Lumexa Imaging (Nasdaq: LMRI) Reports Strong Q4 and Full Year 2025 Results and Reiterates 2026 Outlook

Raleigh, North Carolina, March 26, 2026 – Lumexa Imaging Holdings, Inc. (Nasdaq: LMRI), one of the largest providers of outpatient imaging services in the United States, has released its preliminary, unaudited financial results for the fourth quarter and full year ended December 31, 2025. The company also reaffirmed its guidance for 2026.

Key Highlights – Potentially Price-Sensitive Information

• Strong Revenue Growth: Consolidated revenues for Q4 2025 rose to \$267.7 million, representing a 7.9% year-over-year increase. Full-year 2025 revenues were \$1.023 billion, up 7.8% from 2024.
• Adjusted EBITDA Growth: Q4 Adjusted EBITDA increased 18.6% year-over-year to \$63.8 million, with a 23.8% margin. For the full year, Adjusted EBITDA was \$230.2 million, up 14.6%, with a 22.5% margin.
• Leverage Reduction: The company reduced its leverage ratio by two turns, from 5.5x to 3.5x, generating over \$50 million in annual cash savings. This substantial deleveraging strengthens the balance sheet and reduces financial risk.
• Net Loss Narrows: Net loss was \$28.7 million for Q4 2025 versus \$25.1 million in Q4 2024. For the full year, net loss significantly narrowed to \$47.1 million from \$94.1 million in 2024.
• Expansion of Imaging Centers: Ten new imaging facilities were added in 2025—nine de novo centers (six wholly owned, three joint ventures) and one acquired site. This is a record for the company and sets the stage for future growth.
• Advanced Procedure Growth: Same-center advanced volume growth was 12.7% (consolidated) and 9.2% (system-wide) in Q4. For the year, growth was 8.0% (consolidated) and 7.1% (system-wide).
• Return to In-Network Status: The company returned in-network with a large payer in New Jersey, supporting increased imaging volumes.
• System-wide Expansion: In 2025, Lumexa conducted approximately 4 million outpatient procedures system-wide across more than 188 centers in 13 states.

2026 Outlook (Reiterated)

• Revenue Guidance: Consolidated revenues expected to be between \$1.045 billion and \$1.097 billion.
• Adjusted EBITDA: Projected in the range of \$234 million to \$242 million, including approximately \$7 million in public company costs not incurred in 2025. At the midpoint, EBITDA growth would be 4% year-over-year (7% excluding new public company expenses).
• Adjusted EPS Guidance: Adjusted EPS projected between \$0.71 and \$0.77 per share.

Strategic Initiatives and Operational Focus

• The company’s growth strategy centers on same-center expansion, geographic expansion, and advanced imaging modalities.
• Durable demand tailwinds and the ongoing shift toward outpatient care are expected to further support growth and margin expansion.
• Management highlighted a continued focus on delivering high-quality, lower-cost imaging and improving access for patients, providers, and payors.

Financial Condition and Liquidity

• Balance Sheet: As of December 31, 2025, cash and cash equivalents were \$58.8 million, up from \$26.1 million at the end of 2024.
• Total Assets: \$1.76 billion (2025) vs. \$1.67 billion (2024).
• Total Liabilities: \$1.18 billion (2025) vs. \$1.51 billion (2024).
• Total Equity: \$586.1 million (2025) up sharply from \$161.7 million (2024), reflecting the impact of the initial public offering (IPO) and other capital actions.
• IPO Activity: Proceeds from the IPO netted \$434.8 million.
• Debt Reduction: The company repaid \$1.2 billion of long-term debt and issued \$827.8 million in new long-term debt, with ongoing efforts to optimize its capital structure.

Operating Performance and Procedure Volume Details

• Q4 Consolidated Procedures: 627,293 total procedures (up 10.1% YoY), with 190,982 advanced procedures (up 14.2% YoY).
• 2025 Full-Year Consolidated Procedures: 2,418,096 total (up 4.6%), with 728,304 advanced procedures (up 7.8%).
• System-wide Procedures: 3,972,228 for the year (up 3.4%), with 1,444,618 advanced procedures (up 7.7%).
• Advanced Procedures Mix: Advanced procedures (MRI and CT) made up 30.1% of consolidated volumes (up 90bps) and 36.4% system-wide (up 145bps).

Non-GAAP Measures and Adjustments

The company utilizes Adjusted EBITDA and Adjusted EPS as non-GAAP performance metrics. Adjustments include add-backs for depreciation/amortization, interest, tax, equity earnings, stock-based compensation, severance and recruiting expenses, strategic initiatives, transaction costs (including IPO and M&A due diligence), litigation/settlements, and other one-time items.

Risks and Forward-Looking Statements

The company emphasizes that its guidance and projections contain forward-looking statements subject to risks and uncertainties, including but not limited to those outlined in its SEC filings. Actual results may differ materially from those currently anticipated.

Upcoming Events

• Earnings Call: Lumexa Imaging will host an earnings conference call and webcast on March 26, 2026 at 8:30 a.m. ET. Details and a link for registration are provided in the release.

Potential Share Price Impact

• Key Price-Sensitive Drivers:
  • Strong Adjusted EBITDA growth and margin expansion.
  • Significant reduction in leverage, improving the company’s financial flexibility and lowering interest costs.
  • Narrowing net losses and a substantial improvement in equity, bolstered by IPO proceeds.
  • Record expansion in de novo imaging centers, supporting future revenue and volume growth.
  • Confirmation and reiteration of 2026 guidance.
  • Return to in-network status with a major payer, positively impacting volumes and revenues.

Disclaimer: This article is for informational purposes only and does not constitute investment advice. The financial results discussed are preliminary and unaudited, and actual results could differ. Investors should review the company’s official SEC filings and consult with a financial advisor before making investment decisions. The company’s forward-looking statements are subject to risks and uncertainties.

View Lumexa Imaging Holdings, Inc. Historical chart here