Q2 2026 BillionToOne, Inc. Earnings Call Transcript
Key Points
- Revenue grew 64% year-over-year to $109.4 million, with test volume up 35% and ASPs up 21%.
- Gross margin expanded to 70.5%, up 5 percentage points year-over-year, driven by higher ASPs.
- Achieved GAAP operating income of $5.5 million and a 15% adjusted EBITDA margin, with positive free cash flow of $5.1 million.
- Unity Confirm, the first non-invasive confirmation assay for high-risk pregnancies, saw strong adoption with providers ordering it on over 50% of eligible patients.
- Oncology revenue grew 176% year-over-year to $13.7 million, and the company is on track for MOLD-X coverage for Northstar Response and the launch of a tumor-naive MRD test by year-end.
- True-up revenue declined to $2.8 million in Q2 from $9.2 million in Q1, impacting reported revenue and operating margin sequentially.
- Overall COGS per test increased to $161 from $152 in Q1 due to a mix shift toward oncology, which has higher costs.
- The company held more than $10 million in claims pending in-network implementation by national payers, temporarily impacting cash collections and ASPs.
- Operating margin fell to 5% in Q2 from 16% in Q1, partly due to lower true-up revenue and increased investments in commercial and R&D.
- The accelerated hiring of 70 sales reps in the first half has had a short-term negative impact on sales productivity, with benefits expected only later in the year.
Good Dan, thank you for standing by. Welcome to the Billion to second quarter 2026 earnings call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there'll be a question-and-answer session. To ask a question during the session, you'll need to press star 11 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 11 again. Please. Advised that today's conference is being recorded. I would now like to turn the conference over here to speak today. Gabby Gabel, Investor Relations, please go ahead.
Good afternoon, everyone.
Thank you for participating in today's conference call. Joining me on the call from Billion to One, we have Ozan Atay, Co-Founder and Chief Executive Officer and Ross Taylor, Chief Financial Officer. Earlier today, Billion to One released financial results for the second quarter ended June 30, 2026. A copy of the press release is available on the company's website.
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