Nutex Health (NASDAQ:NUTX) reported lower third-quarter revenue and earnings despite a rise in hospital visits, as executives pointed to prior-year revenue adjustments tied to collections under the federal independent dispute resolution process.
Revenue fell to $217.6 million in the third quarter of 2026 from $267.8 million a year earlier, a decline of about 19%. Net income attributable to Nutex dropped to $40.2 million from $55.4 million, while adjusted EBITDA fell to $63.9 million from $98.5 million.
Hospital division visits rose 18.1% to 54,622, and visits at same hospitals increased 12.4%. Chief Operating Officer Wes Bamburg attributed the growth in part to a more coordinated business development effort and an expansion of services.
Revenue Comparisons and Collections
Chief Financial Officer Jon Bates said the revenue decline reflected, in part, a higher comparison in 2025, when additional collection history led Nutex to increase its estimated collection percentage as it gained experience with independent dispute resolution, or IDR.
Bates said revenue per visit was approximately $5,600 in the third quarter of 2025, compared with a cumulative average of about $4,200 from the start of Nutex’s IDR process in July 2024 through the end of 2025. He said revenue per visit was around $4,000 for the first nine months of 2026 and described an analyst’s suggested range of roughly $3,800 to $4,200 per quarter as fair, while noting that the figure could move either way.
Chairman and CEO Tom Vo also said ineligible charts had been included from mid-2024 through the first three quarters of 2025 and were adjusted in the fourth quarter of 2025. He said physician fee collections had declined slightly relative to hospital collections, a trend the company is monitoring.
For the first nine months of 2026, revenue fell 11% to $644.9 million from $723.6 million, and adjusted EBITDA declined 13% to approximately $211 million. Net income attributable to Nutex rose to $152.9 million from $59 million. Executives said lower earnout and arbitration-related expenses helped the results; nine-month stock compensation expense fell to $6.4 million from $119.6 million.
Arbitration and Reimbursement
Bates said approximately 50% to 60% of billable visits are submitted through IDR, and 40% to 50% result in an award determination. Nutex prevailed in more than 80% of determinations over the preceding nine months and collected, on average, more than 80% of award amounts for awards from the process’s inception through March 2026, he said.
Bates said the share of visits resulting in determinations had been consistent and that the company added the metric to provide more clarity. Some submissions do not reach a determination because of timing or eligibility issues, including incomplete plan information, he said.
Vo highlighted a Fifth Circuit decision invalidating the use of so-called ghost rates in federal calculations of the qualifying payment amount, a benchmark used in IDR. He said more accurate initial payments could reduce the need for arbitration over time. Bates said Nutex was seeing slightly better initial payments from payers, although the change was not material.
Vo said Nutex supports the Murphy bill, which he said would preserve independent arbitration and strengthen enforcement, and opposes the Pallone bill, which he said would eliminate IDR beginning in 2028 and generally make the payer-calculated qualifying payment amount the final reimbursement. Asked about potential policy changes, Vo said the company did not know what would happen and that proposals still faced multiple steps before becoming law.
Expansion and Capital Plans
Nutex expects hospitals in San Antonio, Texas, and Jacksonville, Florida, to open in the fourth quarter. Four additional projects are under construction, with openings targeted for late 2027 or, depending on construction timelines, early 2028, Vo said.
Cash rose to $249.9 million at September 30 from $185.6 million at the end of 2025. Operating cash flow for the first nine months increased to $188.1 million from $177.7 million a year earlier.
Bates said opening hospitals remains the company’s first priority for capital deployment. Nutex also completed some buybacks earlier in 2026 and continues to discuss alternatives including potential dividends, he said. Vo said the board remains focused on growth and is targeting three to five hospitals per year.
President Warren Hosseinion said the population health division oversees nearly 40,000 members and plans to begin enrolling patients in new independent physician associations in Dallas and San Antonio in 2027. The company aims to build one or two such associations around its hospitals each year, he said.
Asked about providing a 2027 outlook, Bates said there was a “good chance” Nutex would offer more detail on its future expectations after discussions as the year ends, but he did not provide guidance on the call.
About Nutex Health (NASDAQ:NUTX)
Nutex Health, Inc (NASDAQ:NUTX) is a physician-led healthcare services company that operates an integrated network of hospitals, medical facilities and physician practices in the United States. The company focuses on providing convenient, community-based care through its micro-hospitals and other healthcare locations.
Its hospital operations generally include emergency services, inpatient care, diagnostic testing and outpatient treatment. Nutex also operates physician networks and supports primary care and specialty providers.
