Castle Biosciences (NASDAQ:CSTL) Releases Earnings Results

Castle Biosciences (NASDAQ:CSTL) posted its earnings results on Thursday. The company reported ($0.08) earnings per share for the quarter, topping analysts’ consensus estimates of ($0.23) by $0.15, FiscalAI reports. Castle Biosciences had a negative net margin of 3.56% and a positive return on equity of 1.73%. The firm had revenue of $81.88 million for the quarter, compared to analysts’ expectations of $81.19 million.

Here are the key takeaways from Castle Biosciences’ conference call:

• Castle reported Q4 revenue of $87.0 million and full-year 2025 revenue of $344.2 million, beating guidance, and guided 2026 revenue of $340–350 million (mid-to-high teens growth ex certain assets).
• DecisionDx‑Melanoma delivered 39,083 test reports (≈9% YoY), reached ~31% patient penetration with nearly 17,000 ordering clinicians and 58 peer‑reviewed publications, and Castle is preparing a de novo 510(k) submission (targeting late this year/early next) to help commercial reimbursement under state biomarker laws.
• TissueCypher test volume grew 86% to 39,014 reports in 2025, surpassed 80,000 orders to date, was highlighted in the AGA Barrett’s esophagus guideline, and management sees only ~11% patient penetration today with a long runway for further adoption.
• AdvanceAD‑Tx launched in limited access in late Nov 2025 (≈150 initial accounts) and generated ≈500 orders by mid‑Feb; Castle expects immaterial 2026 revenue with material contribution in 2027–2028 and reimbursement updates expected in H2 2026.
• Profitability pressured in 2025: net loss of $24.2 million (vs. prior‑year income), adjusted EBITDA fell to $44.0 million, and adjusted gross margin compressed partly due to loss of DecisionDx‑SCC revenue and a one‑time ~$20.1 million amortization acceleration, while operating expenses increased—offset by a strong cash position of ~$299.5 million.

Castle Biosciences Stock Up 3.4%

Shares of NASDAQ CSTL opened at $31.88 on Friday. The company’s 50 day moving average price is $37.37 and its 200-day moving average price is $31.06. The company has a debt-to-equity ratio of 0.02, a quick ratio of 6.31 and a current ratio of 6.47. Castle Biosciences has a 52-week low of $14.59 and a 52-week high of $44.28. The company has a market capitalization of $930.58 million, a P/E ratio of -70.84 and a beta of 1.06.

Insiders Place Their Bets

In other Castle Biosciences news, insider Derek J. Maetzold sold 4,017 shares of the stock in a transaction dated Tuesday, January 20th. The stock was sold at an average price of $40.01, for a total transaction of $160,720.17. Following the completion of the sale, the insider directly owned 87,715 shares in the company, valued at approximately $3,509,477.15. This trade represents a 4.38% decrease in their position. The sale was disclosed in a legal filing with the SEC, which is accessible through this link. Also, COO Kristen M. Oelschlager sold 14,888 shares of the business’s stock in a transaction dated Wednesday, December 17th. The shares were sold at an average price of $39.31, for a total value of $585,247.28. Following the completion of the transaction, the chief operating officer directly owned 12,323 shares in the company, valued at $484,417.13. This represents a 54.71% decrease in their ownership of the stock. The SEC filing for this sale provides additional information. Insiders have sold 29,617 shares of company stock valued at $1,167,887 in the last three months. 6.50% of the stock is owned by insiders.

Institutional Investors Weigh In On Castle Biosciences

A number of hedge funds have recently added to or reduced their stakes in the business. Federated Hermes Inc. bought a new stake in Castle Biosciences during the 4th quarter valued at $26,000. Kemnay Advisory Services Inc. bought a new position in shares of Castle Biosciences in the fourth quarter valued at $35,000. Jones Financial Companies Lllp grew its holdings in shares of Castle Biosciences by 10,592.0% during the first quarter. Jones Financial Companies Lllp now owns 2,673 shares of the company’s stock valued at $54,000 after buying an additional 2,648 shares during the last quarter. Tower Research Capital LLC TRC increased its position in shares of Castle Biosciences by 256.9% during the second quarter. Tower Research Capital LLC TRC now owns 2,791 shares of the company’s stock worth $57,000 after acquiring an additional 2,009 shares in the last quarter. Finally, Russell Investments Group Ltd. increased its position in shares of Castle Biosciences by 63.7% during the third quarter. Russell Investments Group Ltd. now owns 2,508 shares of the company’s stock worth $57,000 after acquiring an additional 976 shares in the last quarter. 92.60% of the stock is currently owned by institutional investors.

Analyst Ratings Changes

A number of brokerages have issued reports on CSTL. Weiss Ratings reaffirmed a “sell (d)” rating on shares of Castle Biosciences in a report on Monday, December 29th. Canaccord Genuity Group boosted their price target on Castle Biosciences from $37.00 to $50.00 and gave the stock a “buy” rating in a report on Monday, December 22nd. Robert W. Baird upped their price objective on Castle Biosciences from $39.00 to $41.00 and gave the company an “outperform” rating in a research note on Tuesday, November 4th. Guggenheim lifted their target price on shares of Castle Biosciences from $43.00 to $47.00 and gave the stock a “buy” rating in a research report on Monday, January 26th. Finally, KeyCorp reissued an “overweight” rating and set a $50.00 target price on shares of Castle Biosciences in a report on Thursday, January 29th. One equities research analyst has rated the stock with a Strong Buy rating, seven have issued a Buy rating and one has issued a Sell rating to the company. According to MarketBeat, the stock has a consensus rating of “Moderate Buy” and an average price target of $47.14.

Castle Biosciences News Summary

Here are the key news stories impacting Castle Biosciences this week:

• Positive Sentiment: Q4 results beat expectations — EPS loss was smaller than feared and quarterly revenue beat consensus, signaling better near‑term operating performance than analysts expected. Castle Biosciences, Inc. (CSTL) Reports Q4 Loss, Beats Revenue Estimates
• Positive Sentiment: Full‑year 2025 revenue exceeded guidance at $344M and core test reports (DecisionDx‑Melanoma, TissueCypher) grew ~37%, showing demand strength in its diagnostic franchises. Management highlighted product launches (AdvanceAD‑Tx) that expand TAM. Castle Biosciences Reports Fourth Quarter and Full–Year 2025 Results
• Positive Sentiment: 2026 revenue outlook of $340‑350M (above consensus ~$335M) gives a clearer top‑line target and likely supported the rally despite mixed profitability metrics. Castle Biosciences Reports 37% Increase in Core Test Reports for 2025, Achieving $344 Million in Revenue
• Neutral Sentiment: Company ended 2025 with a strong liquidity position (~$299.5M in cash & marketable securities), which reduces near‑term financing risk but doesn’t resolve profitability trends. Castle Biosciences Reports Fourth Quarter and Full–Year 2025 Results
• Neutral Sentiment: Analyst coverage remains constructive (average “Moderate Buy” / several Buy ratings and $41–$52 price targets), which can amplify positive reaction to beats/guidance. Castle Biosciences, Inc. (NASDAQ:CSTL) Receives Average Rating of “Moderate Buy” from Analysts
• Negative Sentiment: Profitability weakened — 2025 showed a net loss (~$24.2M) and adjusted EBITDA declined materially year‑over‑year; Q4 still posted a small GAAP loss — a reminder that top‑line growth has not fully restored margins. Castle Biosciences Reports Fourth Quarter and Full–Year 2025 Results
• Negative Sentiment: Operational headwinds — Medicare coverage changes and the discontinuation of the IDgenetix test reduced some revenue and required one‑time amortization adjustments, which pressured margins. Castle Biosciences Reports 37% Increase in Core Test Reports for 2025, Achieving $344 Million in Revenue
• Negative Sentiment: Significant insider selling activity was reported over the past six months, which can be viewed negatively by the market even if it’s routine liquidity. Castle Biosciences Reports 37% Increase in Core Test Reports for 2025, Achieving $344 Million in Revenue

About Castle Biosciences

Castle Biosciences, Inc is a molecular diagnostics company specializing in the development and commercialization of prognostic and diagnostic tests for patients with dermatologic conditions. The company’s proprietary portfolio of genomic assays is designed to improve risk assessment and guide clinical decision-making for individuals with skin cancers and other skin-related diseases. By combining genomic data with advanced statistical algorithms, Castle Biosciences seeks to provide actionable insights that help physicians tailor treatment plans and monitoring strategies.

The company’s flagship test, DecisionDx-Melanoma, evaluates the probability of metastasis in patients diagnosed with cutaneous melanoma, supporting more personalized surveillance and therapeutic approaches.