Vivos Therapeutics, Inc. (VVOS) Q4 2025 Earnings Call Transcript
Access earnings results, analyst expectations, report, slides, earnings call, and transcript.
Overview
The earnings call reveals significant financial challenges: a 50.5% increase in operating expenses, a widened net loss, and substantial liabilities, which overshadow the 17% gross profit increase. The Q&A section highlights revenue drops due to provider absences and an unclear path to cash flow positivity. While there are growth prospects with new models and partnerships, the immediate financial health and guidance issues, coupled with increased debt, suggest a negative stock price reaction.
Key Financial Performance
Full Year 2025 Revenue $2.4 million increase (16% YoY). This was primarily due to a $4.8 million increase in sleep testing services and $2.2 million from treatment revenue at SCN's sleep centers. However, it was partially offset by a $1.4 million decline in product revenue, $2 million decrease in VIP enrollment revenue, and $700,000 decrease in sponsorship, conference, and training revenue.
Oral Appliances and Tooth Positioners Revenue $6.5 million in 2025, an 18% decrease from $7.9 million in 2024. This decline was due to increased discounts ($1.6 million in 2025 vs. $200,000 in 2024) and a shift towards lower-priced tooth positioners.
Cost of Sales $6.9 million in 2025, a 15% increase from $6 million in 2024. This was driven by $1.1 million higher costs in diagnostic services and $0.5 million in additional staff costs for sleep center affiliations.
Gross Profit $10.5 million in 2025, a 17% increase from $9 million in 2024. This was due to a $2.4 million revenue increase, offset by a $900,000 rise in cost of sales. Gross margin remained constant at 60%.
Operating Expenses $30.4 million in 2025, a 50.5% increase from $20.2 million in 2024. This was primarily due to a $9.8 million rise in general and administrative expenses, including $6.7 million for SCN operations, $1.6 million in professional fees, $800,000 in salaries, and $600,000 in infrastructure costs.
Sales and Marketing Expenses $1.4 million in 2025, a $300,000 decrease from $1.7 million in 2024. This was due to a $200,000 reduction in commissions and $100,000 decrease in convention and trade show expenses.
Depreciation and Amortization $1.3 million in 2025, a 116.7% increase from $600,000 in 2024. This increase was due to additional depreciable assets from the SCN acquisition and affiliations model.
Net Loss $21.2 million in 2025, an increase from 2024. This was due to higher costs from the strategic transition, including $1.4 million in one-time expenses, recruiting and training staff, and infrastructure investments.
Net Cash Used in Operating Activities $15.3 million in 2025, compared to $12.7 million in 2024. This reflects increased operational costs.
Total Liabilities $26.7 million as of December 31, 2025, compared to $7.3 million in 2024. This increase was due to debt incurred for the SCN acquisition and funding.
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Operating Highlights
FDA Clearance for Severe OSA Treatment: In November 2023, Vivos received FDA clearance for specific appliances to treat severe OSA, eliminating the need for off-label use.
Pediatric OSA Treatment: In September 2024, FDA clearance was obtained for treating moderate to severe OSA in children aged 6 to 17 years.
Acquisition of Sleep Center of Nevada (SCN): Acquired SCN in June 2025, leading to a 16% revenue increase in 2025, primarily from sleep testing services and treatment revenue.
Expansion in Las Vegas: Expanded physical facilities and staffing at SCN to meet higher-than-expected patient demand for OSA treatments.
Detroit Affiliation: Opened a new Sleep and Airway Medicine Center in Auburn Hills, Michigan, as part of a national expansion strategy.
Revenue Growth: Achieved a 16% revenue increase in 2025, driven by SCN acquisition and new treatment revenue, despite a decline in legacy VIP dentist revenue.
Cost Management: Operating expenses increased due to SCN integration, including $6.7 million in SCN-related costs and $1.6 million in professional fees.
Insurance Coverage: SCN received in-network status with several commercial insurers and Medicare, improving patient access to treatments.
Shift to Medical Provider Model: Pivoted from a VIP dentist-focused model to a medical provider-focused strategy, resulting in reduced legacy revenue but higher potential growth.
Affiliation Model: Exploring partnerships with medical specialty groups across the U.S. to replicate the SCN model, which is more capital-efficient than acquisitions.
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Risk or Challenges
Revenue Decline in Legacy Programs: The company experienced a decline in product revenue from legacy VIP dentists, with a $1.4 million decrease in appliance and tooth positioner sales and a $2 million decrease in VIP enrollment revenue. This was attributed to the strategic pivot away from the legacy business model.
Increased Discounts and Lower Price Point Products: Revenue from oral appliances and tooth positioners decreased by 18% due to increased discounts ($1.6 million in 2025 compared to $200,000 in 2024) and a shift towards lower price point products.
Higher Operating Expenses: Operating expenses increased significantly to $30.4 million in 2025 from $20.2 million in 2024, driven by costs associated with the new business model, including $6.7 million for SCN operations, $1.6 million in professional fees, and $800,000 in salaries and wages.
Net Loss and Cash Flow Challenges: The company reported a net loss of $21.2 million in 2025, reflecting higher costs from the strategic transition. Net cash used in operating activities increased to $15.3 million in 2025 from $12.7 million in 2024, and total liabilities rose to $26.7 million from $7.3 million.
Capacity Constraints at SCN: The SCN locations faced capacity constraints, with insufficient physical space, inadequate number of trained providers, and delays in insurance credentialing, limiting the ability to meet patient demand.
Dependence on Additional Financing: The company raised $4.6 million in January 2026 and $2.25 million in April 2026 to bolster equity and comply with NASDAQ requirements, indicating a reliance on external financing to sustain operations.
Integration and Scalability Risks: The integration of SCN into operations required significant time, investment, and effort, with ongoing challenges in scaling the model to other locations.
Regulatory and Insurance Challenges: Delays in obtaining full access to major insurance carriers and third-party payer credentialing posed barriers to servicing more patients and generating revenue.
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Guidance & Outlook
Revenue Growth: The company expects more revenue from higher price point products in 2026 and beyond, following the integration of SCN and the achievement of critical insurance coverage for advanced OSA appliances.
Operational Expansion: Plans to deploy additional Sleep Optimization (SO) teams in 2026 to meet patient demand, with each team potentially generating over $500,000 per month in net collections. Expansion of diagnostic and treatment services, including a pediatric OSA program and collaborations with specialty medical groups, is also planned.
Market Expansion: The company is exploring affiliation opportunities with medical specialty groups across the U.S., aiming to replicate the SCN model in other markets. Affiliations are expected to be more capital-efficient than acquisitions, preserving 75%-80% of economics for the company.
Financial Goals: The company aims to achieve cash flow positive operations by the end of 2026, supported by cost-saving initiatives and strengthened capital structure.
Insurance Coverage: SCN has received in-network status with several commercial health insurance payers and Medicare, which is expected to improve patient access and revenue.
New Revenue Streams: Plans to offer additional diagnostic and treatment services, such as CO2 laser treatments, myopia functional therapy, and home EEG testing, to enhance revenue and patient outcomes.
Scalability: The SAMC model is designed to be scalable and replicable across multiple markets, with potential for higher revenue and better gross margins.
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Shareholder Return Plan
The selected topic was not discussed during the call.
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Key Q&A
Q:What caused the revenue drop from $6.8 million in Q3 to $3.8 million in Q4?
A:The revenue drop was due to a decrease in total doctor days caused by unexpected provider absences, including family problems, health issues, and travel constraints among dentists. This led to a significant loss in productivity. The company has since recruited additional providers to address this issue.
Q:What are the expectations for Q1 and Q2 revenue performance?
A:The company expects some improvement in Q1, with most of the impact seen in Q2. This is due to the recruitment of new providers and gaining in-network access with payers, which started contributing to revenue in late Q1.
Q:What quarterly revenue run rate is needed to achieve cash flow positivity by 2026?
A:The company needs to double its 2025 revenue run rate of $17 million by 2027 to achieve cash flow positivity, while also reducing legacy VIP costs.
Q:What is the status of the $8.3 million in current portion of long-term debt?
A:The debt, previously classified as long-term, has been reclassified as short-term due to its 2026 maturity date. The company plans to either roll it over or pay it off, depending on compliance with debt covenants and capital-raising efforts.
Q:What was the year-on-year growth in diagnostic and treatment revenue under the new model?
A:Diagnostic revenue increased from $4.8 million in 2024 to $6 million in 2025, driven by SCN. Treatment revenue from positive OSA diagnoses reached $2.2 million in 2025. The total increase in new model revenue was over $8 million, offset by a $2 million decrease in VIP revenue.
Q:What lessons has the company learned from integrating SCN, and how will these shape future expansion?
A:The company has learned to collaborate with medical doctors, coordinate patient care across specialties, navigate insurance payer systems, and establish regulatory-compliant entities. These lessons will accelerate in-network participation and revenue generation in future expansions.
Q:What is the status of the partnership with SoundHealth?
A:The partnership is in its early stages, but patient demand in Las Vegas has exceeded expectations. While not expected to be a material contributor to earnings, the company is seeking to expand the relationship.
Q:What are the company's long-term growth prospects and reasons for optimism?
A:The company is optimistic due to the success of its new business model, which intercepts patients at the diagnosis stage and offers an alternative to CPAP. Demand from specialty groups and the cost-effectiveness of expanding SOTs further support growth prospects. The company believes it has the best technology for treating obstructive sleep apnea.
Q:How does the company plan to address challenges in recruiting and retaining providers?
A:The company has implemented redundancy in its provider pool to address unexpected attrition. It has successfully recruited additional doctors, nurse practitioners, and staff, and does not foresee recruitment challenges as a limiting factor in the future.
Q:Review of Unclear Management Responses
A:No questions were avoided or lacked clarity in the responses provided by management.
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Earnings Word Cloud
The most frequently occurring keywords in this quarter's earning call
Depreciation amortization
Detroit affiliation
Detroit center
Full Conference
General increase
Huntsman progress
NASDAQ stockholder
Nevada Detroit
Nevada pivot
New Seneca
OSA appliance
Partners proceeds
SCN treatment
Treatment
VIP dentist
affiliation increase
age
appliance tooth
asset
center affiliation
discount
point product
positioner decrease
positioner sale
price point
product legacy
requirement
section website
side
sleep center
staff
stockholder equity
tooth positioner
training
treatment patient
year
VVOS Transcript
Vivos Therapeutics, Inc. (VVOS) Q4 2025 Earnings Call Transcript
Unknown4-15
The earnings call reveals significant financial challenges: a 50.5% increase in operating expenses, a widened net loss, and substantial liabilities, which overshadow the 17% gross profit increase. The Q&A section highlights revenue drops due to provider absences and an unclear path to cash flow positivity. While there are growth prospects with new models and partnerships, the immediate financial health and guidance issues, coupled with increased debt, suggest a negative stock price reaction.
Vivos Therapeutics, Inc. (VVOS) Q3 2025 Earnings Call Transcript
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The earnings call presents a mixed picture. While there is a significant revenue growth and expansion plans, concerns remain about cash flow and profitability due to ongoing net losses and high expenses. The Q&A section reveals optimism for future growth but lacks specific timelines for breakeven, which could worry investors. The slight decrease in gross margin and the substantial net loss further contribute to a neutral sentiment. Without market cap data, the impact on stock price is uncertain, but the lack of clear guidance tempers the positive elements.
Vivos Therapeutics, Inc. (VVOS) Q2 2025 Earnings Call Transcript
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The earnings call reveals several concerns: a 6% revenue decline, increased operating losses, high acquisition costs, and cash flow challenges. Despite potential long-term benefits from acquisitions and strategic alliances, the immediate financial strain and reliance on debt raise red flags. No positive shareholder return plan was discussed, and the Q&A section did not clarify management's responses. Without a market cap, the stock's volatility is uncertain, but the financial issues suggest a negative short-term outlook.
Earnings call transcript: Vivos Therapeutics reports Q1 2025 earnings, stock rises
Unknown5-15
The earnings call reveals mixed financial performance, with declining total revenue and gross margins, and an increase in operating loss. While there are positive developments, such as the SCN acquisition and potential revenue growth, the company's financial health is concerning, with significant cash burn and increased operational expenses. The Q&A section highlighted management's vague responses regarding financial impact, raising concerns. Given these factors, the stock price is likely to react negatively in the short term, with a potential decline between -2% to -8%.
VVOS Report
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