0001628280-25-053166
SEC filingRevenue surged 240% YoY to $267.8M driven by IDR process success and 11% visit growth, net income swung to $55.4M.
For the three months ended September 30, 2025, Nutex Health reported total revenue of $267.8 million, a 239.8% increase from $78.8 million in the prior year period. Net income attributable to Nutex Health was $55.4 million ($8.27 per diluted share) compared to a net loss of $8.8 million ($1.72 loss per share) in 2024. The dramatic improvement was driven by a 262.8% revenue increase in the hospital division, which accounted for the vast majority of total revenue. Revenue per visit benefited from successful Independent Dispute Resolution (IDR) outcomes and a shift to higher-acuity services (observation and in-patient stays). Patient visits rose 11.0% year-over-year, boosted by four new hospitals opened in 2024. Gross margin expanded to 57.8% from 27.8% as revenue growth outpaced cost of services.
Corporate and other costs increased to $24.5 million from $12.3 million, primarily due to a $11.3 million surge in stock-based compensation for under-construction and ramping hospitals. Interest expense edged up slightly to $5.5 million. Income tax expense rose to $27.1 million from $4.6 million, reflecting higher pre-tax income. Adjusted EBITDA reached $98.5 million, up from $9.7 million, underscoring operating leverage.
The hospital division revenue grew 262.8% to $260.2 million, with mature hospitals (opened by end of 2021) contributing 208.9% of the increase. Gross profit for the hospital division soared 618.8% to $154.1 million. The population health management division revenue increased modestly by 7.1% to $7.6 million, with gross profit of $0.9 million. The real estate division had a nominal gross loss. Segment momentum is heavily weighted toward the hospital division, which benefits from out-of-network billing and the federal IDR process.
Management expects to open three new hospital facilities by year-end 2025 and launch one to three additional IPAs annually. The company faces regulatory uncertainty, particularly regarding the No Surprises Act and ongoing litigation that could affect IDR outcomes. The share repurchase program of up to $25 million was authorized in August 2025. No specific quantitative guidance was provided. The company’s cash position strengthened to $166.0 million, supporting growth initiatives. Key risks include potential adverse changes in healthcare laws and the outcome of lawsuits against HaloMD, though Nutex is not a party.
As of September 30, 2025, Nutex Health held $166.0 million in cash and cash equivalents, a significant increase from $40.6 million at December 31, 2024, driven by strong operating cash flow of $177.7 million in the first nine months. Total debt stood at $49.1 million, up from $41.4 million, primarily due to new seller notes and deferred payments from acquisitions. Shareholders' equity more than doubled to $438.0 million, reflecting net income and stock-based compensation.
Accrued arbitration expenses reached $64.3 million, related to out-of-network claim disputes under the No Surprises Act. The company also has $11.2 million in stock-based compensation liabilities for under-construction hospitals, measured at fair value using Monte Carlo simulation. Operating and finance lease liabilities total $309.7 million, with $9.2 million current. The company has $5.9 million available under lines of credit.
Net debt increased by $7.7 million during the period. Capital expenditures were modest at $1.4 million (0.19% of revenue), focused on the hospital division. No share buybacks or dividends were declared. The company issued $0.5 million in common stock for debt conversion and $0.3 million through employee stock purchases.
The company operates three segments: Hospital, Population Health Management (PHM), and Real Estate. Hospital division revenue of $260.2 million in Q3 2025 (up 263% YoY) contributed 97% of total revenue. Hospital division income before taxes was $147.5 million, reflecting a 56.7% margin. PHM revenue grew 7.1% to $7.6 million, with income before taxes of $0.9 million. Real estate division recorded a small loss. No geographic breakdown is provided.
Net income of $163.7M provided a strong base, but operating cash flow of $177.7M exceeded net income due to non-cash charges like stock-based compensation ($119.6M), depreciation ($15.3M), and deferred taxes ($22.9M). However, large working capital outflows tempered cash generation: accounts receivable increased $155.0M, income tax receivable rose $12.1M, and prepaid expenses grew $6.4M. These were partially offset by increases in accounts payable ($36.6M) and accrued arbitration expenses ($16.6M).
Capital expenditures were minimal at $1.1M, indicating low reinvestment. Despite strong operating cash flow, the company made significant members' distributions of $42.2M, reducing cash available for growth. Financing activities used $52.2M, primarily from distributions and debt repayments.