SANUWAVE Health Inc.

Revenue for the second quarter of 2026 was $9.7 million, down 3% from $10.1 million in the prior-year quarter. UltraMIST system revenue declined approximately 34% to $2.3 million from $3.4 million, while UltraMIST applicator revenue grew approximately 13% year over year and applicator unit volume increased 27% year over year. Gross margin was 76.2%, down about 183 basis points from 78.1% last year. Operating loss was $0.3 million versus operating income of $1.4 million a year ago; net loss was $0.7 million versus net income of $0.6 million. EBITDA was positive $0.1 million and adjusted EBITDA was positive $1.2 million, compared with $3.2 million last year. Cash and cash equivalents were $9.4 million at June 30, 2026, and the company made $2.9 million of scheduled principal payments in the first half of the year while remaining in compliance with JPMorgan covenants. Management withdrew previously issued fiscal 2026 revenue guidance and said it will not provide quarterly or annual guidance until there is greater clarity after CMS finalizes its reimbursement rule, expected in or around the first week of November.

Morgan Frank said applicator sales were strong and in line with plan, but system sales were meaningfully disrupted by an unprecedented wave of used UltraMIST devices entering the market as wound care providers closed or consolidated. He framed the CMS reimbursement process as the key near-term variable, saying the company will push hard in the comment period and citing a broader strategic move toward hospitals, burns, post-acute, pediatrics, and long-term care where customers may be stickier. His tone was candid and defensive on reimbursement, but optimistic about UltraMIST’s clinical and economic value.

Peter Sorensen highlighted that the top-line decline came from capital/system sales, while the recurring consumables business held up well. He cited gross margin of 76.2%, down from 78.1%, and said the margin pressure came from mix shift toward consumables and lower average selling prices from reseller/wholesale pricing. He also pointed to $7.7 million of operating expenses versus $6.4 million a year earlier, $9.4 million of cash and equivalents, $2.9 million of principal payments in the first half, and compliance with all JPMorgan covenants. He noted a favorable roughly $0.9 million swing in sales tax from VDA settlements that helped offset higher personnel, legal, bad debt, and investment-related spending.

An analyst asked how the customer base splits between for-profit mobile wound care and hospitals/other non-profit settings, and management said the line is too fuzzy to size precisely because many customers use hybrid models. Morgan Frank said mobile has historically been a larger use case, but hospital groups like Healogics tend to ramp more slowly and then create more durable momentum. The analyst also asked about the CMS reimbursement estimate of about $316 versus the current $397 average, and Frank walked through the RVU math behind the estimate. On timing, he said the 60-day comment period ends September 14, and the final rule is expected around the first week of November.