Key financial results
- Revenue: Total revenue for the third quarter of 2026 reached $794 million, representing a 34% increase compared to $592 million in the third quarter of last year.
We generated $794 million in revenue, up approximately 34% over the $592 million that we reported in Q3 of last year.
- Revenue: Excluding true-ups, revenue grew by more than 40% year-over-year.
excluding the true-ups, revenues grew north of 40% year-over-year.
- Gross Margin: Reported gross margin was approximately 65%, driven by strong organic improvements in both cost of goods sold and average selling prices.
Gross margin was approximately 65%, driven by strong organic improvements in both COGS and ASPs.
- True-ups: True-ups fell to about $32 million in the quarter, down from $52 million in the second quarter.
True-ups fell to about $32 million this quarter, down from $52 million in the second quarter.
- Gross Margin: Excluding true-ups, gross margin was 63.2%, which is up about 140 basis points from the second quarter.
excluding the true-ups, gross margin was up 63.2%, which is up about 140 basis points just from the second quarter.
- Cash Flow: The company generated cash again in the quarter and narrowed its losses significantly.
We generated cash again in the quarter and narrowed our losses significantly even as we continue to invest aggressively in our future growth.
Business segment results
- Volume: Total test volume reached approximately 1.1 million tests in the third quarter, up more than 22% from about 894,000 a year ago.
processed approximately 1.1 million tests in the third quarter, up more than 22% from about 894,000 a year ago.
- Oncology: Clinical MRD units reached approximately 316,000 compared with 202,000 in the third quarter of last year, representing 56% growth.
Clinical MRD units reached approximately 316,000 compared with 202,000 in the third quarter of last year for growth of 56%.
- Oncology: Clinical MRD volumes increased by approximately 33,000 units sequentially over the second quarter.
That was up about 33,000 units over the second quarter, which makes this the second quarter in a row with more than 30,000 sequential units
- Women's Health: Women's Health posted another strong quarter of mid- to high single-digit growth.
Women's Health posted another strong quarter of mid- to high single-digit growth
- Organ Health: Organ Health grew volumes almost 40% compared to the same period last year.
Organ Health grew volumes almost 40% compared to this time last year.
- Oncology: Signatera average selling prices stepped up to approximately $1,290, up from $1,271 in the second quarter.
Signatera ASP stepped up again to approximately $1,290, up from $1,271 in the second quarter
- Biopharma: Biopharma revenue for the first 3 quarters of the year was up roughly 70% over all of 2025.
the first 3 quarters of this year are already up roughly 70% over all of 2025 with a strong Q4 expected as well.
Capital allocation
- R&D Spend: Management plans to raise the top end of the Research and Development range by $25 million to support expanded efforts in pharma and data services, accelerated clinical trial enrollment, and FIND trial costs.
We are going to bump the top end of the range of R&D by $25 million, and I remain biased towards the top end.
- SG&A Spend: Management will increase the top end of Selling, General, and Administrative expenses from $1.225 billion to $1.3 billion to incorporate onetime legal expenses and investments in pharma commercial teams.
On SG&A, we're going to bump from $1.225 billion to $1.3 billion at the top end.
- Outlook: Operating expenses are projected to grow in the 10% to 12% range next year while remaining cash flow generative.
net impact of all these initiatives imply OpEx growth in the 10% to 12% range next year, which should allow us to continue to be cash flow generative
Industry trends and dynamics
- Reimbursement: Medicare granted coverage for serial use of Signatera in patients with early-stage hepatocellular carcinoma in the surveillance setting.
Medicare has granted coverage for serial use of Signatera in patients with early-stage hepatocellular carcinoma, or HCC, in the surveillance setting.
- Reimbursement: Medicare coverage of surveillance for organ transplant monitoring took effect on August 30 and positively impacted both volumes and average selling prices.
Medicare coverage of surveillance, which was announced in July, and which took effect on August 30. This has had a positive impact on both volumes and ASPs.
- Biopharma: Biopharma demand for MRD technology in clinical trials surged following the read out of the IMvigor011 trial and its publication in the New England Journal of Medicine.
Over the last 9 months, we've seen a real surge in biopharma demand for our MRD technology in clinical trials.
Competitive landscape
- Competition: Management views competition as something they welcome and noted they have been competing against other laboratories providing MRD testing for years without any big change in the market.
competition is something that we welcome in the space. We've been competing in the market against other laboratories providing MRD testing for years.
- Women's Health: Consolidation in the prenatal market, such as LabCorp offering a fetal recessive testing assay, represents a change in the market but does not significantly change anything for Natera.
Certainly, it is a change in the market, but it doesn't really change anything significant for us. We've been competing with Myriad and LabCorp for years.
Macroeconomic environment
- The call did not discuss macroeconomic environment factors outside of healthcare industry trends.
Growth opportunities and strategies
- Long-Term Target: Natera set a long-term goal to double revenues in the next 3 years, reaching $6 billion in revenue in 2029.
We're setting the goal to double revenues in the next 3 years, reaching $6 billion in revenue in 2029.
- Early Detection: The FIND study for early cancer detection is fully enrolled with 30,000 patients in the PMA cohort, progressing toward a colorectal cancer readout in 2027.
The study is fully enrolled with 30,000 patients in the PMA cohort. The population we needed for a definitive colorectal cancer readout, which we're progressing towards in 2027.
- Early Detection: The FDA granted breakthrough device designation to Natera's multi-cancer early detection assay in October.
in October, the FDA granted breakthrough device designation to our multi-cancer early detection assay.
- International: Natera is on track with the regulatory approval and launch of colorectal cancer and muscle-invasive bladder cancer indications in Japan.
In Japan, we are on track with the launch of colorectal cancer and muscle-invasive bladder cancer
Financial guidance and outlook
- 2026 Guidance: Gross margin guidance for 2026 is maintained at a centering range of 64% to 66%.
On gross margins, we are continuing to hold steady centering at 64% to 66%.
- 2027 Outlook: For preliminary 2027 planning, management assumes growing the same number of units grown in 2026 and holding average selling prices relatively steady.
For preliminary planning purposes, I'd stick with our standard approach to revenue, presume we can grow the same number of units we grew this year and hold ASP relatively steady.
Executive leadership transition
- Management Change: Steve Chapman stepped down from the CEO role, transitioning leadership to Solomon Moshkevich after an almost 8-year tenure as CEO.
I'm stepping down from the CEO role as now is an excellent time to transition to new leadership for Natera.
- Management Change: Steve Chapman will remain engaged as a consultant with the company and as an adviser to the Board.
I'm going to remain engaged as a consultant here with the company and as an adviser to the Board
- Management Change: Solomon Moshkevich assumed the role as Natera's third CEO after previously serving in commercial and product-focused roles including driving the launch of Signatera and Prospera.
I'm honored to serve as Natera's third CEO.
Q3 FY2026 results
| Metric | Result | Change |
|---|---|---|
| Revenue | $794 million | up approximately 34% |
| Total test volume | approximately 1.1 million tests | up more than 22% |
| Clinical MRD units | approximately 316,000 | 56% growth |
| Gross margin | approximately 65% | Not stated |
| Signatera ASP | approximately $1,290 | Not stated |
How management sounded
Balanced (+35 on our -100 to +100 scale). Management highlighted strong volume growth, an exceptional quarter across clinical MRD, and raised full-year guidance, while also setting an ambitious long-term revenue target of $6 billion by 2029. Management sounded more upbeat than on 9% of the 194 calls we cover; most companies sound positive on their own calls, so the comparison says more than the label.
Read the analyst Q&A summary and guidance and outlook for this call.
What to watch before the next call
- Progress and timing of remaining MolDX submissions and coverage decisions.
- Regulatory approval and pricing finalization for Signatera in Japan.
- Execution of the FIND study and early cancer detection pipeline milestones in 2027.
Earlier calls
- Q2 2026 (Aug 6, 2026), tone Balanced: Natera reported record second quarter 2026 revenue of $753 million and raised its full year revenue guidance by $100 million at the midpoint, driven by strong test volumes and clinical adoption.
