Achieved the critical milestone of positive operating cash flow in Q4 2025, validating the strategic thesis of the Greenbrook acquisition through revenue growth and expense discipline.

Delivered 23% adjusted pro forma revenue growth driven by record capital shipments and a 28% increase in clinic revenue, reflecting successful integration of the national care delivery network.

Realigned the NeuroStar capital sales team to focus on 'TMS-ready' accounts—practices with existing staff and insurance credentialing—to accelerate the timeline from system purchase to first patient treatment.

Expanded the referring provider network by 25% year-over-year through a Regional Account Manager program that completed over 47,000 physician outreach activities in 2025.

Optimized clinic economics by implementing a disciplined, state-by-state approach to SPRAVATO billing, balancing 'buy-and-bill' versus 'administer-and-observe' models based on payer dynamics.

Leveraged internal infrastructure to launch a B2B service model, providing benefits investigation and patient management support to external national enterprise accounts like Transformations Care Network.

Projecting 2026 total revenue between $160 million and $166 million, with clinic business growth expected in the double digits to mid-teens.

Implementing efficiency initiatives to reach an annualized operating expense run rate of less than $100 million by the fourth quarter of 2026.

Anticipating positive operating cash flow for the full second half of 2026, following typical first-quarter seasonality and annual incentive outlays.

Piloting new capital acquisition models in Q1 2026 to provide flexible technology access for diverse customer segments beyond traditional purchase structures.

Preparing for a potential 2027 commercial launch of COMP360 psilocybin therapy, utilizing existing REMS-compliant infrastructure and clinical staff at Greenbrook locations.

Announced a leadership transition with Dan Reavers appointed as President and CEO, effective March 23, 2026, to lead the company's next scaling phase.

Amended the debt agreement with Perceptive in March 2026, including a $5.0 million principal paydown to reduce interest expense and optimize the balance sheet.

Disclosed an ongoing investigation by the U.S. Attorney's Office in Florida regarding Greenbrook's billing practices prior to its acquisition by Neuronetics.

Noted that Q1 2026 guidance reflects typical seasonality where patient volumes and capital budgets are historically at their lowest annual levels.

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Management confirmed they are cooperating fully with the U.S. Attorney's Office regarding a Civil Investigative Demand (CID).

The documentation requested specifically pertains to billing practices that occurred prior to Neuronetics' acquisition of Greenbrook.

The treatment is expected to be administered under a REMS protocol similar to SPRAVATO, requiring supervised dosing in certified clinic settings.

Management stated they will only pursue the therapy if reimbursement levels ensure it is a profitable business, with ongoing discussions alongside COMPASS Pathways to establish favorable payer policies.

SPRAVATO represented approximately 35% of treatment volume by the end of 2025 and is expected to continue growing as a percentage of total volume due to its long-term maintenance nature.

Q1 2026 growth will be specifically aided by the year-over-year comparison of 'buy-and-bill' revenue, which was not fully established in early 2025.

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