CareDx (NASDAQ:CDNA) reported fourth-quarter and full-year 2025 results alongside a detailed outlook for 2026, highlighting growth across its testing services, patient and digital solutions, and lab products businesses. Management also discussed continued improvements in revenue cycle management, progress with Epic integrations, and a planned expansion into cell therapy with its AlloHeme program.
Fourth-quarter performance driven by testing services and patient/digital growth
Total fourth-quarter revenue was $108.4 million, up 25% year-over-year, with non-GAAP gross margin of 68.5%. The company reported adjusted EBITDA of $6.5 million for the quarter, which management said included a $6.7 million one-time cash bonus paid to non-executives in lieu of equity awards.
Patient and digital solutions revenue increased 47% year-over-year to $16.8 million, while lab products revenue rose 17% to $13.3 million.
Full-year 2025 results and cash collections improvement
For full-year 2025, CareDx reported revenue of $379.8 million, an increase of 14% year-over-year. Testing services revenue increased 10% to $274.5 million on volume of approximately 200,000 tests, up 14%.
Patient and digital solutions revenue was $56.9 million (up 31%), and lab products revenue was $48.4 million (up 19%). Non-GAAP gross margin for the year was 69.3%, consistent with the prior year.
CareDx emphasized improved execution in billing and collections. Full-year cash collections were $405.6 million, up 32%, contributing to a $22.5 million year-over-year reduction in accounts receivable and a 42% improvement in days sales outstanding (DSO), which decreased from 71 days to 41 days.
Management also pointed to specific revenue cycle metrics discussed during the call, including claim rejection rates declining by more than 60% over the course of 2025 through September and overall zero-pay claims improving by approximately 10% through the same period.
Business updates: kidney momentum, SHORE evidence, and Epic integrations
CEO John Hanna said testing services growth was strong across heart, lung, and kidney transplantation, with kidney testing continuing to lead growth. He attributed kidney growth to both increased surveillance protocol adoption and expanded for-cause use of AlloSure Kidney, noting that as centers restart surveillance protocols, volumes can build gradually as newly transplanted patients are added to schedules.
In heart transplantation, CareDx highlighted the publication of the third manuscript from the Surveillance HeartCare Outcomes Registry (SHORE) in The Journal of Heart and Lung Transplantation. Management said the analysis included 1,934 heart transplant recipients across 59 centers and showed HeartCare’s combined molecular testing provided prognostic information beyond biopsy alone. According to the company, abnormal HeartCare results from two months to five years post-transplant were associated with an approximately threefold increase in 30-day risk of graft dysfunction and cardiovascular death, even without biopsy evidence of rejection.
On Epic integrations, the company said seven transplant centers are fully live on its Epic Aura instance, with 14 additional centers in active implementation. Management said early indications include roughly a 40% reduction in login-related issues, and it noted early signs of volume growth at initial live sites after go-live, though leadership said it is still too early to quantify the full-year lift in guidance.
Separately, CareDx said it plans to migrate its lab information management system (LIMS) infrastructure to Epic Enterprise Solutions in 2026, describing it as a strategic move intended to support faster new-product launches and facilitate more seamless data exchange with Epic centers.
Pipeline and evidence strategy: AlloHeme and ImmuneScape
Hanna said a major 2026 priority is advancing CareDx’s “Transplant Plus” cell therapy pipeline. The company recently disclosed pivotal clinical validation results for AlloHeme, an AI-powered NGS surveillance solution designed to predict relapse in patients with AML and MDS following allogeneic cell transplantation.
Management said the ACROBAT study—a prospective multicenter trial across 11 U.S. transplant centers—showed AlloHeme identified relapse a median of 41 days earlier than clinical detection, with 85% sensitivity and 92% specificity. The company added that patients with a positive AlloHeme result at six months post-transplant had a 12-fold higher risk of relapse versus those with negative results. CareDx outlined an anticipated pathway that includes publishing ACROBAT results, achieving CLIA readiness in 2026, introducing the test commercially in early 2027, and pursuing payer coverage in 2028.
On evidence generation, CareDx described a three-part 2026 approach:
- Translational research through its ImmuneScape program, including a collaboration with 10x Genomics focused on multi-omics research related to transplant rejection mechanisms.
- Observational studies and continued publications from registries including KOAR, SHORE, and ALAMO.
- Interventional trials in heart and kidney, including trials such as HARBOR and MERIT, aimed at demonstrating the clinical actionability of molecular testing.
2026 outlook: growth, LCD risk, and leadership changes
For full-year 2026, CareDx guided to revenue of $420 million to $444 million. Testing services revenue is expected to be $306 million to $326 million on volume of 220,000 to 228,000 tests.
Management said it incorporated a $7.5 million revenue headwind in guidance tied to a draft Local Coverage Determination (LCD) for solid organ transplant, assuming the policy is finalized mid-year. The company stated it expects a $15 million full-year impact if finalized, and therefore included a half-year effect in its outlook.
The company also noted a new PLA code effective January 1, 2026, which reduced AlloSure Kidney reimbursement by 4% from $2,841 to $2,753. CareDx modeled revenue per test starting around $1,400 in the first quarter and the full-year blended revenue per test in the low $1,400s. It also expects to recognize approximately $5 million in prior-period revenue during the first half of 2026.
CareDx guided to non-GAAP gross margin of approximately 69% to 71% and adjusted EBITDA of $30 million to $45 million, noting the first quarter is typically its softest due to annual employee benefit resets and the impact of recent hires.
Finally, CFO Nathan Smith said he will transition out of his role after the filing of the company’s Form 10-K, citing personal reasons. Hanna announced that COO Keith Kennedy will assume the role of Chief Financial Officer in addition to COO, effective February 26.
About CareDx (NASDAQ:CDNA)
CareDx, Inc (NASDAQ: CDNA) is a precision diagnostics company focused on the care of transplant patients. The firm develops and commercializes non?invasive tests designed to detect organ transplant rejection and infection risk, helping physicians make informed management decisions throughout the post?transplant journey.
The company’s core product portfolio includes AlloMap®, a gene expression profiling test for heart transplant recipients, and AlloSure®, a donor?derived cell?free DNA assay used primarily in kidney transplant monitoring.
