GeneDx (NASDAQ:WGS) reported fourth-quarter revenue of $121 million, bringing full-year 2025 revenue to $428 million, as management highlighted accelerating exome and genome testing demand and maintained its outlook for 2026. On the company’s Feb. 23 earnings call, President and CEO Katherine Stueland said the quarter “was a strong finish to a transformative year,” pointing to 54% exome and genome revenue growth for the full year and a strategy centered on expanding beyond core specialist markets into broader clinical settings.
Quarterly performance and 2025 exit rate
CFO Kevin Feeley said total fourth-quarter revenue rose 27% year-over-year, with exome and genome revenue of $104 million up 32%. Excluding a $6.8 million one-time payor recovery recorded in the prior-year quarter, Feeley said exome and genome revenue growth was 42% on an organic basis.
The company’s average reimbursement rate (ARR) for exome and genome testing was approximately $3,750 in Q4. Feeley said ARR can fluctuate due to mix, but argued the long-term trend remains “up and durable,” citing a progression from $2,500 in 2023 to $3,000 in 2024 and $3,750 in 2025.
Margins and profitability
Adjusted gross margin was 71% in both the fourth quarter and full year 2025, which Feeley attributed “mostly” to higher reagent costs while adding that reagent costs are expected to decline as adoption scales. He emphasized that GeneDx’s “dry site cost advantage applies equally between exome and genome,” and pointed to margin expansion over time: 45% in 2023, 65% in 2024, and 71% in 2025.
GeneDx posted adjusted net income of $4.4 million for Q4 and $4.8 million for full-year 2025. Feeley said those results demonstrate operating leverage in the business model.
Strategy: expanding markets and scaling the commercial footprint
Stueland described GeneDx’s competitive positioning around its dataset, GeneDx Infinity, which she said includes more than 2.5 million rare genetic tests, over 1 million exomes and genomes, and more than 8 million phenotypic data points. She added that more than 60% of the exomes and genomes include parental data and over 50% are from patients of non-European descent. Stueland also discussed GeneDx’s use of AI, including its proprietary gene ranking tool Multiscore, which she said analyzes “billions of internal and external data points” to help identify likely causal genes.
The CEO said GeneDx is operating across six “massive, untapped markets,” and described three primary growth levers:
- Activating new clinicians in existing call points
- Driving higher utilization among clinicians already ordering
- Introducing testing to new markets
Management discussed penetration levels in different segments. Stueland said GeneDx has reached roughly 80% clinician penetration among geneticists but sees room to grow through continued conversion from single-gene and panel testing to exome and genome. Among pediatric specialists, she said the company has reached about 30% of clinicians and about 15% of eligible patients. In newer U.S. markets—prenatal, NICU, adult specialists, and general pediatricians—she said clinician adoption remains in the single digits.
Feeley provided detail on commercial expansion, saying the company is “deploying capital to nearly triple our commercial footprint in 2026.” He characterized the 2025 base as about 50 outpatient-focused sales reps plus a roughly 10-rep NICU team, and said GeneDx is adding about 100 reps on top of that. He also said the company is investing in a next-generation customer portal “designed by pediatricians for pediatricians,” launching later this summer, along with increased R&D to support clinical research and evaluate technologies such as supplementing short-read with long-read sequencing.
2026 guidance reiterated; cadence considerations
GeneDx reaffirmed 2026 guidance calling for total revenue of $540 million to $555 million and exome and genome volume growth of 33% to 35%. Feeley said the company expects foundational markets to contribute 25% to 27% of the growth rate, expansion markets 7% to 8%, and future markets about 1%, with only a “very modest” second-half contribution from general pediatricians in 2026.
Feeley said a 33% growth rate in 2026 would equate to about 32,000 additional tests versus fiscal 2025. He also gave a baseline assumption of 33% growth for Q1, while cautioning that Q1 typically steps down seasonally due to deductible resets and fewer operating days. He said the company had already factored weather-related disruptions into Q1 projections and noted that missed appointments are typically rescheduled rather than lost.
On profitability, Feeley guided to adjusted gross margin of approximately 70% for 2026 and said the company expects adjusted net income to be positive for the full year and for each individual quarter. He said Q1 will be “close to breakeven” as GeneDx prioritizes market capture, and that adjusted operating margin is expected to build toward double digits by Q4 as newly deployed territories ramp.
Reimbursement, policy, and additional commercial initiatives
In Q&A, Feeley said the company is taking a conservative view of reimbursement assumptions in new outpatient markets, citing historical experience where denial rates were elevated when GeneDx entered new physician types and diagnosis codes. He also said nothing is included in guidance for Medi-Cal pricing because the company did not yet have a public price, despite policy becoming effective Nov. 1. He added that the 2026 guide assumes “zero new Medicaid states,” consistent with the company’s approach to excluding policy expansion until it is finalized.
Feeley also addressed pending federal legislation referenced by an analyst, saying no uplift from national legislation is assumed in 2026 and that GeneDx is part of a group working to advance the bill, but the company is not incorporating it into near-term expectations.
Stueland discussed an EMR strategy shift, saying GeneDx learned from earlier efforts that were tied closely to the NICU and is now focusing Epic-related efforts more on new customers—such as general pediatricians—rather than trying to unlock volume from existing customers who already use the company’s portal. She also described efforts to drive NICU adoption by focusing more directly on neonatologists and peer-to-peer engagement, noting early-year ordering momentum that the company is monitoring.
About GeneDx (NASDAQ:WGS)
GeneDx is a clinical diagnostics company specializing in comprehensive genetic and genomic testing for rare and inherited disorders. The company offers a broad portfolio of assays, including targeted gene panels, whole exome sequencing, whole genome sequencing and chromosomal microarray analysis. GeneDx’s laboratory services support the diagnosis of a wide range of conditions—from rare pediatric diseases and hereditary cancer syndromes to neuromuscular and metabolic disorders—by providing clinicians with detailed variant interpretation and reporting.
Founded in 2000 and based in Gaithersburg, Maryland, GeneDx was established with the aim of accelerating the translation of genomic discoveries into clinical care.
