bill Bonello
That's really helpful. Thank you.
Tony Zook
Thanks, Bill.
Operator
Your next question is coming from Andrew Brackman with William Blair. Please pose your question, your line is live.
Andrew Brackman
Hi, guys. Good morning.
Thanks for taking the questions. Maybe just also a similar line of questioning to Bill here just sort of around guidance.
Just by my math, it looks like that the core clinical business, when I exclude Pathline and some of these new contributions from LBx and MRD, it looks like that core is called just sort of growing that high single digits to maybe 10% year-over-year. Can you maybe just unpack some of the underlying assumptions there for that core book of business?
I guess in particular, just sort of reconciling that to, I think you did 14% same-store sales growth in Q4. Just sort of reconciling that to that high single to 10% growth.
Thanks.
Tony Zook
Andrew, again I'll kick it off, and I'll look to Abhishek and Jeff to add additional color. Yes, in 2025 you saw, ex-Pathline we were about 13% growth on the clinical side.
We are anticipating double-digit growth on the clinical. What's within there?
First, there will be the full year of Pathline. That will be built into the numbers as well.
As I just mentioned with Bill, that one contract that we exited, that has an impact in the totality of the clinical side. Of course, in the guide itself, Andrew, just to be clear, we wanted to be prudent relative to the back half with LBx.
Since we still do not have LBx approval in hand, we thought it better to only pack in revenue for the second half of the year at a modest rate. We don't really see the benefits of that coming through in the current guide.
If we in fact get MolDX support for LBx earlier than that, then it would represent upside in our total growth, and of course that would be on the backs of the total clinical business. Again, I hope that gives you some color.
Abhishek, Jeff, if I missed any key points, please call out for Andrew.
Abhishek Jain
No, I think you have covered it well, Tony. Andrew, we are expecting the clinical business to be growing at about 11 points based on our low to mid-single digit on the non-clinical side.
It's kind of in the range that we have been expecting the company to be growing in, at about 10 points. That's what we have called out, and that's where our midpoint currently is, $797 million, is pretty close to that 10%.
I think the guide is pretty prudent to the extent that it gives us a very high degree of confidence to be able to meet these numbers, and then we will of course see if the things were to pan out as we are anticipating, it gives us some room to actually do better than the expectations. Yeah.
Tony Zook
Does that help, Andrew?
Andrew Brackman
That's helpful. Then, yeah, that's very, very helpful.
Thanks for all that color. Then just on the LIMS rollout here, obviously that's a multiyear process for that rollout.
Anything you can maybe share with respect to how that might be impacting the model, or sort of the workflow in 2026? Thanks.
Tony Zook
Great question. Thanks for that.
As historically we were built for effectiveness, not necessarily for efficiency. Moving to a common LIMS system we think is foundational for us to continue to advance towards ever-improving margins and efficiencies for the company.
What we will see through the course of 2026, Andrew, we have these eight existing LIMS systems, we'll be on a path to migrating to one common system. What we want to do though is manage that effectively over time.
We are going modality by modality, site by site. We're not going to just do kind of a big bang theory and put any risk at all into the business.
That means the benefits of LIMS only start to become evident for us in the latter part of this year. Now there are some natural efficiencies that Warren's team already seeing, and I will look to him to add some of that added color for you, but the more pronounced impact will be in '27 and '28 as we can retire all the legacy systems and build upon the existing LIMS architecture.
Warren, any added color?
Warren Stone
Thanks, Tony. Andrew, I think in terms of sort of technical debt benefit, that's coming in 2027 to be clear.
As we put the LIMS system in now, we're actually not just replacing our existing eight LIMS with a new LIMS, we're actually looking at the workflows and optimizing the workflows based on how we understand the business and how it's likely to develop over time. As we get each modality in place or in each site, we start to see workflow efficiency there.
That's sort of something that will start to come through in operational efficiency. I think the other big benefit that we're getting is far greater capabilities from the analytics and insight point of view to really understand where inefficiencies lie within our workflows, and that analytics and sort of transparency will also help us translate a better customer experience by providing visibility to real-time sample tracking, etc., which is one of our key initiatives for 2026.
Tony Zook
I would say, Andrew, again, this is foundational for us because it affords us then the opportunity to build on that, which is why I maintain that we're still in the early innings relative to gross margin expansion opportunities for ourselves. You throw in LIMS, and then you look to other platform opportunities like DX and things that Warren and his team can do with digital pathology and automation.
We believe that the gross margins are early, and we can continue to build not just revenue, but margin expansion as well.
Andrew Brackman
Appreciate all the color. Thanks, guys.
Tony Zook
Thank you.
Warren Stone
Thank you.
Operator
Your next question is coming from Subbu Nambi with Guggenheim. Please pose your question, your line is live.
Subbu Nambi
Hey, guys. Thank you for all the color in different businesses.
Given some longer selling cycles and maybe some easing of the funding pressure, where do you see pharma ordering playing out this year between first half and second half, and what products do you expect to lead the order book from pharma?
Tony Zook
Could you repeat the second half of the question, please?
Subbu Nambi
What products do you expect to lead the order book for pharma?
Tony Zook
Got it. Relative to pharma, I would say that my views certainly have not changed from where we were about 6 to 8 months ago.
We anticipated that this erosion that we were experiencing on the pharma side of the business would continue into 2026, albeit not at the same rate that we saw in 2025. I have always been of the belief that it would be 2027 before we would see a return to growth for that book of business, and that's how we built the guide.
We expect still to see modest erosion in the pharma book of business for 2026. Certainly it'll be much reduced from where it was, but still in that mid to upper 5% to 10% range for the pharma side of business.
I think the big part of the return to growth there is based on RaDaR ST. That will be one of the key growth drivers for us in that book of business.
There, we've had pretty good conversations, we've been well received. We're back at the table with RaDaR ST.
There seems to be a really good sense of interest in it, and that portfolio of opportunities continues to grow. Relative to the year, again the guide would still anticipate modest erosion in the pharma side of the business.
If we can get that back flat, that would then represent upside opportunity for us. Warren, I know the long lead cycle times, but perhaps you could talk about RaDaR ST and how that's been received.
Warren Stone
Tony, maybe a couple of comments there, Subbu. First and foremost, in terms of the focus, a little bit like on the clinical side, really our focus is to protect our position in diagnosis, but really look to grow in therapy selection and MRD.
We look at pharma in a very similar way. We're very well known from an IHC perspective, and we continue to focus on IHC because it's very relevant for pharma from an antibody-drug conjugate perspective, and it's a good door opener for us, but expect our focus to really lie towards therapy selection and MRD.
There's a strong alignment here between what we're doing in clinical and with pharma. As Tony said, robust opportunity pipeline that's developing with regards to RaDaR ST in pharma, some legacy users and many new users, and expect first bookings to materialize shortly.
Tony Zook
I do appreciate the question, Subu, because it gives us the opportunity to clarify it. The other thing I just would remind the group, this is a relatively small portion of our overall business.
We're talking it's about 5% to 6% of our overall business, and so we continue to put the primary focus and energies on the clinical side of the business with the intent to stabilize this business and return to growth in '27. Thanks for the question.
Subbu Nambi
Absolutely. Thank you for clarifying this.
Can you talk about the framework for LIMS integration this year, what's been finished, what's left to go, and then maybe how that will show up in earnings in 2026?
Warren Stone
I'd say where our focus is today, we've completed Flow, one of our key modalities. Our next step right now is around accessioning, and NGS is really where our focus is.
Again, aligning to our strategic priority, looking to be able to provide increased value both from an efficiency perspective and testing the traceability. Those would certainly be things that you would look to conclude in 2026, probably other modalities as well rolling into that, but we can certainly take that offline and provide more granular detail if you like.
Those are the key focus areas for us in 2026 is Molecular and Accessioning.
Tony Zook
All right. Thank you.
Subbu Nambi
All right. Thank you so much, guys.
Operator
Your next question is coming from Mike Matson with Needham. Please pose your question, your line is live.
Mike Matson
Hi, thanks everybody for taking our questions. This is Joseph on for Mike.
Just, I guess in terms of the guide for RaDaR for 2026 in the mid-single-digit millions, I'm just kind of wondering framing up your guys's confidence in the ability to hit that mid-single-digits number. I guess just trying to understand how much of that is the clinical side versus the biopharma side?
Maybe for both of those, which do you see to have the higher potential to drive upside to that mid-single-digit number?
Tony Zook
Thanks for the question, Mike. I would say first and foremost, we do have a high degree of confidence in that.
That's why it's in the guide at the midpoint level. We do have a high degree of confidence there.
Relative to the mix, yeah, I think it would be fair to say in the early part of the launch, you would expect a heavier component of that to probably be more on the pharma side than the clinical side, only because the clinical launch just takes time to build, right? We'll have the indications of head and neck and breast, and then you'll build, and you'll start to see a slow build of that activity.
Just with the lead times of the product, you start to see the clinical effect of that probably in the latter part of the year, whereas pharma, you have the opportunity to take on a little bit more of a pan orientation, and can secure pricing sooner. Then as we build the indications over time, you're going to see the clinical side of that business certainly accelerate, and that would be the largest of the drivers moving into the outer years with RaDaR ST.
Abhishek, anything else?
Abhishek Jain
No, I think, Tony, you have covered it very well. As we basically discussed in our prepared remarks, we are actually launching RaDaR ST by the end of this month, and that gives us very high degree of confidence of the numbers that we are putting in our guide.
Tony Zook
Thank you.
Mike Matson
Great. Then maybe just one more quick one.
Can you maybe just talk about the potential for continued ASP growth, I think you guys were kind of talking about high single digits, or upper single digits, maybe for 2026, but the potential for that to continue without any additional reimbursement announcements? What is currently approved and reimbursed in your pipeline of NGS products, PanTracer, as it stands today without LBx?
Tony Zook
I'll start, and Abhishek can join in as well. I think, look, the continued shift into NGS is going to continue to be the big driver of our AUP growth, as it was in 2025 as well.
I think that that is one factor. We expect to continue to have success with direct client bill pricing increases, which generally go in in the first quarter of the year.
We also are continuing to have success with managed care pricing increases, which started in the back half of last year. We're expecting full year impact of those to hit in '26, as well as new agreements and new increases approved.
Then finally, we're still working on other RCM initiatives to kind of close that gap between what we expect to be paid and what we are being paid. That AUP growth will come from those drivers to the extent we get additional indications or tests approved, that will be incremental on top of that growth.
Mike Matson
Thank you.
Operator
Your next question is coming from Tycho Peterson with Jefferies. Please pose your question, your line is live.
Tycho Peterson
Hey, thanks. Maybe one for Warren just on the sales force.
I appreciate your color on go-forward additions, but as we look back over the last year, obviously, ramping the sales force was a big focus. Maybe with that cohort matured, can you just talk about where they are in terms of productivity?
I think you called out over five tests ordered on providers, but maybe just any other metrics we can look to track the scaling up of the sales force over the last year? Then separately, are you baking anything in for Adaptive-related revenues this year, and any metrics you can provide there?
Warren Stone
Thanks, Tycho. Absolutely.
As you've pointed out, we did expand our sales force late '24 and into the beginning of 2025. We kind of see that sort of 6 to 9-month ramp-up period, and I'd say that then sort of maturing or that productivity of those resources was a big contributor to our success in H2 of 2025.
We anticipate that that's going to be a tailwind for us in the first half of the year for sure as that sort of momentum continues to annualize into this year. Again, the focus of those resources, they were oncology sales specialists, they're really focusing in on therapy selection and they're going to be supporting our launch from a RaDaR ST perspective in MRD.
That's really where the focus is. I would say that those resources are at productivity now, sort of in stride.
A positive is we've seen very, very low attrition as well, it's not like there's been a high turnover or anything, I feel we're executing well, and we're starting to see general increased productivity across our entire sales team, not just the 35 that we brought on board in 2025, the sort of entire 140 or so that we have within our complement today.
Tony Zook
Tycho, the only other few points, I'll do a little bragging for Warren and his team. He may be a little humble here.
I think if you look at how that expansion has taken place, there are some proof points that we can look to. First and foremost, you do got to look at that NPS score, right?
To have an NPS score of 79, which is step up from where it was already, and that's heavily based now with feedback from oncologists. I think that is a really positive sign that the reach and frequency model is beginning to have an effect.
Then within the subsegments of our own data, when you start to see 14% of oncologists and pathologists are now ordering five or more Neo tests, I think that's another proof point that this model is taking effect. We have now over 40%, we estimate, of oncologists, pathologists prescribing five or more tests.
I think these things are what's fueling the NGS growth opportunities for us, and I think to take this sales force on that journey over the past 12 to 16 months has been an incredible one, and one we're proud of, and one we're going to continue to build on. Then relative to your second question, I would say that from a revenue perspective, we look at the Adaptive partnership much probably more strategically than economically.
We see it as an offering that we can offer our customers that offers them then an expansive portfolio of opportunities for us. Over time, we'll be a company that can offer Flow MRD, we can offer Heme MRD, we'll have RaDaR ST, we'll have Next-Gen MRD.
That whole suite of products we think is an important one to offer. To have an outstanding partner like Adaptive is more strategic than I would say it's economic, at least for us, but we're going to continue to work and manage that relationship to the best of our ability.
Thanks for the questions.
Tycho Peterson
Thank you.
Operator
Your next question is coming from Dan Brennan with TD Cowen. Please pose your question, your line is live.
Dan Brennan
Great, thank you. Maybe just to start off just on PanTracer.
I understand the conservatism there. Just any more color about kind of the back and forth.
It sounds like it's imminent. The blood market is growing a lot faster than the tissue CGP market, you've had really good success on tissue volumes.
Just, is it just conservatism, or what do you expect once that's really dialed in for that PanTracer Liquid to grow at from a volume basis?
Tony Zook
I'll kick us off, and then Abhishek and Warren could add a little bit more. Dan, we have responded to all the questions that MolDX had relative to LBx, and so we're just kind of in a waiting a response mode.
Now what we have seen is across, it's not just us, but across the sector, it's been averaging about four to five turns through MolDX for new offerings, and so that puts us right around, four turns is right around the 12-month mark, and so that's kind of where we sit today. We are confident.
We see this is a when we get it, not an if we get it, and then that's why we thought just it was prudent to not include revenue for the first half of the year, and then just kind of a modest and slow build in the second half of the year, and anything that would come before that would then be opportunistic upside for us. Relative to kind of modeling at the high level, again you called it out, PanTracer Tissue is enjoying robust growth.
We highlighted before the volumes for '23 to '24 doubled. We saw the same almost nearly doubling in '24 to '25.
We think that's probably a decent predicate as a way to look at LBx over time. We look to our total NGS portfolio, of which the PanTracer family is a big driver of that, to experience a robust growth again in 2026 and beyond.
It's certainly in line with 2025, and then depending on MolDX timing, it could be better than 2025. Hopefully that gives you a little bit more color.
Warren, I don't know if you want to get any more specifics about how you're seeing with LBx and Tissue.
Warren Stone
I'll say the following. I think, Dan, you're right that the liquid market is growing faster.
Since the launch of PanTracer Liquid, we've actually seen a good acceleration across the category. We saw increase in utilization of PanTracer Tissue, and we've seen attractive uptake of PanTracer Liquid as well.
We feel, and actually we launched PanTracer Pro very late last week, and expect that to be another inflection point in terms of how this solution for solid tumor therapy selection is positioned for the market. I'm very confident in terms of the outlook here.
It's really just around unknowns with regards to MolDX reimbursement timing, I think, is what you're seeing within the thought process from a guide point of view.
Jeff Sherman
We launched PanTracer Tissue in the end of Q1 of '23, and it started to build throughout '23, and then we really saw a big uptake in the first and second quarter of 2024. That was a big driver of our NGS growth during that time.
Thanks, Dan.
Tony Zook
Great.
Operator
Your next question is coming from Puneet Souda with Leerink. Please pose your question, your line is live.
Puneet Souda
Hi, guys. Thanks for the questions here.
Just clarifying given the guide here, is the long-term LRP that you had put out earlier, I believe 12% to 13%, is that still in consideration or is that off the table? Then if I look at the same-store sales versus new test, 5% revenue per test growth reported versus 7% same-store sales, can you elaborate on how do you expect to convert these new customers to sort of higher-value test and how long would that take for us to start to see an impact there?
Thank you.
Tony Zook
Puneet, first on the first question, we're not talking LRP. We've tried to make it clear as we can that we're taking our feet and firmly planting them in the year we are in.
I'm not projecting out. I would simply say that I believe that this guide we are very confident in.
I think we will end the year in a very strong position with accelerated growth opportunities as we head into '27, and we would start to then see the full benefit of RaDaR ST and PanTracer LBx coming through the system. I won't go into any more relative to an LRP discussion.
The second question?
Jeff Sherman
From an AUP perspective, with the guide going on, I think adding those tests and coming in the back half of the year, you should expect AUP will grow as we add those incremental tests over time. I think '25 was kind of a good example of that.
Abhishek Jain
No, my sense is also that AUP as we kind of move into these high-value tests, right, because in any case these are going to be priced at a much better rate, and we expect the AUP will grow as you move in this direction.
Jeff Sherman
Yep. As you said, Puneet, the same-store excluding Pathline was higher, was in the mid-single digit in the quarter, and I think over time adding these tests in the back half of 2026 will help drive AUP growth as well.
Warren Stone
Puneet, maybe building on this sort of opportunity to penetrate and how long. Again coming back to that commercial strategy: protect, expand, acquire.
Done a really good job of protecting, that sort of hole in the bucket is really something that has improved significantly, and the NPS score sort of helps to drive that. The expand element of the strategy is very much around taking new products and selling them to existing customers.
That's an active part of the strategy, and we do that both on the pathology side of the business with the TBMs where relevant, but very specifically on the oncology side as well with the oncology sales specialists. As we bring on more and more new oncology practices, we typically lead in with a heme solution because that's where we're differentiated, and then we use that as a basis to expand into solid tumor.
It's difficult to give you a finite example of exactly how long it takes because every practice is different, but sales cycles here are relatively quick, and as soon as we can put sort of interfaces in place to streamline workflows, introduce things like PanTracer Pro, we expect the speed to accelerate through '26 and into '27 as well. It's an active part of the strategy, and very confident in our ability to pull that through based on past experiences.
Puneet Souda
Thanks, Puneet. Thanks.
Just very quickly on the leading with heme and then entering with solid tumor into those accounts, could you just elaborate on sort of what you see as the competitive landscape in tissue CGP today and also liquid, obviously, significant penetration in the market, multiple competitors out there? Maybe just give a sense of how you think you're positioned today in the community setting versus the competition that you're seeing in the community setting?
Thank you.
Warren Stone
Puneet, I'd say that we haven't seen a marked change in terms of what's happening from a landscape perspective on the solid tumor side of things in the community setting where we're focused. As we've said before, we tend to bump into most of the normal competitors in different parts of the country, etc.
We find our portfolio to be very well received based on the fact that we focus on actionability and a high degree of service. A stat that Tony shared earlier that 75% or three out of four new oncologists that try us tend to stay with us.
That's not only unique in the heme side of things, that happens through on the solid tumor side of things as well. Certainly it is a competitive landscape, but I can't say I've seen any material changes, and we're seeing success on the liquid side of things as well, despite the fact that we're a late entrant.
I put that down to the fact that we have a broad portfolio and physician practices are looking to simplify their workflows and standardize on vendors, and that places NeoGenomics in a very favorable position. Thank you.
Puneet Souda
Great. Thank you.
Operator
Your next question is coming from Mason Carrico with Stephens Inc. Please pose your question, your line is live.
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Mason Carrico
Hey, guys. On MRD, for the two indications that you submitted, do you plan on launching RaDaR for those indications ahead of MolDX approval to start building that volume stream, or do you plan on launching after you gain coverage?
Abhishek Jain
As I tried to convey earlier, we're going to stay focused on the two initial indications of head and neck and the subsets of breast in the initial launch period, and then we will expand accordingly as we get MolDX coming through the system. There certainly would be enough on our plate in the short term with just those two, and then we'll build in the latter half of the year.
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Mason Carrico
Got it. Then on the 23% NGS growth in the quarter, could you provide any additional detail, I guess, on how much of that maybe came from the core existing business versus pull-through tied to the Pathline acquisition?
Puneet Souda
The bulk of it would still be the existing business, with Pathline starting to ramp is how I would characterize it.
Warren Stone
We're certainly seeing increased activity and penetration in the Northeast, but just, yeah, the center of gravity lies towards the other business, therefore that's where the lion's share is still coming from. ):
Mason Carrico
Got it. Thanks.
Operator
Your next question is coming from Mark Massaro with BTIG. Please pose your question, your line is live.
Mark Massaro
Hey, guys. Thanks for taking the questions.
I'll keep it to one. Can you just speak about how we should think about gross margins in 2026?
2025 was obviously down. When we put sort of the different increase in next-gen, I can see how there could be a path to gross margins increasing in '26, but however, there are some other headwinds as well.
Can you just give us a sense if you think gross margins can grow this year and any ability to quantify, that would be helpful.
Abhishek Jain
Sure. Absolutely, Mark.
Let me take this question. Most of our adjusted EBITDA margin expansion in the current year in 2026 is going to be coming from the gross margin.
We are anticipating the gross margins to expand at about 100 basis points, and that's going to basically drop to the adjusted EBITDA margin expansion as well. There are multiple reasons, of course, on the gross margin expansion as we kind of look at our pricing increases, as well as we rationalize our portfolio to the high-value, high-margin products, as well as the work that our labs are doing to be more efficient being there.
The gross margin is expected to improve at about 100 to 120 basis points in 2026, and most of that is going to be dropping to our bottom line on the adjusted EBITDA.
Mark Massaro
Great. Thank you.
Puneet Souda
Thanks, Mark.
Operator
Your next question is coming from Andrew Cooper with Raymond James. Please pose your question, your line is live.
Warren Stone
Hey, everybody. Thanks for the question.
Maybe first, Tony, I think you said you expected NGS growth to look pretty similar in '26 to 2025. I know the target's 25%.
You were almost there, but not quite. You have some of these tailwinds when we think about PanTracer Liquid coming on at least in the back half.
I don't know if you'll count MRD in kind of that bucket with NGS when you think about the target, but how do we think about that trending through the year, especially in context of a sales force that'll be essentially tripled or quadrupled by the time you're done adding?
Abhishek Jain
I think as you rightly put out, we showed about 23% for the quarter, about 22% year-over-year for NGS growth. I would expect that we should be able to do that in 2026, if not even slightly better than that.
That's going to be driven, as you say, by the momentum of the sales force that we have, the addition of LBx into the portfolio, PanTracer Pro. We expect that we should do at least as well as we did in 2025 with the opportunity to maybe even beat that slightly, and much of that will be dependent on the timing of LBx.
I think that's a safe assumption to take into the year.
Andrew Cooper
That's helpful. Then maybe just lastly, for Jeff or Abhishek or Tony, if you want to chime in as well, but when we think about that shift of growth being heavier volume versus ASP to the other way around and more ASP or AUP driving that growth, how does that change the way you think about that margin drop-through over the longer term?
It sounds like, when we think about '26, there's certainly some reinvestment that's probably eating up a bit of the flow-through that would be there otherwise, but how does that change the way you think about sort of the long-term trajectory from a margin perspective, if at all?
Tony Zook
Great question.
Abhishek Jain
No, that's a great question, Andrew. That's, I think, the key strategy question that we have with Neo, that we have a broad range of portfolio here.
We have tests that are $100, $200 AUP, and then we have very high-value tests of the NGS side. Now, that also basically kind of differentiates us from some of the other specialty diagnostic labs as to how we are thinking about our volumes.
Now, when we look at our capacity, when we're looking at our portfolio, we would definitely want to be selling to the customers that are giving us the business which is not only the low value, but also either there's a portfolio which combines the low-value tests with the high-value testing, and then that becomes more positive for us. If a client is only giving us the low-order-value test, and there is a natural shift that we do not want to be kind of taking that particular business.
That's where we are looking at more carefully as to okay, what are those tests that we would want to be in. From the margin standpoint, in the long term, as we kind of shift towards the high-value, high-margin tests, that will definitely be accretive to our gross margins, as we kind of also going to be able to improve our operational efficiencies using our lab infrastructure.
Andrew Cooper
Thank you. Great.
Operator
Thank you. This does conclude today's question-and-answer session.
I'd now like to turn the floor back over to Tony Zook.
Tony Zook
I'd just like to thank everybody for joining us on the call, and I'd also like to thank our roughly 2,400 teammates for their unwavering commitment to our mission and their hard work throughout all of 2025. I'm very excited for the year ahead for our company, for our oncology physician customers, and their patients.
I look forward to our next quarterly update in April, where we'll report our first quarter results. Thank you again, and have a great day.
Operator
Thank you, everyone. This does conclude today's conference call.
You may disconnect your phone lines at this time, and have a wonderful day. Thank you for your participation.