second quarter of 2026
Filed Aug 10, 2026RadNet Reports Second Quarter Financial Results with Record Quarterly Revenue and Adjusted EBITDA and Revises Upwards 2026 Financial Guidance Ranges
Total Company Revenue increased 25.0% to a quarterly record of $622.7 million and Adjusted EBITDA increased 22.7% to a quarterly record of $99.7 million. Imaging Center guidance was raised, while GAAP net income, Adjusted Earnings and Adjusted Earnings Per Share declined from the second quarter of 2025 and Digital Health Adjusted EBITDA declined amid growth investments.
Key metrics
as reported| Metric | Value | q/q | y/y |
|---|---|---|---|
| Total Company RevenueGAAP | $622.7 million | – | 25.0% |
| Service fee revenueGAAP | $592,589 (in thousands) | – | – |
| Revenue under capitation arrangementsGAAP | $30,131 (in thousands) | – | – |
| Income from operationsGAAP | $39,468 (in thousands) | – | – |
| Total operating expensesGAAP | $583,252 (in thousands) | – | – |
| Consolidated net incomeGAAP | $20,254 (in thousands) | – | – |
| Net income attributable to RadNet, Inc. common stockholdersGAAP | $7.5 million | – | – |
| Diluted net income per share attributable to RadNet, Inc. common stockholdersGAAP | $0.10 | – | – |
| Adjusted EBITDA - RadNet, Inc.non-GAAP | $99.7 million | – | 22.7% |
| Adjusted net income attributable to RadNet, Inc. common stockholdersnon-GAAP | $23.2 million | – | – |
| Adjusted diluted net income per share attributable to RadNet, Inc. common stockholdersnon-GAAP | $0.29 | – | – |
| Imaging Center Segment Adjusted EBITDAnon-GAAP | $97.2 million | – | – |
| Imaging Center Segment Adjusted EBITDA marginnon-GAAP | 16.1% | – | 17 basis points |
| Digital Health Adjusted EBITDAnon-GAAP | $2.5 million | – | (27.2%) |
| Digital Health Annual Recurring Revenueother | $105.5 million | 8.9% | 97.2% |
| Advanced imaging procedural volume mixother | 29.9% | – | 238 basis points |
| Aggregate advanced imaging procedural volumesother | 21.2% | – | 21.2% |
| Same-center advanced imaging procedural volumesother | 9.6% | – | 9.6% |
| MRI volumeother | 593,143 | – | 21.0% |
| CT volumeother | 352,734 | – | 20.9% |
| PET/CT volumeother | 29,027 | – | 31.0% |
| Routine imaging volumeother | 7.9% | – | 7.9% |
| Same-center MRI volumeother | 10.2% | – | 10.2% |
| Same-center CT volumeother | 8.6% | – | 8.6% |
| Same-center PET/CT volumeother | 8.8% | – | 8.8% |
| Same-center routine imaging volumeother | 1.7% | – | 1.7% |
| Six-month Total Company RevenueGAAP | $1,198 million | – | 23.6% |
| Six-month Adjusted EBITDA - RadNet, Inc.non-GAAP | $162.9 million | – | 27.6% |
| Six-month net loss attributable to RadNet, Inc. common stockholdersGAAP | $25.9 million | – | – |
| Six-month diluted net loss per share attributable to RadNet, Inc. common stockholdersGAAP | $(0.33) | – | – |
Segments
| Segment | Revenue | q/q | y/y |
|---|---|---|---|
| Digital Health reportable segmentRevenue growth reflected incremental Digital Health sales and licenses of Enterprise Imaging and AI solutions. Adjusted EBITDA decreased predominantly from investments in headcount for sales, marketing, customer service and implementation teams. | $32.4 million | – | 56.5% |
| Imaging Center reportable segmentGrowth was driven by aggregate and same-center procedural-volume increases, recent acquisitions, and a continuing shift toward advanced imaging. The higher growth of MR, CT and PET/CT relative to routine imaging contributed to the advanced-imaging mix shift. | $622.7 million | – | 25.0% |
full-year 2026 outlook
- RevenueImaging Center Segment Total Net Revenue: $2,370 - $2,420 million
- NoteImaging Center Segment Adjusted EBITDA: $345 - $358 million
- NoteImaging Center Segment Capital Expenditures: $165 - $175 million
- NoteImaging Center Segment Cash Interest Expense: $48 - $53 million
- NoteImaging Center Segment Free Cash Flow: $115 - $125 million
- NoteDigital Health Segment Total Net Revenue (inclusive of intersegment revenue): $135 - $145 million
- NoteDigital Health Segment Adjusted EBITDA Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI: $10 - $12 million
- NoteDigital Health Segment Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI: $17 - $19 million
- NoteDigital Health Segment Capital Expenditures: $9 - $12 million
- NoteDigital Health Segment Free Cash Flow Before Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI: $(1) - $3 million
- NoteDigital Health Segment Free Cash Flow After Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI: $(17) - $(19) million
What drove it
- Total Company Revenue increased $124.5 million, driven by strong aggregate and same-center procedural volumes, contributions from recent acquisitions, higher advanced-imaging mix, and incremental Digital Health sales and licenses.
- MRI volume increased 21.0%, CT volume increased 20.9%, and PET/CT volume increased 31.0% versus the second quarter of 2025.
- ARR generated by external customers comprised approximately 63% of Digital Health Revenue.
- The company signed new Digital Health business with Total Contract Value of approximately $21 million during the second quarter and approximately $37 million during the first six months.
- 157 of 442 locations, or approximately 36%, were held within health system partnerships as of the end of the second quarter.
Concerns
- Digital Health Adjusted EBITDA decreased $0.9 million, or 27.2%, due predominantly to investments in headcount across sales, marketing, customer service and implementation teams.
- GAAP net income attributable to RadNet, Inc. common stockholders declined to $7.5 million from $14.5 million, while Adjusted Earnings declined to $23.2 million from $25.7 million.
- Second-quarter unusual or one-time items included $6.6 million of acquisition transaction costs, $6.8 million of Digital Health intangibles amortization, and $3.4 million of debt restructuring and extinguishment expenses.
- Cash and cash equivalents decreased to $726,272 (in thousands) at June 30, 2026 from $767,215 (in thousands) at December 31, 2025.
What to watch
- Implementation of DeepHealth's breast ultrasound AI solution across RadNet breast imaging centers by year-end, including the anticipated Revenue and cost-savings contributions in the second half of the year.
- Delivery against the raised Imaging Center Segment Total Net Revenue guidance range of $2,370 - $2,420 million and Adjusted EBITDA guidance range of $345 - $358 million.
- Digital Health ARR growth, external-customer revenue mix, conversion of approximately $37 million of six-month new-business Total Contract Value, and the effect of continued infrastructure investment on segment Adjusted EBITDA.
- Advanced-imaging procedural volumes and mix, including MRI, CT and PET/CT growth relative to routine imaging.
- Capital spending, acquisition activity, debt levels and Free Cash Flow delivery.
Balance sheet and cash flow
- Cash and cash equivalents as of June 30, 2026: $726,272 (in thousands); December 31, 2025: $767,215 (in thousands).
- Notes payable, net of current portion as of June 30, 2026: $1,301,862 (in thousands); December 31, 2025: $1,064,495 (in thousands).
- Current portion of notes payable as of June 30, 2026: $30,669 (in thousands); December 31, 2025: $25,424 (in thousands).
- Net Debt to Adjusted EBITDA Ratio as of June 30, 2026: 1.8x.
- Six-month net cash provided by operating activities: $173,071 (in thousands); 2025: $161,829 (in thousands).
- Six-month purchase of imaging facilities and other acquisitions, net of cash acquired: $(315,707) (in thousands); 2025: $(31,985) (in thousands).
- Six-month purchase of property and equipment and other: $(126,215) (in thousands); 2025: $(101,776) (in thousands).
- Six-month proceeds from issuance of new debt, net of issuing costs: $248,937 (in thousands); 2025: $99,001 (in thousands).
- Six-month net decrease in cash and cash equivalents: $(40,943) (in thousands); 2025: $93,132 (in thousands).
Analysis
RadNet delivered record quarterly Total Company Revenue of $622.7 million, up 25.0% from $498.2 million, and record Adjusted EBITDA of $99.7 million, up 22.7% from $81.2 million. The growth profile was supported by procedural volumes, recent acquisitions, a greater mix of advanced imaging, and Digital Health sales and licenses. Aggregate advanced imaging procedural volumes increased 21.2%, while same-center advanced imaging procedural volumes increased 9.6%.
Imaging mix was favorable. Advanced imaging represented 29.9% of total procedural volumes, compared with 27.5% in the second quarter of 2025. MRI, CT and PET/CT volumes increased 21.0%, 20.9% and 31.0%, respectively, while routine imaging increased 7.9%. The mix shift contributed to a 16.1% Imaging Center Segment Adjusted EBITDA margin, compared with 16.0% in the prior-year period.
Digital Health revenue increased 56.5% to $32.4 million and ARR reached $105.5 million, compared with $53.5 million at June 30, 2025 and $96.9 million at March 31, 2026. However, Digital Health Adjusted EBITDA declined to $2.5 million from $3.4 million because of investment in growth headcount. External customers generated approximately 63% of Digital Health Revenue, and new business signed during the quarter had Total Contract Value of approximately $21 million.
GAAP earnings did not follow the revenue and Adjusted EBITDA gains. Net income attributable to RadNet, Inc. common stockholders was $7.5 million and diluted EPS was $0.10, compared with $14.5 million and $0.19. Adjusted Earnings declined to $23.2 million from $25.7 million, and Adjusted EPS declined to $0.29 from $0.34. The quarter included acquisition transaction costs, Digital Health intangibles amortization, non-capitalized research and development expenses, lease abandonment charges and debt restructuring and extinguishment expenses.
Management raised 2026 Imaging Center guidance for Total Net Revenue to $2,370 - $2,420 million, Adjusted EBITDA to $345 - $358 million and Free Cash Flow to $115 - $125 million. Digital Health guidance ranges were reaffirmed. Cash and cash equivalents were $726,272 (in thousands) at June 30, 2026, Net Debt to Adjusted EBITDA Ratio was 1.8x, and six-month investing cash use included $(315,707) (in thousands) for imaging facilities and other acquisitions and $(126,215) (in thousands) for property and equipment and other.
Management, verbatim
The Imaging Center and Digital Health reportable operating segments continue to demonstrate strong growth and achieve record quarterly results.
Dr. Howard Berger, President and Chief Executive Officer
This favorable business mix shift contributed to a 16.1% Adjusted EBITDA (1) margin for the Imaging Center segment during this year’s second quarter, a 17 basis point improvement as compared with last year’s second quarter.
Dr. Howard Berger, President and Chief Executive Officer
Given the positive trends within the industry and RadNet’s strong financial performance of the second quarter, we are revising upwards 2026 Imaging Center guidance levels for Revenue, Adjusted EBITDA (1) and Free Cash Flow (2) in anticipation of financial results that we believe will exceed both our original expectations and the amendments we made to the guidance ranges upon releasing first quarter 2026 results in May.
Dr. Howard Berger, President and Chief Executive Officer
Not in the filing
stated, not guessed- Previous-release outlook was not provided, so no comparison of reported results with prior guidance is included.
- Quarterly free cash flow was not reported.
- Quarterly operating cash flow was not reported.
- Gross margin was not reported.
- Quarterly segment revenue for the Imaging Center Segment was not separately reported.
- Capital returns, including share repurchases and dividends, were not reported.
- Total debt at par value was not reported.
- Forward guidance for gross margin, operating expenses and tax rate was not reported.
AlphAI analysis generated from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure was cross-checked against the filing text; consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.