NeoGenomics Raises 2026 Guidance as Q3 NGS Revenue Grows 29%

NeoGenomics Inc. raised its full-year 2026 revenue and adjusted EBITDA guidance after third-quarter revenue increased 11%, supported by double-digit clinical growth, strong next-generation sequencing demand and wider adjusted margins.

The oncology testing company reported quarterly revenue of $209 million, up from $188 million a year earlier. Adjusted EBITDA rose 53% to $19 million from $12 million, while adjusted EBITDA margin expanded 240 basis points to 8.9%.

NeoGenomics now expects 2026 revenue of $807 million to $809 million, compared with its July forecast of $802 million to $806 million. The company also increased its adjusted EBITDA outlook to approximately $60 million from a previous range of $56 million to $58 million. The updated targets imply roughly 11% revenue growth and about 38% adjusted EBITDA growth at the guidance levels provided.

Clinical and NGS Growth

Clinical revenue increased 13% to $195 million from $172 million. Clinical test volume rose 2% to 367,000 tests despite headwinds from the strategic reduction of a high-volume, low-value contract and the exit from non-oncology testing associated with the Pathline acquisition.

Average unit price increased 11% to $530. NeoGenomics attributed about two-thirds of that improvement to a shift toward higher-value tests and one-third to revenue-cycle management.

Next-generation sequencing remained the principal growth driver. NGS revenue increased 29%, with volume up 17%. NGS represented approximately one-third of clinical revenue while accounting for about 10% of clinical volume, reflecting the higher value of those tests. Large-panel volume across hematologic malignancies and solid tumors grew more than 25%.

For the full year, management expects NGS revenue growth of more than 25% and mid-teens volume growth. The guidance also assumes low-teens clinical revenue growth, mid-single-digit millions of revenue from both PanTracer LBx and RaDaR solid-tumor testing, and a low-double-digit percentage decline in non-clinical revenue.

Margins and Infrastructure Investment

Third-quarter adjusted gross margin reached 49%, expanding by more than 300 basis points year over year. The company cited a mix shift toward higher-value testing, revenue-cycle management and efficiencies from its “Lab of the Future” program.

NeoGenomics expects full-year adjusted gross margin of at least 47.5%, representing well over 150 basis points of annual expansion. Adjusted gross margin and adjusted EBITDA are non-GAAP measures.

Operating expenses increased 4% on a non-GAAP comparative basis to $105 million, excluding $7.1 million of non-recurring impairment charges recorded in the prior-year quarter. Investments in sales and research and development were partly offset by general and administrative leverage.

The company ended the quarter with $139 million in cash. During the period, it invested $5 million in NovaSeq X systems and related data infrastructure and completed a $10 million payment to the U.S. Department of Justice to resolve a legacy, self-disclosed matter.

NeoGenomics’ infrastructure program includes digital pathology, laboratory automation and AI-assisted analysis, sequencing-platform upgrades, a unified laboratory information management system, procurement savings and laboratory-footprint optimization. The company is also modernizing its information technology and revenue-cycle management systems, while the NovaSeq X transition remains on track.

MRD Expansion and Leadership Transition

NeoGenomics identified RaDaR solid-tumor minimal residual disease testing as a strategic growth area. The company said MolDX reimbursement for immunotherapy monitoring supports its launch into a U.S. opportunity it estimates at approximately $3.9 billion. The use case involves recurring blood draws for patients receiving immunotherapy across multiple solid tumors.

RaDaR orders have also generated additional testing demand, with an approximately 30% concurrent attachment rate. NeoGenomics said it currently has access to more than 20% of the MRD total addressable market through three indications and could reach more than 40% if two pending submissions are successful. Reimbursement timing and outcomes remain outside the company’s control.

The company had more than 160 sales resources at the end of the quarter, organized into dedicated oncology and pathology teams. It is also integrating ordering and result delivery with systems including Epic Aura and Flatiron and providing customers with greater visibility into expected test completion times.

NeoGenomics separately outlined leadership changes effective Jan. 4, 2027. President and Chief Operating Officer Warren Stone will become chief executive and join the board, while current CEO Tony Zook will become executive chairman. Michael Kelly will become lead independent director, and current chair Lynn Tetrault will not seek reelection.

The outlook depends on NeoGenomics achieving anticipated test adoption, reimbursement and collection levels while executing laboratory, information technology and billing-system changes without significant disruption. Other risks identified by the company include competition, the ability to retain key personnel during the leadership transition, commercialization of new tests and the execution of its margin-expansion initiatives.