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Dec 31, 2025
BillionToOne, Inc. Q4 2025 Earnings Report
BillionToOne, Inc. Q4 2025 Earnings Report
Key Takeaways
BillionToOne delivered a strong fourth quarter with 113% revenue growth and a successful transition to GAAP profitability. The company saw significant expansion in its oncology segment and improved gross margins to 71%, leading to a raise in its full-year 2026 revenue guidance.
Total revenue grew 113% year-over-year to $96.1 million, driven by volume growth and higher ASP.
Achieved GAAP operating income of $10.3 million, compared to an $11.7 million loss in the prior year period.
Oncology clinical testing revenue increased more than 8x year-over-year to $9.1 million.
Gross margin expanded by 14 percentage points to 71% due to higher ASP and lower cost-per-test.
Revenue by Segment
Forward Guidance
BillionToOne raised its full year 2026 revenue outlook and expects continued profitability.
Positive Outlook
- Raised 2026 revenue guidance to $430 million - $445 million.
- Expected annual revenue growth of 41% to 46%.
- Expects positive GAAP operating income for the full year 2026.
- Recent launch of Northstar PGx and Northstar Select CH in oncology.
- Expansion of Red Blood Cell and Platelet Fetal Antigen NIPT offerings.
Challenges Ahead
- Operating expenses increased 56% year-over-year.
- Clinical Trial Support segment showed minimal growth (6%) compared to core clinical lines.
- Potential for increased competition in the NIPT and oncology profiling markets.
- Macroeconomic risks associated with healthcare payer coverage shifts.
Revenue & Expenses
Visualization of income flow from segment revenue to net income
Historical Earnings Impact
Analyze how earnings announcements historically affect stock price performance
Avg. Return Before/After Earnings
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