Lifestance Health Group (LFST) Q3 2026 Earnings Report

The call was strongly positive, supported by 25% revenue growth, substantial adjusted EBITDA and net income improvement, raised full-year guidance, strong clinician additions, specialty-services outcomes and continued geographic expansion. The main challenges were the temporary 2027 EHR-related revenue headwind and $20 million to $30 million implementation cost, a lower fourth-quarter EBITDA cadence due to planned investments, stable rather than improving clinician retention, and reimbursement variability for Spravato.

Full-year 2026 guidance was raised to revenue of $1.741 billion to $1.761 billion, implying a growth rate of 23% at the midpoint; center margin of $599 million to $613 million; adjusted EBITDA of $242 million to $250 million, implying an adjusted EBITDA margin as a percentage of revenue of 14% and roughly 3 percentage points of margin expansion year-over-year; and stock-based compensation of approximately $60 million to $70 million. Fourth-quarter guidance is revenue of $446 million to $466 million, center margin of $149 million to $163 million and adjusted EBITDA of $56 million to $64 million. The 2027 outlook includes revenue growth towards the lower end of the long-term mid-teens range, with the EHR implementation expected to impact 2027 revenue growth by approximately 1 to 2 percentage points, while margins are expected to keep expanding in 2027 and beyond; de novos are guided to 20 to 30 and M&A to roughly 1 to 2 a quarter, and the total revenue per visit expectation is low to mid-single digits. The company expects the EHR implementation to cost roughly between $20 million and $30 million, with no carryover into '28, specialty services growth next year to be similar to this year and meaningfully above the overall book of business, and long-term adjusted EBITDA margins of 15% to 20%, with the 20% not representing a ceiling.