8-K: Tempus AI Soars: Q4, Full Year 2025 Growth & Strong 2026 Outlook

Tempus AI, Inc. reported robust financial results for Q4 and full year 2025, driven by significant growth in diagnostics and data, alongside positive 2026 revenue and Adjusted EBITDA guidance.

Summary

• Fourth quarter 2025 revenue reached $367.2 million, an 83.0% increase year-over-year, with 33.5% organic growth excluding Ambry.
• Full year 2025 revenue was $1.3 billion, up 83.4% year-over-year.
• Diagnostics revenue in Q4 2025 grew 121.6% year-over-year to $266.9 million, fueled by 29% Oncology volume growth and 23% Hereditary volume growth.
• Full year 2025 Diagnostics revenue was $955.4 million, an increase of 111.5% year-over-year.
• Data and Applications revenue for Q4 2025 was $100.4 million, up 25.1% year-over-year, with Insights (data licensing) growing 69.5% excluding the AstraZeneca warrant impact in Q4 2024.
• Full year 2025 Data and Applications revenue accelerated 30.9% year-over-year to $316.4 million.
• MRD volume in the fourth quarter was approximately 4,700 tests, a 56% increase quarter-over-quarter.
• The company ended 2025 with over $1.1 billion in Total Remaining Contract Value and 126% Net Revenue Retention.
• Cash and marketable securities stood at $759.7 million as of December 31, 2025.
• Gross profit increased 94.7% year-over-year to $237.7 million in Q4 2025, and 109.4% to $797.9 million for the full year.
• Net loss for Q4 2025 was ($54.2 million), which included $48.7 million of stock compensation expense.
• Full year 2025 net loss was ($245.0 million), including $136.3 million of stock compensation expense.
• Adjusted EBITDA improved to $12.9 million in Q4 2025, compared to ($7.8 million) in Q4 2024 and $1.5 million in Q3 2025.
• Full year 2025 Adjusted EBITDA improved by $97.3 million year-over-year to ($7.4 million).
• Tempus AI provided 2026 revenue guidance of approximately $1.59 billion, representing about 25% annual growth, and expects full year 2026 Adjusted EBITDA of approximately $65 million.
• Recent operational highlights include the launch of Paige Predict, an AI-powered digital pathology suite, and results demonstrating the Tempus AI-driven Immune Profile Score (IPS) test's accuracy in predicting immunotherapy outcomes.
• The company entered a multi-year strategic collaboration with NYU Langone Health and was selected by Northwestern Medicine to expand genomic testing access.

Sentiment

Score: 8

Explanation: StockSavvy.ai views this as a strong report, demonstrating significant revenue growth, improving profitability metrics (especially Adjusted EBITDA turning positive in Q4), and clear positive guidance for 2026, indicating strong operational momentum and market adoption of its AI-driven precision medicine solutions.

Positives

• Strong revenue growth: 83.0% year-over-year in Q4 2025 and 83.4% for the full year 2025, reaching $1.3 billion.
• Significant Diagnostics revenue growth: 121.6% year-over-year in Q4 2025 and 111.5% for the full year, driven by robust volume increases (Oncology +29%, Hereditary +23% in Q4).
• Accelerating Data and Applications revenue growth: 25.1% year-over-year in Q4 2025 and 30.9% for the full year, with Insights growing 69.5% in Q4 (excluding AstraZeneca warrant impact).
• Improved profitability metrics: Q4 2025 Adjusted EBITDA turned positive at $12.9 million, a substantial improvement from a loss in the prior year and prior quarter. Full year Adjusted EBITDA improved by $97.3 million to ($7.4 million).
• Strong balance sheet: $759.7 million in cash and marketable securities as of December 31, 2025.
• High Total Remaining Contract Value: Over $1.1 billion, indicating future revenue visibility.
• Excellent Net Revenue Retention: 126%, demonstrating strong customer loyalty and expansion.
• Positive 2026 guidance: Revenue of $1.59 billion (~25% growth) and Adjusted EBITDA of $65 million, signaling confidence in continued growth and profitability.
• Key operational advancements: Successful launch of Paige Predict and validation of the AI-driven Immune Profile Score (IPS) test, enhancing product offerings and clinical utility.
• Strategic collaborations: New partnerships with NYU Langone Health and Northwestern Medicine expand market reach and research capabilities.

Negatives

• The company reported a net loss of ($54.2 million) in Q4 2025 and ($245.0 million) for the full year 2025.
• Significant stock compensation expense of $48.7 million in Q4 2025 and $136.3 million for the full year 2025 contributed to the net loss.
• Full year 2025 Adjusted EBITDA remained negative at ($7.4 million), despite substantial improvement.
• Loss from operations was ($61.4 million) in Q4 2025 and ($252.9 million) for the full year 2025.
• Interest expense for the full year 2025 was $70.3 million.
• A loss on debt extinguishment of $12.0 million was recorded for the full year 2025.

Risks

• Risks related to the intended use of Tempus products and services.
• Risks related to Tempus' financial performance.
• The ability to attract and retain customers and partners.
• Challenges in managing Tempus' growth and future expenses.
• Competition and new market entrants in the precision medicine and AI healthcare space.
• Compliance with new laws, regulations, and executive actions, including evolving regulations in the artificial intelligence space.
• The ability to maintain, protect, and enhance Tempus' intellectual property.
• The ability to attract and retain qualified team members and key personnel.
• The ability to repay or refinance outstanding debt, or to access additional financing.
• Risks associated with future acquisitions, divestitures, or investments, including the ability to realize the expected benefits of the acquisition of Paige AI, Ambry Genetics, and Deep 6 AI.
• Potential adverse impact of climate change, natural disasters, health epidemics, macroeconomic conditions, trade tensions and tariffs, and war or other armed conflict.

Future Outlook

Tempus AI projects full year 2026 revenue of approximately $1.59 billion, representing about 25% annual growth, and anticipates full year 2026 Adjusted EBITDA to be approximately $65 million. The company expects network effects from its investments in AI to continue compounding, driving significant growth over the next several years and enhancing the lives of millions of patients around the world.

Management Comments

• "In 2025, Tempus continued to set the standard for what it means to be a technology company operating in the healthcare space."
• "The strength of our unit growth in diagnostics along with the accelerating growth of our data business is proof that we are unique in this space."
• "As the network effects from our investments in AI continue to compound, we expect to not only drive significant growth over the next several years, but to also enhance the lives of millions of patients around the world."

Industry Context

StockSavvy.ai notes that Tempus AI's strong performance in diagnostics and data, particularly with AI-driven solutions like Paige Predict and the Immune Profile Score, positions it favorably within the rapidly evolving precision medicine and AI in healthcare sectors. The company's focus on leveraging multimodal data and AI for personalized patient care aligns with broader industry trends emphasizing data-driven insights and targeted therapies, potentially differentiating it from traditional diagnostic or pharmaceutical companies.

Comparison to Industry Standards

• The filing does not provide specific comparable companies, projects, or results to global benchmarks.

Related Party Transactions

• Related party revenue of $65,251 thousand for the year ended December 31, 2025.
• Related party accounts receivable of $6,428 thousand as of December 31, 2025.
• Related party deferred revenue of $3,938 thousand as of December 31, 2025.

Stakeholder Impact

• Shareholders: Positive impact due to strong revenue growth, improving profitability, and positive future guidance, potentially leading to increased share value.
• Customers (Physicians/Healthcare Systems): Enhanced patient care and informed testing decisions through new AI-powered tools like Paige Predict and the IPS test, and expanded genomic testing access.
• Employees: Continued growth and strategic advancements may lead to job stability and opportunities, though stock-based compensation is a significant expense.
• Partners (NYU Langone Health, Northwestern Medicine): Strengthened collaborations and expanded research opportunities in precision medicine.

Next Steps

• Continue driving significant growth over the next several years.
• Enhance the lives of millions of patients around the world through AI investments.
• Host a conference call and webcast on February 24, 2026, to discuss results and provide commentary.
• Make supplemental financial information and a letter from the CEO and CFO available on the investor relations website.

Key Dates

Recommendation

The filing demonstrates exceptional year-over-year revenue growth exceeding 80%, a significant turnaround in Adjusted EBITDA to positive in Q4 2025, and robust guidance for 2026 indicating continued strong growth and profitability. The company's strategic advancements in AI-driven precision medicine, coupled with strong contract value and net revenue retention, suggest a compelling growth trajectory and increasing market leadership. These factors, particularly the shift towards profitability, make it a strong buy for investors seeking exposure to high-growth healthcare technology.

Keywords

Precision Medicine, AI in Healthcare, Diagnostics, Oncology, Genomics, Data Licensing, Cancer Care, Digital Pathology, Biomarkers, Immunotherapy, SEC Filing, Financial Results, NASDAQ: TEM