Sensus Healthcare (NASDAQ:SRTS) used its fourth-quarter and full-year 2025 earnings call to emphasize a major regulatory and reimbursement milestone that management believes reshapes the company’s growth outlook heading into 2026. Executives highlighted newly established, dedicated CPT codes for the company’s superficial radiotherapy (SRT) and image-guided SRT (IG-SRT) technologies for treating non-melanoma skin cancer, which they described as providing clear physician reimbursement and improving adoption prospects.
Management highlights CMS reimbursement milestone
Chairman and CEO Joe Sardano said Sensus’ SRT and IG-SRT are non-invasive technologies “exclusively designed, developed and distributed” by the company, and noted that SRT has been awarded “exclusive and dedicated CPT codes” for non-melanoma skin cancer. He described the development as the result of a 16-year effort and said the new codes give physicians clarity on reimbursement for patients seeking a non-surgical alternative to surgery-related scarring and longer healing times.
Shift away from reliance on a single customer
Sardano said two factors had weighed on results: customer concentration and the lack of reimbursement codes dedicated to Sensus’ technology. He noted that the company shipped 14 systems during the quarter, but none went to its “very large” historically largest customer. While management said it believes the customer could contribute in the future, Sardano said the company expects growth to come from direct sales and shared services with end users, adding, “We will no longer have to rely on any one entity.”
When asked whether 2026 projections assume any contribution from that customer, Sardano said the company’s 2026 model does not include expectations from the largest customer because the customer is reevaluating its approach. He added that any contribution would be upside, but the company feels “very, very comfortable” moving forward with the new CPT codes.
Commercial strategy: expanding sales coverage and refining lead generation
President and Chief Commercial Officer Michael Sardano said reimbursement certainty and “highly attractive economics” are expanding adoption pathways. He said small and mid-sized practices are increasingly evaluating outright purchases and fair market value leases, influenced by breakeven timing, flexible financing, and tax considerations. He also said Sensus can support multiple acquisition models, including Fair Deal agreements, ownership, renting, or leasing depending on customer needs.
Management discussed several commercial initiatives for 2026:
- Sales force expansion: The company has added one sales representative and plans to hire an additional three to five reps “as soon as possible,” with a focus on education and lead conversion as practices work through the reimbursement framework.
- More targeted conference strategy: Sensus plans to emphasize select national and regional meetings that generate higher-quality leads while reducing participation in lower-yield events.
- Product and system mix considerations: In response to a question about SRT versus IG-SRT, management said it sees a tendency toward the SRT-100 system paired with a handheld ultrasound device, describing this as cost-saving for customers and better margin for Sensus, even though there is only one code reimbursing for the ultrasound component.
In addition, management said private equity-backed roll-up groups continue to view the Fair Deal Agreement program as a priority approach, though these groups are reevaluating how they want to enter the market. The company also said larger users may be less inclined to share revenue under a shared services model now that reimbursement is “guaranteed,” and may prefer to purchase or lease equipment instead.
Fair Deal Agreement program and utilization trends
Sardano described the Fair Deal Agreement (FDA) program as an “important strategic component” of the business. The company ended 2025 with 18 active FDA sites and 10 additional sites pending activation. He said utilization increased substantially year over year, with treatments up more than eightfold in 2025 versus 2024 and the number of patients treated rising more than 250%.
Management also said that, while the market waited for CMS clarity, Sensus advised prospects to pause decisions until the codes were public, and that the company’s transparency was appreciated. In some cases, FDA placements served as a bridge to ownership, with customers choosing to purchase systems outright after evaluating the economics.
International demand and regulatory progress
Executives said international demand was strong in the fourth quarter, with six of the 14 systems shipped internationally, including shipments to China. Joe Sardano noted international sales can be attractive from a margin perspective because of lower installation, commissioning, and service requirements.
On the call, Michael Sardano identified China as the company’s largest international market and said Taiwan has been growing with “four or five installations” over the last two years. He also discussed broader Asia demand, citing South Korea, Japan (over time) supported by the company’s MDSAP certification, and demand tied to the keloid market. He said Sensus is also “holding out hopes” for the Middle East, and referenced India and South America as potential opportunities. For Brazil specifically, he said the company is working through secondary regulatory steps and expects to obtain Brazil clearance in 2026.
Sensus also addressed its TDI program, with Joe Sardano calling it a “long” and “tenuous” effort and saying the company continues to work with the FDA. He said he did not know when approval might happen but indicated Sensus will continue to pursue it.
Financial results: steep revenue decline and full-year loss
Chief Financial Officer Javier Rampolla reported fourth-quarter 2025 revenue of $4.9 million, down from $31.0 million in the fourth quarter of 2024, attributing the decline primarily to fewer unit sales due to reduced sales to the company’s largest customer. The company reported fourth-quarter gross profit of $1.9 million (38.8% margin), down from $7.1 million (54.2% margin) a year earlier, which Rampolla said reflected lower sales volumes, higher servicing costs, and costs tied to new FDA placements.
For the full year, revenue was $27.5 million versus $41.8 million in 2024. Gross profit was $11.9 million (43.3% margin), down from $24.4 million (58.4% margin) in 2024. Rampolla said operating expenses increased in several areas, including selling and marketing, and research and development. R&D spending rose to $7.8 million from $4.2 million, driven by significantly higher costs related to billing and reimbursement efforts, increased headcount, and next-generation system development work.
Rampolla reported a net loss of $7.7 million for 2025, or $0.47 per share, compared with net income of $6.6 million in 2024, or $0.41 per diluted share. Adjusted EBITDA was negative $9.6 million for 2025 compared with positive $8.7 million in 2024.
On liquidity, the company ended 2025 with $22.1 million in cash and cash equivalents, unchanged from year-end 2024, and no outstanding borrowings under its revolving line of credit. Prepaid inventory was $1.5 million at year-end versus $3.3 million a year earlier, while inventories increased to $14.6 million from $10.1 million, reflecting an inventory build “in support of anticipated future demand.”
2026 outlook: higher Q1 revenue expected and profitability target
Looking ahead, management said early first-quarter 2026 activity has been encouraging. Joe Sardano said, based on the current pipeline and engagement, the company expects first-quarter system shipments to exceed fourth-quarter levels, even without contributions from its historically largest customer. Rampolla also said the company expects first-quarter revenue to exceed the fourth quarter.
Both Joe Sardano and Rampolla said the company’s objective is to achieve full-year profitability in 2026, citing the new reimbursement environment, a more diversified customer base, and expanding international opportunities as key factors.
About Sensus Healthcare (NASDAQ:SRTS)
Sensus Healthcare, Inc is a medical technology company specializing in the development, manufacture and commercialization of superficial radiation therapy (SRT) systems. The company’s SRT devices utilize low-energy X-rays to treat a range of dermatological and oncological conditions, most notably non-melanoma skin cancers such as basal cell carcinoma and squamous cell carcinoma, as well as benign lesions including keloids. By delivering targeted radiation to superficial tissue layers, Sensus Healthcare’s systems aim to provide an alternative to surgical excision or systemic therapies, offering clinicians a non-invasive treatment option for eligible patients.
The company’s flagship products include the SRT-100™ and SRT-100+™ platforms, which feature handheld applicators, adjustable energy settings and integrated safety controls.
