Lumexa Imaging Holdings, Inc. Common Stock

Consolidated revenue came in at $264.2 million, up 5.1% year over year. System-wide revenue growth was 6%, system-wide volume growth was 3.1%, and advanced modality volumes rose 6.8% on a consolidated basis and 6.3% system-wide. Outpatient net patient service revenue was $143.7 million, professional fee net patient service revenue was $64.2 million, and management fee and other revenue was $60.4 million. Adjusted EBITDA was $56.4 million, roughly flat versus $56.3 million a year ago, with adjusted EBITDA margin of 21.4% versus 22.4% last year; GAAP EPS was $0.03 and adjusted EPS was $0.20. Net income was $2.7 million versus a net loss of $7.2 million in Q2 2025, and pretax income was $5.8 million versus a pretax loss of $2.4 million. Cash from operations was $32.8 million and free cash flow was $23.1 million, a record, versus negative $2.5 million a year ago. Net leverage was 3.6x at June 30 and cash and cash equivalents were $69.7 million. For full year 2026, management narrowed adjusted EBITDA guidance to $235 million to $241 million from $234 million to $242 million, kept consolidated revenue guidance at $1.045 billion to $1.097 billion, and reiterated adjusted EPS guidance of $0.71 to $0.77. Management said it still expects about $5 million to $7 million of cash CapEx per quarter and 2026 free cash flow conversion of approximately 25% to 30% of adjusted EBITDA.

Caitlin Zulla framed the quarter as progress against a long-term strategy to build a lower-cost outpatient imaging platform for health systems, physicians and patients. She emphasized record advanced-modality mix, continued de novo ramps, new joint ventures, and a growing partnership pipeline, including the Hospital for Special Surgery collaboration and a broader opportunity set of nearly 100 health systems. Her tone was upbeat and confident, with repeated comments that the company is on track for its full-year commitments and that site neutrality could strengthen the business over time.

Tony Martin focused on the mechanics behind the quarter: $264.2 million of revenue, $56.4 million of adjusted EBITDA, $23.1 million of free cash flow, and margin of 21.4%. He highlighted lower interest expense after debt paydown and a June repricing, saying Q2 interest expense was $16.2 million and the repricing should reduce interest by $1 million per quarter starting in Q3, with an additional $4 million of annual cash interest savings beginning in Q3 from the term loan repricing. He also called out G&A of $24.4 million, including $1.5 million of pubco costs and $12.7 million of stock-based comp, and said 2026 stock-based compensation should be about $50 million, with roughly half tied to historic M&A. He reiterated CapEx of about $5 million to $7 million per quarter and said the balance sheet ended with $69.7 million of cash and net leverage of 3.6x.

Analysts pressed on second-half seasonality, payor mix, cash flow, PET expansion, advanced imaging mix, labor constraints, and the new HSS joint venture. Management said the year is tracking to the expected 45%/55% first-half/second-half earnings split, with Q2 aided by seasonal ramp and de novo maturation, and said the slight payor mix shifts were small and not durable. On PET, they said they have 8 machines today, are aiming for 11 this year, and expect growth to accelerate after two new machines came online in July. On HSS and the broader JV pipeline, management said the partnership is a de novo-style build in the New York metro area with a longer timeline because of CON requirements, and that the pipeline remains robust.