# XGN earnings call intelligence

LOPJLB CallCard / temporal rollup · freemium · [stock page](https://www.lopjlb.com/stock/XGN) · [Earnings tab](https://www.lopjlb.com/stock/XGN?tab=earnings)

Updated: 2026-08-04T06:54:57

Quarters analyzed: 8

## Cross-quarter narrative

Across eight earnings calls Exagen moved from a recovery phase in early 2024 to a sustained growth trajectory by mid‑2026. Revenue climbed from $14.4 M in Q1 2024 to $17.3 M in Q1 2026, while average selling price rose each quarter, reaching $444 TTM. Gross margins held steady near 60%, and guidance was repeatedly lifted, ending with FY26 revenue of $70‑73 M. The company progressed from launching new T‑cell and RA markers in late 2024 to adding anti‑PAD4 assays in 2025 and advancing a myositis product slated for early‑2027. Commercial expansion accelerated, with sales‑force footprint reductions early on followed by territory additions and a growing pharma‑services backlog. Recurring concerns about regulatory compliance, ASP sustainability and execution timing appeared in the first call and persisted, while new risks emerged in 2026 – weather‑related volume loss, LCD approval uncertainty, and commercialization risk for the myositis product. Cash‑flow outlook improved from a vague positivity target in 2024 to a concrete expectation of EBITDA positivity by FY25‑26. Overall the narrative shows accelerating top‑line growth, stable margins, expanding product pipeline, and a shift from early‑stage execution fears to more specific regulatory and operational risks.

## Latest CallCard · Q1

Exagen reports record Q1 revenue of $17.3M (+12% YoY), reaffirms FY26 guidance $70-73M, ASP expands to $444 TTM, myositis product targeting early 2027 launch. Weather disrupted ~2k tests in Q1. Gross margin 59%, adj. EBITDA loss $2.2M improved 14%. Pharma backlog >$5M. Sales territories expanding. L

**Guidance:** maintained — Reaffirmed FY26 revenue guidance of $70-73M, assuming high single-digit volume growth and low single-digit ASP growth from Q4 2025 exit rate ~$430.

**Tone:** mgmt 0.3 · Q&A pressure 0.4 · divergence 0.1

Management highlights record revenue, ASP expansion, volume growth, and reaffirms guidance while acknowledging weather impact and collection variability.

### Demand visibility

Volume grew 10% YoY, ordering clinicians up 15%, but weather disrupted two weeks in Q1; Q2 start strong with weeks exceeding 2025 highs.

AVISE CTD test volume grew 10% YoY to mid-30k quarterly run rate; ordering clinicians increased 15% to ~2,700; weather in late Jan/early Feb reduced volume ~30% for two weeks (~2k tests lost); demand outside weather weeks tracked expectations; Q2 start strong with several weeks exceeding 2025 weekly highs.

### Margins / costs

Gross margin 59% flat YoY, up 360bps sequentially; OpEx up 9% YoY; adjusted EBITDA loss improved 14% to $2.2M.

Gross margin benefited from ASP strength and COGS rationalization; target mid-60s over time via ASP expansion, scale, cost optimization. SG&A up 8% driven by commercial talent/territory expansion; revenue growth outpacing SG&A growth. R&D up >20% to $1.6M for myositis launch prep. Adjusted EBITDA loss $2.2M, 14% improvement. Cash ~$22M, higher AR due to holding claims early year, expect normalization H2.

### Capital allocation

Investing in commercial expansion (5 new territories), R&D for myositis launch, pharma services backlog growing to $5M.

Added 5 territories in H2 2025, ramping productivity; plan further sales expansion in H2 2026; R&D spending increased for myositis product targeting early 2027 launch; pharma services contract backlog >$5M expected to realize over 2-3 years; no major M&A or buybacks mentioned.

### Milestones

- **AVISE CTD volume growth** [on_track]: 10% YoY growth to mid-30k quarterly run rate; ordering clinicians up 15% to ~2,700
- **ASP expansion** [on_track]: Trailing 12-month ASP $444, up 6% YoY; 12 consecutive quarters of increase; target 50% of Medicare (~$600-650)
- **Myositis product development** [on_track]: First stand-alone product since 2020; targeting commercialization early 2027; 9 abstracts accepted at Autoimmunity 2026; 2 manuscripts accepted for publication
- **Pharma services backlog growth** [on_track]: Contract backlog >$5M, up from $4M range in 90 days; driven by RA and lupus; 2 pharma contracts for PAD4 and RA33
- **LCD filing progress** [at_risk]: On file for years; no clear timeline; would memorialize Medicare coverage and aid Medicare Advantage/commercial discussions
- **New biomarkers (PAD4, RA33) commercialization** [on_track]: Launched 2025; gaining clinical adoption and pharma contracts; only U.S. provider of these markers
- **Sales territory expansion** [on_track]: 5 new territories added H2 2025; 4% improvement in sales productivity TTM; further expansion planned H2 2026
- **Revenue cycle management improvements** [on_track]: Prior period collections $900k in Q1 vs $1.5M full year 2025; appeals improving across multiple payers; medical director engagements increasing

### Fears / risks

- **ASP sustainability**: Prior-period collections are lumpy and hard to project; $900k in Q1 vs $1.5M full year 2025; management not ready to call run rate
- **Volume recovery from weather**: Lost tests are peripheral blood samples with viability constraints; cannot be caught up; Q2 comp may not fully recover
- **LCD approval uncertainty**: Filing pending for years; no update on timing; impact on ASP uplift uncertain
- **Myositis commercialization risk**: First stand-alone product since 2020; requires clinician education and marketing; launch targeted early 2027 but execution risk remains
- **Pharma services revenue conversion**: Backlog >$5M but realization depends on trial enrollment; revenue timing uncertain over 2-3 years
- **Payer reimbursement pressure**: Managed Medicaid patient responsibility evolving; denials and appeals cycles long; in-network contracting needed to lock in rates
- **Sales territory ramp execution**: New territories less than a year old; productivity ramping but further expansion planned H2 2026; execution risk on hiring and support
- **Prior period collections variability**: Collections from older claims can be lumpy quarter-to-quarter; difficult to forecast; may cause ASP volatility

### Key quotes

> “We're starting 2026 off well. Today, we reported record first quarter revenue of $17.3 million, up 12% year-over-year and with continued improvement in profitability metrics as we execute our plan.” — John Aballi

> “We expanded trailing 12-month ASP to $444, up $25 per test or”

## Quarter one-liners

- **2026 Q1:** Exagen reports record Q1 revenue of $17.3M (+12% YoY), reaffirms FY26 guidance $70-73M, ASP expands to $444 TTM, myositis product targeting early 2027 launch. Weather disrupted ~2k tests in Q1. Gross margin 59%, adj. EBITDA loss $2.2M improved 14%. Pharma backlog >$5M. Sales territories expanding. L
- **2025 Q3:** Exagen reports record Q3 revenue of $17.2M, 19% YTD growth driven by volume and ASP gains; launches anti-PAD4 assays; maintains $65-70M FY guidance but ASP ramp slower than expected; cash position strong.','tone': {'mgmt': 0.3, 'mgmt_rationale': 'CEO highlights strongest quarter ever, volume growth,
- **2025 Q2:** Exagen reports record Q2 revenue of $17.2M (+14% YoY), driven by volume growth and ASP expansion; guides FY25 revenue $65-70M with positive adjusted EBITDA expected in Q4.','tone': {'mgmt': 0.7, 'mgmt_rationale': 'Management emphasizes record revenue, strong volume growth, commercial leverage, and p
- **2025 Q1:** Exagen Q1 2025: record $15.5M revenue, ASP $419, volume +6% QoQ; new biomarkers driving growth, first ALJ win, TRICARE policy, Perceptive debt refi extends maturity to 2030; guidance $65M+ revenue, targeting adj EBITDA positive Q4.','tone': {'mgmt': 0.8, 'mgmt_rationale': 'Management highlights nint
- **2024 Q4:** Exagen posted record 2024 revenue of $55.6M (+6%) driven by ASP growth to $411, launched new RA/T-cell biomarkers in Jan 2025 adding ~$90/test incremental revenue, targets adj. EBITDA positivity in Q4 2025. Volume declined 11% YoY but sales territory expansion planned. Gross margins near 60%, target
- **2024 Q3:** Exagen Q3 revenue $12.5M with $1.2M one-time adjustments; expects cash flow positivity by end of 2025; new biomarker launch pending NY approval, commercial launch by year-end. ASP up 7th straight quarter, OpEx down 9% YoY. Gross margin 59.7% ex-adjustments, targeting mid-60s. Cash $22M, burn $2.5M. 
- **2024 Q2:** Exagen Q2: record $15.1M revenue (+6.6% YoY), adj. EBITDA loss $1.6M; raises FY guidance to ≥$57M revenue, adj. EBITDA loss <$12M; AVISE CTD ASP >$400; product enhancements by year-end target cash flow positivity within a year.','tone': {'mgmt': 0.8, 'mgmt_rationale': 'Management highlights record r
- **2024 Q1:** Exagen Q1 2024 revenue jumped 28% to $14.4M on higher AVISE CTD ASP, gross margin rose to 59.6%, adjusted EBITDA improved to -$2M and full‑year revenue guidance was raised to at least $55M, with new T‑cell and RA markers slated for Q4 launch.

## Theme arcs

- **Revenue growth** (improving): From $14.4M in Q1 2024 to $17.3M in Q1 2026 with multiple record quarters
- **ASP expansion** (improving): ASP rose each quarter, reaching $444 TTM in Q1 2026
- **Gross margin** (stable): Margins hovered around 59‑60% throughout the period
- **Guidance trajectory** (improving): Guidance lifted from $55M (2024) to $70‑73M (2026)
- **Product pipeline** (new): Initial T‑cell/RA markers in 2024, anti‑PAD4 in 2025, myositis product development in 2026
- **Commercial expansion** (improving): Territory reduction in 2024 followed by addition of new territories and pharma services backlog
- **Regulatory risk** (stable): FDA final‑rule compliance noted early and LCD approval risk surfaced in 2026
- **Cash‑flow outlook** (improving): From vague positivity target to expected EBITDA positivity by FY25‑26
- **Weather impact** (new): Q1 2026 volume loss of ~2k tests due to weather
- **LCD filing uncertainty** (new): Pending filing with no clear timeline in Q1 2026

## Guidance path

2024 Q1:raised → 2024 Q2:vague → 2024 Q3:vague → 2024 Q4:vague → 2025 Q1:vague → 2025 Q2:vague → 2025 Q3:vague → 2026 Q1:maintained

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