Tempus AI, Inc.

Tempus reported first-quarter revenue of $348.1 million, up a little over 36% year over year. Diagnostic revenue was $261.1 million, up almost 35%, with Oncology unit growth of about 28%; data and applications revenue was $87 million, up 40.5%, including data licensing and modeling/business insights growth of over 44%. Adjusted EBITDA was a $3 million loss in the quarter, and management reiterated that free cash flow was elevated in Q1 due to timing of payables and bonuses. For 2026, the company raised revenue guidance to $1.59 billion-$1.6 billion and adjusted EBITDA guidance to about $65 million.

Eric Lefkofsky struck a highly upbeat tone, saying the company had a 'great quarter' and that the business is performing at or above plan. He emphasized strong durable demand in data and AI collaborations, including new and expanded relationships with Merck and Gilead, plus increasing adoption of Tempus' de-identified data for model building. He also highlighted broad diagnostic strength across solid tumor, liquid biopsy, and MRD, while saying hereditary should return to mid-teens growth in the second half as comps ease.

Jim Rogers focused on the path to improved profitability and cash flow. He said Q1 free cash flow was elevated for seasonal reasons, but expects 'significant improvement' in Q2 as payables normalize and contracts with prepayments or deferred revenue move to quarterly billing, with continued improvement as adjusted EBITDA rises. He also pointed to Q1 adjusted EBITDA being negative $3 million versus about $13 million of year-over-year improvement, and reiterated that the company feels good about its cash position and does not need additional financing.

Analysts pressed management on the durability and size of the Insights business, especially around large pharma renewals, the Merck and Gilead wins, and whether Tempus can hit implied data revenue targets. Management said core data relationships are strong, renewals have historically come in at or above prior levels, and the pipeline remains robust; Eric said the company now has almost half a dozen $100 million-plus strategic agreements. Questions also focused on FDA timing for xF, xT, and xR, cash flow cadence, and whether companion diagnostics would change ordering behavior. Management said xF timing is still pending, expects no 2026 pricing impact, and argued that companion diagnostics in the U.S. should not materially change physician ordering for Tempus' core therapy selection business.