Biodesix delivered its strongest quarterly print since the company's 2020 IPO, with $26.9 million of total revenue (+34% year-over-year), $25.4 million of Diagnostic Tests revenue (+42%), 20,900 tests performed (+38%), 82% gross margin (+200 basis points), a $5.4 million operating loss (a 45% improvement from a $9.7 million loss in Q2 2025), a $7.3 million net loss (a 37% improvement), and a $3.2 million Adjusted EBITDA loss (a 56% improvement). The quarter was reported in the August 5, 2026 8-K (Exhibit 99.1) and the corresponding 10-Q for the period ended June 30, 2026, filed the same day.
The single most important narrative is the commercial-payer coverage restoration. In Q3 2025, a major third-party commercial payer that had previously stopped reimbursing Biodesix for certain of its tests began reimbursing claims for the use of those tests again, and the company has cited the resulting improvement in average revenue per test as a tailwind to the 2026 print, all of it disclosed in the Q2 10-Q for the period ended June 30, 2026. Medicare remains the single largest payer at 35% of Q2 2026 revenue, providing a stable reimbursement floor for the Nodify Lung and IQLung franchises.
The diagnostic revenue line grew 42% on test volume growth of 38%, meaning the average revenue per test expanded as well. Management attributes the per-test improvement to expanded payer coverage, continued improvements to revenue cycle management, and higher contracted rates, in the August 5, 2026 quarterly update. Direct costs and expenses rose 20% to $4.8 million, slower than the 38% volume growth, producing the 200-basis-point gross margin expansion. Total operating expenses rose 8% to $32.2 million, and within that envelope, sales, marketing, general and administrative expense rose 8% to $24.3 million while research and development held essentially flat at $3.1 million, evidence of operating leverage rather than reinvestment.
Biodesix reiterated full-year 2026 revenue guidance of $108 million to $114 million, with the midpoint representing approximately 25% growth over 2025, and it committed to maintaining gross margin of approximately 80% and continued improvement on the path to Adjusted EBITDA profitability. The H1 2026 print of $52.4 million of total revenue implies an H2 2026 back-half run-rate of $55.6 million to $61.6 million to hit the guidance range, an acceleration from the H1 pace that the company has not previously guided to explicitly but that follows from management's repeated commentary about sales-force productivity gains, the resumed commercial-payer coverage, and the operating leverage demonstrated in the first half.
The stock has been one of the most explosive movers in small-cap diagnostics in 2026. The 52-week range of $5.26 to $26.40, with the August 2026 print above $25, reflects a roughly 5x re-rating from the 52-week low in the back half of 2025. The 1-for-20 reverse stock split effective September 15, 2025, which reduced outstanding shares from 155,958,071 to 7,797,830, mechanically lifted the share price by a factor of 20 at the same time that the underlying business re-accelerated, so the optical move and the fundamental move compounded.
The next test for the bull thesis is whether the third quarter confirms the second-quarter operating leverage pattern, whether the resumed commercial-payer coverage holds through a full year of claim experience, and whether ALTITUDE and CLARIFY produce a guideline-inclusion signal that opens the next leg of payer coverage expansion. A miss on any of the three forces a re-rating lower; a hit on all three keeps the trajectory toward the FY 2026 Adjusted EBITDA breakeven target on the table.