Inspire Medical Systems Q4 2025 Earnings Call Insights
Written by Emily J. Thompson, Senior Investment Analyst
Updated: 1h ago
0mins
Should l Buy INSP?
Source: seekingalpha
- Revenue Growth: Inspire Medical Systems reported Q4 revenue of $269 million, a 12% increase year-over-year, with full-year revenue reaching $912 million, primarily driven by growth at existing centers and new center additions, indicating the company's ongoing market expansion potential.
- Fee Adjustment Impact: CEO Timothy Herbert highlighted that the coding with the -52 modifier could reduce physician professional fees by 10% to 50%, which may influence physicians' willingness to perform the Inspire V procedure and potentially limit the number of cases, reflecting significant challenges faced by the company.
- Outlook Revision: The company revised its 2026 revenue outlook to $950 million to $1 billion, representing 4% to 10% growth, considering the expected impact of coding uncertainty on the first quarter, demonstrating management's cautious approach to future revenue.
- Clinical Performance Improvement: The Inspire V system demonstrated a 79.5% responder rate in the Singapore study, significantly surpassing the 66% responder rate from the STAR Phase III trial in 2012, indicating that ongoing product performance improvements may support the company's future competitive position.
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Analyst Views on INSP
Wall Street analysts forecast INSP stock price to rise over the next 12 months. According to Wall Street analysts, the average 1-year price target for INSP is 145.31 USD with a low forecast of 91.00 USD and a high forecast of 180.00 USD. However, analyst price targets are subjective and often lag stock prices, so investors should focus on the objective reasons behind analyst rating changes, which better reflect the company's fundamentals.
19 Analyst Rating
13 Buy
6 Hold
0 Sell
Moderate Buy
Current: 68.140
Low
91.00
Averages
145.31
High
180.00
Current: 68.140
Low
91.00
Averages
145.31
High
180.00
About INSP
Inspire Medical Systems, Inc. is a medical technology company. The Company is focused on the development and commercialization of advanced, minimally invasive solutions for patients with obstructive sleep apnea (OSA). Its proprietary Inspire therapy is FDA, EU MDR, and PDMA-approved neurostimulation technology that provides a safe and effective treatment for moderate to severe obstructive sleep apnea. It has developed a novel, closed-loop solution that continuously monitors a patient’s breathing and delivers mild hypoglossal nerve stimulation to maintain an open airway. The Company sells its Inspire system to hospitals and ambulatory surgery centers (ASCs) in the United States (U.S.) and in select countries in Europe and Japan through a direct sales organization and sells its Inspire system in Singapore and Hong Kong through distributors. Its direct sales force engages in sales efforts and promotional activities focused on ear, nose and throat (ENT) physicians and sleep centers.
About the author

Emily J. Thompson
Emily J. Thompson, a Chartered Financial Analyst (CFA) with 12 years in investment research, graduated with honors from the Wharton School. Specializing in industrial and technology stocks, she provides in-depth analysis for Intellectia’s earnings and market brief reports.
- Earnings Beat: Inspire Medical Systems (INSP) reported a non-GAAP EPS of $1.65 for Q4 2025, exceeding expectations by $0.97, while revenue reached $269.1 million, surpassing forecasts by $2.88 million, indicating ongoing growth potential in the sleep apnea treatment sector.
- Revenue Guidance Cut: The company revised its 2026 revenue guidance to $950 million to $1 billion, below the consensus of $1 billion, primarily due to coding uncertainties and the transition of the implant procedure to a different CPT code, which may hinder future revenue growth.
- Negative Market Reaction: Despite the strong earnings report, Inspire's shares fell approximately 6% in after-hours trading, reflecting investor concerns over the lowered revenue guidance, which could impact investor confidence in the medical device market.
- Significant Policy Impact: In January, Inspire's stock declined following a correction from the Centers for Medicare & Medicaid Services (CMS), which stated that obstructive sleep apnea is not a covered indication under the vagus nerve stimulation National Coverage Determination, further exacerbating market uncertainty regarding the company's future revenues.
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- Revenue Growth: Inspire Medical Systems reported Q4 revenue of $269 million, a 12% increase year-over-year, with full-year revenue reaching $912 million, primarily driven by growth at existing centers and new center additions, indicating the company's ongoing market expansion potential.
- Fee Adjustment Impact: CEO Timothy Herbert highlighted that the coding with the -52 modifier could reduce physician professional fees by 10% to 50%, which may influence physicians' willingness to perform the Inspire V procedure and potentially limit the number of cases, reflecting significant challenges faced by the company.
- Outlook Revision: The company revised its 2026 revenue outlook to $950 million to $1 billion, representing 4% to 10% growth, considering the expected impact of coding uncertainty on the first quarter, demonstrating management's cautious approach to future revenue.
- Clinical Performance Improvement: The Inspire V system demonstrated a 79.5% responder rate in the Singapore study, significantly surpassing the 66% responder rate from the STAR Phase III trial in 2012, indicating that ongoing product performance improvements may support the company's future competitive position.
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- Strong Earnings Performance: Inspire Medical Systems reported a Q4 non-GAAP EPS of $1.65, beating expectations by $0.97, indicating a significant enhancement in profitability and reflecting increased competitiveness in the market.
- Significant Revenue Growth: The company achieved Q4 revenue of $269.1 million, a 12.3% year-over-year increase, surpassing expectations by $2.88 million, demonstrating sustained demand for its products, particularly the Inspire V system.
- Improved Gross Margin: Gross margin increased by 160 basis points to 86.6%, primarily due to higher sales volume and an improved sales mix of the Inspire V system, further strengthening the company's profitability and market position.
- Increased Operating Expenses: Operating expenses rose by 9% to $186.9 million, mainly driven by higher investments in patient marketing and education, despite a reduction in R&D expenses, indicating the company's strategic focus on market promotion.
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- Earnings Announcement: Inspire Medical Systems is set to release its Q4 2023 earnings report on February 11 after market close, with consensus EPS estimate at $0.68, reflecting a 40.9% year-over-year decline, while revenue is projected at $266.22 million, indicating an 11.1% year-over-year increase.
- Performance Expectations: Over the past year, Inspire has consistently beaten EPS and revenue estimates 100% of the time, showcasing its robust profitability and market adaptability, which is likely to continue attracting investor interest.
- Estimate Revisions: In the last three months, EPS estimates have seen seven upward revisions with no downward adjustments, and revenue estimates have experienced eight upward revisions, indicating growing analyst confidence in the company's future performance, which may positively impact its stock price.
- Management Changes: Inspire recently appointed a new CFO and presented at the 44th Annual J.P. Morgan Healthcare Conference, further bolstering market confidence in its strategic direction moving forward.
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- Investigation Launched: Kuehn Law, PLLC is investigating whether executives at Inspire Medical Systems, Inc. breached their fiduciary duties to shareholders, which could expose the company to legal risks and financial losses.
- Launch Challenges: The Inspire V launch is struggling due to low demand, primarily caused by providers holding significant surplus inventory and disincentives from reduced physician payments, potentially impacting the company's market share and future revenues.
- Critical Tasks Incomplete: The company failed to complete prerequisite tasks necessary for the Inspire V launch, including training and onboarding for many treatment centers and lacking necessary IT approvals, which could lead to operational chaos post-launch.
- False Statement Risks: The company's positive statements regarding its preparedness for the Inspire V launch have been accused of being materially false or misleading, which may erode shareholder trust in management and negatively affect stock prices and investor confidence.
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