CareDx Raises 2026 Outlook as Q3 Revenue Grows 39%

CareDx Inc. (Nasdaq: CDNA) increased its full-year 2026 revenue and adjusted EBITDA guidance after third-quarter revenue rose 39%, supported by transplant testing growth, the first full quarter of its specialty oncology business and out-of-period revenue.

The company now expects 2026 revenue of $520 million to $530 million, up from its previous range of $490 million to $500 million. The updated outlook includes $53 million of out-of-period revenue. CareDx also raised its adjusted EBITDA forecast to $90 million to $100 million from $66 million to $78 million.

At the midpoint, the new guidance represents revenue of $525 million, or 38% growth from 2025, and adjusted EBITDA of $95 million, equivalent to 18% of revenue. CareDx’s implied fourth-quarter model calls for revenue of $131 million to $141 million and adjusted EBITDA of $16 million to $26 million.

Testing services drive quarterly growth

Third-quarter revenue reached $139.4 million, compared with $100.1 million a year earlier and $131.9 million in the second quarter. Testing-services revenue increased 65% year over year to $119 million, lifting testing’s share of total revenue to 86% from 72% in the prior-year period.

Patient and digital revenue rose 31% to $20 million. CareDx recorded no lab-products revenue after selling that business at the end of the second quarter.

Testing volume increased 51% year over year to 75,900 tests. Transplant volume grew 21% and advanced 5% sequentially, while specialty oncology contributed 15,150 tests following the July 1 acquisition of that business. CareDx said specialty oncology volume was 35% above the volume reported by Naveris for the prior-year quarter before the acquisition, though those earlier volumes were not part of CareDx’s reported results.

Overall testing revenue per test was $1,570, up 9% year over year but down 9% sequentially as specialty oncology entered the mix at a lower revenue per test. Transplant testing accounted for 80% of volume and generated $1,756 per test, a 22% year-over-year increase. Specialty oncology represented the remaining 20% at $823 per test.

Profitability expands, with out-of-period revenue contributing

GAAP gross profit was $99.1 million, producing a 71% gross margin, compared with 69% a year earlier. Non-GAAP gross margin expanded to 74% from 71%, while non-GAAP gross profit rose to $102.5 million from $70.9 million.

The quarter included $14.7 million of out-of-period revenue, which contributed to the margin performance. CareDx also attributed the improvement to cost discipline and higher revenue per test.

Adjusted EBITDA nearly doubled to $30.5 million from $15.3 million, and the adjusted EBITDA margin widened to 22% from 15%. GAAP net income was $19.3 million, compared with $1.7 million in the prior-year quarter.

GAAP operating expenses increased to $91 million from $69.6 million, reflecting higher research and development, sales and marketing, and general and administrative spending. Non-GAAP operating expenses were $75.3 million, up from $57.9 million.

Free cash flow was $11.1 million, down from $36.1 million a year earlier. CareDx ended the quarter with $250 million in cash and no debt.

Transplant workflows and oncology integration

CareDx said stronger engagement with transplant centers, broader use of testing protocols—particularly in kidney and lung transplantation—and workflow integration supported transplant volume. Twenty-one centers were live on its Epic Aura integration at quarter-end, and the company expects about half of transplant order volume to flow through electronic medical record integrations by year-end.

The quarter was also the first full reporting period for NavDx, CareDx’s specialty oncology test. The company is integrating revenue-cycle operations, reimbursement processes and clinical workflows while using its commercial and patient-support capabilities to expand adoption.

CareDx highlighted additional clinical evidence for its transplant and oncology products. A multinational randomized trial involving 332 kidney transplant recipients found that an AlloSure-based monitoring strategy resulted in 49% fewer biopsies from months three through 12 than biopsy-based monitoring, with similar rates of biopsy-proven acute rejection.

The company also said development of AlloHeme, a blood-based relapse-monitoring test for acute myeloid leukemia and myelodysplastic syndromes, and HistoMap Kidney, a tissue-based molecular test for rejection subtyping, remains on track. CareDx expects both programs to be ready under Clinical Laboratory Improvement Amendments standards by the end of 2026, with commercial launches planned for 2027.

For the fourth quarter, management expects testing volume of 76,000 to 80,000, including 61,000 to 63,000 transplant tests and 15,000 to 17,000 specialty oncology tests. The company projects testing-services revenue of $112 million to $122 million, including about $8 million of out-of-period revenue, and a non-GAAP gross margin of 71% to 72%.

CareDx cautioned that its guidance and pipeline timelines are forward-looking and subject to economic, market and operational uncertainties. The company also noted that forecasted non-GAAP measures cannot be reconciled to GAAP because it cannot accurately quantify certain required adjustments.