NeuroPace (NPCE) Q2 2026 Earnings Report

The call conveyed solid commercial momentum and improving non‑GAAP profitability metrics, highlighted by double‑digit RNS growth (21%+) and upgraded full‑year guidance and margin outlook. Strategic progress was underscored by the AI product launch (ECoG Assistant), deep proprietary EEG data (27M+ recordings), and ongoing model training and remote care development. The principal negative item was the FDA's determination that the IGE PMA supplement was not approvable in its current form, which introduces regulatory timing uncertainty and the need for additional analyses—however, the agency remained interactive and recommended the SIR process, and management expects to pursue an amendment. Other smaller headwinds included a significant decline in service revenue and modest gross margin pressure. On balance, operational momentum, product innovation, and improved adjusted profitability substantially outweigh the setbacks, though regulatory risk remains a key watch item.

NeuroPace raised 2026 total revenue guidance to $99.5–$101.5M (from $99–$101M), with underlying RNS revenue unchanged at $98.5–$100.5M (implying RNS growth of 21%–23% y/y) and service revenue now expected at ~ $1.0M (vs. prior $0.5M); management expects Q3 RNS growth similar to H1 (~20% y/y). Full‑year adjusted gross margin was increased to 82%–83% (from 81.5%–82.5%), and adjusted operating expenses are guided to $90–$92M (including ~ $10M of stock‑based compensation) with adjusted S&M $46–$48M, R&D ≈ $27M and G&A ≈ $17M. The company now expects an adjusted EBITDA loss of $7.5–$8.5M (improved from $8.5–$9.5M). For context, Q2 results driving this outlook included total revenue $22.8M (+17% y/y), RNS revenue $22.5M (+21.3% y/y), H1 RNS $44.2M (+20.4% y/y), Q2 adjusted gross margin 83.4% (GAAP 82.8%), Q2 adjusted EBITDA loss $2.8M, cash & equivalents $51.9M and long‑term borrowings $59.0M as of 6/30/26.