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What changed in RadNet, Inc.'s 10-K — 2024 vs 2025

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Paragraph-level year-over-year comparison of RadNet, Inc.'s 2024 and 2025 10-K annual filings, covering the Business, Risk Factors, Legal Proceedings, Cybersecurity, MD&A and Market Risk sections. Every new, removed and edited paragraph is highlighted side-by-side so you can see exactly what management changed in the 2025 report.

+272 added−285 removedSource: 10-K (2026-03-02) vs 10-K (2025-03-03)

Top changes in RadNet, Inc.'s 2025 10-K

272 paragraphs added · 285 removed · 199 edited across 9 sections

Item 1. Business

Business — how the company describes what it does

54 edited+15 added−6 removed163 unchanged
Biggest changeThe following table sets forth the number of our centers operated directly or managed through joint ventures for each year during the three-year period ended December 31, 2024: Years Ended December 31, 2024 2023 2022 Total centers owned or managed (at beginning of the year) 366 357 347 Centers added by: Acquisition 28 10 8 Internal development 44 11 14 Centers closed or sold (40) (12) (12) Total centers owned or managed (at year end) 398 366 357 Diagnostic Imaging Equipment The following table indicates, as of December 31, 2024, the quantity of principal diagnostic equipment available at our imaging centers operated directly or through joint venture investments: Equipment Count Years Ended December 31, 2024 2023 2022 MRI 382 353 340 CT 220 208 208 PET/CT 66 63 67 Mammography 427 405 387 Ultrasound 907 861 818 X-ray 380 363 440 Nuclear Medicine 56 55 57 Fluoroscopy 120 121 116 Total equipment 2,558 2,429 2,433 The average age of our MRI and CT units is less than five years, and the average age of our PET units is less than four years.
Biggest changeThe following table sets forth the number of our centers operated directly or managed through joint ventures for each year during the three-year period ended December 31, 2025: Years Ended December 31, 2025 2024 2023 Total centers owned or managed (at year end) 418 398 366 8 Diagnostic Imaging Equipment The following table indicates, as of December 31, 2025, the quantity of principal diagnostic equipment available at our imaging centers operated directly or through joint venture investments, including both consolidated and unconsolidated joint ventures: Equipment Count Years Ended December 31, 2025 2024 2023 MRI 420 382 353 CT 230 220 208 PET/CT 74 66 63 Mammography 455 427 405 Ultrasound 976 907 861 X-ray 386 380 363 Nuclear Medicine 52 56 55 Fluoroscopy 110 120 121 Total equipment 2,703 2,558 2,429 The average age of our MRI and CT units is less than five years, and the average age of our PET units is less than four years.
Using specially designed trailers, mobile imaging service providers transport imaging equipment and provide services to hospitals and clinics on a part-time or full-time basis, thus allowing small to mid-size hospitals and clinics that do not have the patient demand to justify fixed on-site access to advanced diagnostic imaging technology.
Using specially designed trailers, mobile imaging service providers transport imaging equipment and provide services to hospitals and clinics on a part-time or full-time basis, thus allowing small to mid-size hospitals and clinics that do not have the patient demand to justify fixed on-site equipment access to advanced diagnostic imaging technology.
PET technology has been found highly effective and appropriate in certain clinical circumstances for the detection and assessment of tumors throughout the body, the evaluation of some cardiac conditions and 2 the assessment of epilepsy seizure sites. The information provided by PET technology often obviates the need to perform further highly invasive or diagnostic surgical procedures.
PET technology has been found highly effective and appropriate in certain clinical 2 circumstances for the detection and assessment of tumors throughout the body, the evaluation of some cardiac conditions and the assessment of epilepsy seizure sites. The information provided by PET technology often obviates the need to perform further highly invasive or diagnostic surgical procedures.
Recent technological advancements include: • MRI spectroscopy, which can differentiate malignant from benign lesions; • MRI angiography, which can produce three-dimensional images of body parts and assess the status of blood vessels; • enhancements in teleradiology systems, which permit the digital transmission of radiological images from one location to another for interpretation by radiologists at remote locations; • the development of combined PET/CT and PET/MRI scanners, which combine technologies to create a powerful diagnostic imaging system; and • use of augmented reality technologies make it possible to create three dimensional images that physicians can examine through virtual reality headsets or print using a three dimensional printer.
Recent technological advancements include: • MRI spectroscopy, which can differentiate malignant from benign lesions; • MRI angiography, which can produce three-dimensional images of body parts and assess the status of blood vessels; • enhancements in teleradiology systems, which permit the digital transmission of radiological images from one location to another for interpretation by radiologists at remote locations; • the development of combined PET/CT and PET/MRI scanners, which combine technologies to create a powerful diagnostic imaging system; and • use of augmented reality technologies which make it possible to create three dimensional images that physicians can examine through virtual reality headsets or print using a three dimensional printer.
We believe that the use of the diagnostic capabilities of MRI and other imaging services will continue to increase because they are cost-effective, time-efficient and non- 3 invasive, as compared to alternative procedures, including surgery, and that newer technologies and future technological advancements will further increase the use of imaging services.
We believe that the use of the diagnostic 3 capabilities of MRI and other imaging services will continue to increase because they are cost-effective, time-efficient, and non-invasive as compared to alternative procedures, including surgery, and that newer technologies and future technological advancements will further increase the use of imaging services.
The Health Information Technology for Economic and Clinical Health Act of 2009 (“HITECH”), signed into law on February 17, 2009, dramatically expanded, among other things, (1) the scope of HIPAA to now apply directly to “business associates,” or independent contractors who receive or obtain PHI in connection with providing a service to a covered entity, (2) substantive security and privacy obligations, including new federal security breach notification requirements to affected individuals, DHHS and prominent media outlets, of certain breaches of unsecured PHI, (3) restrictions on marketing communications and a prohibition on covered entities or business associates from receiving remuneration in exchange for PHI, and (4) the civil and criminal penalties that may be imposed for HIPAA violations, increasing the annual cap in penalties from $25,000 to $1.5 million per year.
The Health Information Technology for Economic and Clinical Health Act of 2009 (“HITECH”), signed into law on February 17, 2009, dramatically expanded, among other things, (1) the scope of HIPAA to now apply directly to “business associates,” or independent contractors who receive or obtain PHI in connection with providing a service to a covered entity, (2) substantive security and privacy obligations, 14 including new federal security breach notification requirements to affected individuals, DHHS and prominent media outlets, of certain breaches of unsecured PHI, (3) restrictions on marketing communications and a prohibition on covered entities or business associates from receiving remuneration in exchange for PHI, and (4) the civil and criminal penalties that may be imposed for HIPAA violations, increasing the annual cap in penalties from $25,000 to $1.5 million per year.
This technology has created cost reductions for our centers in areas such as image storage, support personnel and financial management and has further allowed us to optimize the productivity of all aspects of our business by enabling us to: • capture patient demographic, history and billing information at point-of-service; 8 • automatically generate bills and electronically file claims with third-party payors; • record and store diagnostic report images in digital format; • digitally transmit in real-time diagnostic images from one location to another, thus enabling networked radiologists to cover larger geographic markets by using the specialized training of other networked radiologists; • perform claims, rejection and collection analysis; and • perform sophisticated financial analysis, such as analyzing cost and profitability, volume, charges, current activity and patient case mix, with respect to each of our managed care contracts.
This technology has created cost reductions for our centers in areas such as image storage, support personnel and financial management and has further allowed us to optimize the productivity of all aspects of our business by enabling us to: • capture patient demographic, history and billing information at point-of-service; • automatically generate bills and electronically file claims with third-party payors; • record and store diagnostic report images in digital format; • digitally transmit in real-time diagnostic images from one location to another, thus enabling networked radiologists to cover larger geographic markets by using the specialized training of other networked radiologists; • perform claims, rejection and collection analysis; and • perform sophisticated financial analysis, such as analyzing cost and profitability, volume, charges, current activity and patient case mix, with respect to each of our managed care contracts.
We may also continue to use, where appropriate, highly trained radiology physician assistants to perform, under appropriate supervision of radiologists, basic services traditionally performed by radiologists. We will continue to upgrade our advanced information technology system to create cost reductions for our centers in areas such as image storage, support personnel and financial management. Expand Our Networks.
We may also continue to use, where appropriate, highly trained radiology physician assistants to perform, under appropriate supervision of radiologists, basic services traditionally performed by 5 radiologists. We will continue to upgrade our advanced information technology system to create cost reductions for our centers in areas such as image storage, support personnel and financial management. Expand Our Networks.
Our marketing team regularly meets with managed care organizations and insurance companies to solicit contracts and meet with existing contracting payors to solidify those relationships. The comprehensiveness of our services, the geographic location of our centers and the reputation of the physicians with whom we contract all serve as tools for obtaining new or repeat business from payors.
Our marketing team regularly meets with managed care organizations and insurance companies to solicit contracts and meet with existing contracting payors to solidify those relationships. The comprehensiveness of our 10 services, the geographic location of our centers and the reputation of the physicians with whom we contract all serve as tools for obtaining new or repeat business from payors.
California places a $250,000 limit on non-economic damages for medical malpractice cases. The cap applies whether the case is 10 for injury or death, and it allows only one $250,000 recovery in a wrongful death case. Non-economic damages are defined as compensation for pain, suffering, inconvenience, physical impairment, disfigurement and other non-pecuniary injury. No cap applies to economic damages.
California places a $250,000 limit on non-economic damages for medical malpractice cases. The cap applies whether the case is for injury or death, and it allows only one $250,000 recovery in a wrongful death case. Non-economic damages are defined as compensation for pain, suffering, inconvenience, physical impairment, disfigurement and other non-pecuniary injury. No cap applies to economic damages.
The number of MRI and CT scans performed annually in the 1 United States continues to grow due to their wider acceptance by physicians and payors, an increasing number of applications for their use and a general increase in demand due to the aging population. In recent years, there has been rapid development of AI tools for the radiology field.
The number of MRI and CT scans performed annually in the United States continues to grow due to their wider acceptance by physicians and payors, an increasing number of applications for their use and a general increase in demand due to the aging population. In recent years, there has been rapid development of AI tools for the radiology field.
For performing these management services, which include billing, collecting, transcription and medical coding, we receive management fees, that depending on the agreement are calculated at a fixed or variable rate. Payors The fees charged for diagnostic imaging services performed at our centers are paid by a diverse mix of payors: Commercial Insurance.
For performing these management services, which include 7 billing, collecting, transcription and medical coding, we receive management fees, that depending on the agreement are calculated at a fixed or variable rate. Payors The fees charged for diagnostic imaging services performed at our centers are paid by a diverse mix of payors: Commercial Insurance.
Therefore, we monitor developments in healthcare law and modify our operations from time to time as the business and regulatory environment changes. Facilities Licensing and Certification Laws. Ownership, construction, operation, expansion and acquisition of diagnostic imaging centers are subject to various federal and state laws, regulations and approvals concerning licensing of centers and personnel.
Therefore, we monitor developments in healthcare law and modify our operations from time to time as the business and regulatory environment changes. 11 Facilities Licensing and Certification Laws. Ownership, construction, operation, expansion and acquisition of diagnostic imaging centers are subject to various federal and state laws, regulations and approvals concerning licensing of centers and personnel.
HIPAA, among other things, amends existing crimes and criminal penalties 13 for Medicare fraud and enacts new federal healthcare fraud crimes, including actions affecting non-government healthcare benefit programs. Under HIPAA, a healthcare benefit program includes any private plan or contract affecting interstate commerce under which any medical benefit, item or service is provided.
HIPAA, among other things, amends existing crimes and criminal penalties for Medicare fraud and enacts new federal healthcare fraud crimes, including actions affecting non-government healthcare benefit programs. Under HIPAA, a healthcare benefit program includes any private plan or contract affecting interstate commerce under which any medical benefit, item or service is provided.
To achieve this, leaders across the enterprise partner to develop and deliver talent and culture programs, create total rewards strategies, and provide efficient and effective people operations. We believe the strength of our workforce is critical to the success of our mission to provide comprehensive radiology solutions and change the future of healthcare.
To achieve this, leaders across the 9 enterprise partner to develop and deliver talent and culture programs, create total rewards strategies, and provide efficient and effective people operations. We believe the strength of our workforce is critical to the success of our mission to provide comprehensive radiology solutions and change the future of healthcare.
While X-ray remains the most commonly performed diagnostic imaging procedure, the fastest growing and higher margin procedures are MRI, CT and PET. The rapid growth in PET scans is attributable to the increasing recognition of the efficacy of PET scans in the diagnosis and monitoring of cancer.
While X-ray remains the most commonly performed diagnostic imaging procedure, the fastest growing and higher margin procedures are MRI, CT and PET. The rapid growth in PET scans is attributable to the increasing recognition of the 1 efficacy of PET scans in the diagnosis and monitoring of cancer.
We do not believe that such laws and 14 regulations will either prohibit or require licensure approval of our business operations, although no assurances can be made that such laws and regulations will not be interpreted to extend such prohibitions or requirements to our operations. Insurance Laws and Regulation.
We do not believe that such laws and regulations will either prohibit or require licensure approval of our business operations, although no assurances can be made that such laws and regulations will not be interpreted to extend such prohibitions or requirements to our operations. Insurance Laws and Regulation.
The majority of our centers are multi-modality sites, offering various combinations of MRI, CT, PET, nuclear medicine, ultrasound, X-ray, fluoroscopy 7 services and other related procedures. A portion of our centers are single-modality sites, offering either X-ray or MRI services.
The majority of our centers are multi-modality sites, offering various combinations of MRI, CT, PET, nuclear medicine, ultrasound, X-ray, fluoroscopy services and other related procedures. A portion of our centers are single-modality sites, offering either X-ray or MRI services.
We believe that through our comprehensive utilization management, or UM, program we have become highly skilled at assessing and moderating the risks associated with the capitation agreements, so that these agreements are profitable for us.
We believe that through our comprehensive utilization management ("UM") program we have become highly skilled at assessing and moderating the risks associated with the capitation agreements, so that these agreements are profitable for us.
We also provide radiology services at select imaging centers for the Anaheim Ducks, Los Angeles Angels, Los Angeles Rams, Athletics, San Francisco 49ers and student athletes of the University of Southern California.
We also provide radiology services at select imaging centers for the Anaheim Ducks, Los Angeles Angels, Los Angeles Rams, San Francisco 49ers and student athletes of the University of Southern California.
Our current plans are to strengthen our market presence in geographic areas where 5 we currently have existing operations and to expand into neighboring and other areas where we believe we can compete effectively.
Our current plans are to strengthen our market presence in geographic areas where we currently have existing operations and to expand into neighboring and other areas where we believe we can compete effectively.
Department of Health and 11 Human Services that, among other things, established new "safe harbors" under the Anti-kickback Statute for certain value-based compensation arrangements.
Department of Health and Human Services that, among other things, established new "safe harbors" under the Anti-kickback Statute for certain value-based compensation arrangements.
The useful life of our MRI, CT and PET units is typically ten years. Facility Acquisitions Information regarding our facility acquisitions can be found within Item 7 - “Management’s Discussion and Analysis of Financial Condition and Results of Operations”, as well as Note 4 to our consolidated financial statements included in this annual report on Form 10-K.
The useful life of our MRI, CT and PET units is ten years on average. Facility Acquisitions Information regarding our facility acquisitions can be found within Item 7 - “Management’s Discussion and Analysis of Financial Condition and Results of Operations”, as well as Note 4 to our consolidated financial statements included in this annual report on Form 10-K.
Our diagnostic imaging centers are strategically organized into regional networks concentrated in major population centers in eight states, providing a density that offers unique benefits to our patients, our referring physicians, our payors and us. We are able to increase the convenience of our services to patients by implementing scheduling systems within geographic regions, where practical.
Our diagnostic imaging centers are strategically organized into regional networks concentrated in major population centers in nine states, providing a density that offers unique benefits to our patients, our referring physicians, our payors and us. We are able to increase the convenience of our services to patients by implementing scheduling systems within geographic regions, where practical.
Each medical group 6 maintains control over the physicians it employs and is responsible for staffing the facility with qualified professional medical personnel.
Each medical group maintains control over the physicians it employs and is responsible for staffing the facility with qualified professional medical personnel.
Through our east coast operations, we have entered into sponsorship agreements with the Baltimore Ravens of the National Football League and the Baltimore Orioles of Major League Baseball which permit us to state we are the imaging partner to each organization. Both of those agreements are being renewed through 2025.
Through our east coast operations, we have entered into sponsorship agreements with the Baltimore Ravens of the National Football League and the Baltimore Orioles of Major League Baseball which permit us to state we are the imaging partner to each organization. Both of those agreements are being renewed through 2026.
Environmental Matters. The facilities we operate or manage generate hazardous and medical waste subject to federal and state requirements regarding handling and disposal. We believe that the facilities that we operate and manage are currently in compliance in all material respects with applicable federal, state and local statutes and ordinances regulating the handling and disposal of such materials.
The facilities we operate or manage generate hazardous and medical waste subject to federal and state requirements regarding handling and disposal. We believe that the facilities that we operate and manage are currently in compliance in all material respects with applicable federal, state and local statutes and ordinances regulating the handling and disposal of such materials.
Our imaging centers provide physicians with capabilities to facilitate the diagnosis and treatment of diseases and disorders and may reduce unnecessary invasive procedures, often reducing the cost and amount of care for patients. Our services include magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), nuclear medicine, mammography, ultrasound, diagnostic radiology (X-ray), fluoroscopy and other related procedures.
Our Imaging Centers segment provides physicians with capabilities to facilitate the diagnosis and treatment of diseases and disorders and may reduce unnecessary invasive procedures, often reducing the cost and amount of care for patients. Our services include magnetic resonance imaging ("MRI"), computed tomography ("CT"), positron emission tomography ("PET"), nuclear medicine, mammography, ultrasound, diagnostic radiology ("X-ray"), fluoroscopy and other related procedures.
Generally, insurance companies reimburse us, directly or indirectly, including through the Group or through the contracted radiology groups, on the basis of agreed upon rates. These rates are negotiated and may differ materially with rates set forth in the Medicare Physician Fee Schedule for the particular service. The patients may be responsible for certain co-payments or deductibles.
Generally, insurance companies reimburse us, directly or indirectly, including through the Group or through the contracted radiology groups, on the basis of agreed upon rates. These rates are negotiated and may differ materially with rates set forth in the Medicare Physician Fee Schedule (as described below) for the particular service. The patients may be responsible for certain co-payments or deductibles.
Sports Marketing Program. Our west coast operations renders in stadium digital X-ray for the following organizations: Los Angeles Clippers, Dodgers, Kings and Lakers. In exchange, we receive season tickets and parking. Contract lengths vary from yearly up to five years.
Sports Marketing Program. Our west coast operations render in stadium digital X-ray for the following organizations: Los Angeles Dodgers, Kings and Lakers. In exchange, we receive season tickets and parking. Contract lengths vary from yearly to up to five years.
According to a Pew Research Center report issued January 9, 2024, the number of US residents age over 65 stands at approximately 62 million, representing 18% of the population, and is expected to reach 84 million, or 23% of the total population by 2054.
According to a Pew Research Center report issued January 9, 2024, the number of U.S. residents age over 65 stands at approximately 62 million, representing 18% of the population, and is expected to reach 84 million, or 23% of the total population by 2054.
Medicare is the federal health insurance program for people age 65 or older and people under age 65 with certain disabilities. Medicaid, funded by both the federal government and states, is a state-administered health insurance program for qualifying low-income and medically needy persons.
Medicare is the federal health insurance program for people age 65 or older and people under age 65 with certain disabilities. Medicaid, funded by both the federal and state governments, is a state-administered health insurance program for qualifying low-income and medically needy persons.
At the same time, the industry has increasingly used upgrades to existing equipment to expand applications, extend the useful life of existing equipment, improve image quality, reduce image acquisition time and increase the volume of scans that can be performed.
At the same time, the industry has increasingly upgraded existing equipment to expand applications, extend the useful life of existing equipment, improve image quality, reduce image acquisition time and increase the volume of scans that can be performed.
In addition, AI methods can speed up administrative tasks, such as keeping track of individuals needing procedures on a regular basis (i.e., mammograms, follow-up exams, etc.) and alerting our staff to contact the patient and schedule appointments. Diagnostic Imaging Settings Diagnostic imaging services are typically provided in one of the following settings: Fixed-site, freestanding outpatient diagnostic centers.
In addition, AI methods can speed up administrative tasks, such as tracking of individuals who need procedures on a regular basis (i.e., mammograms, follow-up exams, etc.) and alerting our staff to contact the patient and schedule appointments. Diagnostic Imaging Settings Diagnostic imaging services are typically provided in one of the following settings: Fixed-site, freestanding outpatient diagnostic centers.
We have also established an Artificial Intelligence (AI) division, that develops and deploys AI suites to enhance radiologist interpretations of breast, lung and prostate images. The division is led by our DeepHealth, Inc. subsidiary and includes our acquisitions of Aidence Holding B.V. and Quantib B.V., both based in the Netherlands.
We have also established a Digital Health segment division, that develops and deploys Artificial Intelligence ("AI") suites to enhance radiologist interpretations of, among others, breast, lung and prostate images. The segment is led by our DeepHealth, Inc. subsidiary and includes our acquisitions of Aidence Holding B.V. and Quantib B.V., both based in the Netherlands.
During the year ended December 31, 2024, approximately 22% of our net service revenue generated at our diagnostic imaging centers was derived from federal government sponsored healthcare programs (Medicare) and 2% from state sponsored programs (Medicaid).
During the year ended December 31, 2025, approximately 23.4% of our net service revenue generated at our diagnostic imaging centers was derived from federal government sponsored healthcare programs (Medicare) and 2.5% from state sponsored programs (Medicaid).
Our Scale and Reputation. As of December 31, 2024, we operated, directly or indirectly through joint ventures with hospitals, 398 centers in Arizona, California, Delaware, Florida, Maryland, New Jersey, New York, and Texas. We are the largest operator of freestanding, fixed-site outpatient diagnostic imaging service centers in the United States, based on number of centers and revenue.
Our Scale and Reputation. As of December 31, 2025, we operated, directly or indirectly through hospital and health system joint ventures, 418 centers in Arizona, California, Delaware, Florida, Maryland, Virginia, New Jersey, New York, and Texas. We are the largest operator of freestanding, fixed-site outpatient diagnostic imaging service centers in the United States, based on number of centers and revenue.
Integral to the imaging center business is our software arm headed by our eRad, Inc. subsidiary, which sells computerized systems that distribute, display, store and retrieve digital images. We seek to develop leading positions in regional markets in order to leverage operational efficiencies. We develop our imaging business through a combination of organic growth and acquisitions.
Integral to the imaging center business is our Digital Health operating segment, which sells computerized systems that distribute, display, store and retrieve digital images. We seek to develop leading positions in regional markets in order to leverage operational efficiencies. We develop our imaging business through a combination of organic growth and acquisitions.
We strive to care for our team members and are concerned about their total well-being. Headcount and Labor Representation . As of December 31, 2024, we had a total of 8,546 full-time, 454 part-time and 2,021 per diem employees, including those employed by the Group.
We strive to care for our team members and are concerned about their total well-being. Headcount and Labor Representation . As of December 31, 2025, we had a total of 8,844 full-time, 432 part-time and 1,988 per diem employees, including those employed by the Group.
These numbers include 218 full-time and 91 part-time physicians and 2,725 full-time, 296 part-time and 1,321 per-diem technologists. Diversity, Equity, Inclusion, & Belonging . We are committed to creating an inclusive work environment where team members can be their best and authentic selves.
These numbers include 222 full-time and 88 part-time physicians and 2,835 full-time, 282 part-time and 1,244 per-diem technologists. Diversity, Equity, Inclusion, & Belonging . We are committed to creating an inclusive work environment where team members can be their best and authentic selves.
Although we believe that we comply with both federal and state anti-kickback laws and self-referral laws, any finding of a violation of these laws could subject us to criminal and civil penalties or possible exclusion from federal or state healthcare programs. Such penalties would adversely affect our financial performance and our ability to operate our business. Federal False Claims Act.
Although we believe that we comply with both federal and state anti-kickback laws and self-referral laws, any finding of a violation of these laws could subject us to criminal and civil penalties or possible exclusion from federal or state healthcare programs.
As of December 31, 2024, we operated, directly or indirectly through joint ventures with hospitals, 398 imaging centers located in Arizona, California, Delaware, Florida, Maryland, New Jersey, Texas and New York.
As of December 31, 2025, we operated, directly or indirectly through hospital and health system joint ventures, 418 imaging centers located in Arizona, California, Delaware, Florida, Maryland, Virginia, New Jersey, Texas and New York.
These laws and regulations may require physicians and physician networks to meet minimum capital requirements and other safety and soundness requirements. Implementing additional regulations or compliance requirements could result in substantial costs to the contracted radiology practices, limiting their ability to enter into capitated or other risk-sharing managed care arrangements and indirectly affecting our revenue from the contracted practices.
Implementing additional regulations or compliance requirements could result in substantial costs to the contracted radiology practices, limiting their ability to enter into capitated or other risk-sharing managed care arrangements and indirectly affecting our revenue from the contracted practices. 15 Environmental Matters.
With a heightened focus on upskilling our existing workforce, our investment in new training and development platforms and piloting a coaching capabilities builder program for our leaders, we are promoting timely and effective feedback that fosters trust, respect, teamwork, growth, and excellence.
With a heightened focus on upskilling our existing workforce, our investment in new training and development platforms and piloting a coaching capabilities builder program for our leaders, we are promoting timely and effective feedback that fosters trust, respect, teamwork, growth, and excellence. Furthermore, our tuition reimbursement program encourages team members at all levels of the enterprise to seek additional skills.
We intend to continue to expand in established markets through additional joint ventures, particularly with hospital systems. We believe that these joint ventures deepen and expand our strength in markets where we are already established. Leverage our investment in AI and technology to improve services and operating efficiency .
We intend to continue to expand in established markets through additional joint ventures, particularly with hospital systems. We believe that these joint ventures deepen and expand our strength in markets where we are already established. Advancing a Cloud First, AI Powered Digital Health Platform.
The portfolio of software solutions are anchored by eRad, Inc.'s RIS/PACS, informatics designed specifically for outpatient radiology and DeepHealth OS, a cloud-native operating system that helps operate all aspects of the radiology service line from scheduling and patient preparation to technologist workflow to interpretation and referral management.
The portfolio of AI enabled Health Informatics solutions are designed for outpatient radiology as well as hospital systems and at the center of these solutions is the DeepHealth OS, a cloud-native operating system that helps operate all aspects of the radiology service line from scheduling and patient preparation to technologist workflow to interpretation and referral management.
We focus on providing standardized high quality imaging services, regardless of location, to ensure patients, physicians and payors consistency in service and quality. To ensure the high quality of our services, we monitor patient satisfaction, timeliness of services to patients, and delivery of reports to physicians.
To ensure the high quality of our services, we monitor patient satisfaction, timeliness of services to patients, and delivery of reports to physicians.
An unsatisfactory audit of any of our diagnostic imaging centers or contracted radiology practices could result in any or all of the following: significant repayment obligations, exclusion from Medicare, Medicaid or other governmental programs, and civil and criminal penalties. 12 Federal regulatory and law enforcement authorities have increased enforcement activities with respect to Medicare and Medicaid fraud and abuse regulations and other reimbursement laws and rules, including laws and regulations that govern our activities and the activities of the radiology practices.
An unsatisfactory audit of any of our diagnostic imaging centers or contracted radiology practices could result in any or all of the following: significant repayment obligations, exclusion from Medicare, Medicaid or other governmental programs, and civil and criminal penalties.
While we are not aware of any such intentions or actions, we have only limited knowledge regarding the intentions or actions underlying those arrangements. Conduct and business arrangements that do not fully satisfy one of these safe harbor provisions may result in increased scrutiny by government enforcement authorities such as the Office of the Inspector General.
Conduct and business arrangements that do not fully satisfy one of these safe harbor provisions may result in increased scrutiny by government enforcement authorities such as the Office of the Inspector General. 12 Medicare and Medicaid Fraud and Abuse – Stark Law.
Each customer service representative on our physician marketing team is responsible for marketing activity on behalf of one or more centers.
Sales and Marketing Our sales and marketing team employs a multi-pronged approach to marketing, including physician, payor and sports marketing programs, each of which are described below: Physician Marketing. Each customer service representative on our physician marketing team is responsible for marketing activity on behalf of one or more centers.
We are currently developing solutions to improve the quality and consistency of our core imaging services, expand our service offerings, and improve our operating efficiency, ranging from patient intake through billing and collection. Our Services We offer a comprehensive set of imaging services including MRI, CT, PET, nuclear medicine, X-ray, ultrasound, mammography, fluoroscopy and other related procedures.
Our Services We offer a comprehensive set of imaging services including MRI, CT, PET, nuclear medicine, X-ray, ultrasound, mammography, fluoroscopy and other related procedures. We focus on providing standardized high quality imaging services, regardless of location, to ensure patients, physicians and payors consistency in service and quality.
Alongside our established subsidiary eRad, Inc., which develops and sells computerized imaging data storage and retrieval systems, we have assembled an industry leading team of software developers to create radiology workflow solutions that improve patient care.
We have assembled an industry leading team to create radiology workflow solutions that improve patient care and drive efficiency.
Our Quantib B.V. subsidiary is primarily focused on interpretation of prostate MRI for widespread prostate cancer screening. Quantib’s prostate MRI post-processing software has both FDA clearances and European CE marking. Our digital health segment provides these solutions to us and to over 400 customers in the United States, Europe, and Israel. Business Strategy Maximize Performance at Our Existing Centers.
Our Digital Health segment has by now 22 FDA clearances and 15 CE marks across its portfolio of AI-enabled Health Informatics solutions. Our digital health segment provides these solutions to us and to over 2000+ customers in the US and outside of the US. Business Strategy Maximize Performance at Our Existing Centers.
In 2019, we created an AI division that now hosts the combined efforts of our acquisitions of DeepHealth, Inc., Aidence Holding B.V., and Quantib B.V.. The division is currently focused on developing improved medical interpretation of scans within the fields of mammography, lung and prostate imaging.
In 2019, we created an AI enabled Health Informatics team that now hosts the combined efforts of our acquisitions of DeepHealth, Inc., Aidence Holding B.V., Quantib B.V, Kheiron Technologies, ICAD Inc, See Mode Technologies and CIMAR. All of these businesses now constitute the “Digital Health segment” as a standalone business segment within RadNet.
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Given the importance of training data in building modern AI applications as well as getting feedback on performance, our combination of vertical integration and scale provide advantages over other AI creators.
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The segment is currently focused on developing improved medical interpretation of scans within the fields of Clinical AI for mammography, lung, prostate, ultrasound imaging AI, as well as Enterprise Operations and Enterprise Imaging products such as RIS, PACS, Reporting and a Remote Scanning Solution for imaging modalities.
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Our DeepHealth, Inc. subsidiary has received FDA clearance for use of its SaigeQ “triage”/workflow product, SaigeDX advanced diagnostic product and Saige-Density breast density assessment software for screening breast mammography, which we have begun to roll out in certain markets as an Enhanced Breast Cancer Detection solution.
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In 2025, the Digital Health segment integrated the business of ICAD Inc. which was a leader in providing AI solutions for Breast Cancer detection. This acquisition added roughly 1500 customers to the Digital Health business along with differentiating commercialization and product development capabilities.
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Our Aidence Holding B.V. subsidiary is developing solutions for interpretation of chest and lung CT scans for lung cancer screening. It has received the CE mark for its solution and has existing customers in seven European countries, with its largest concentration in the United Kingdom, and plans to submit an application for FDA clearance to sell in the United States.
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Additionally, in November 2025 the segment acquired CIMAR in UK which provides Image exchange platform Services for various NHS hospitals as well as private healthcare providers. This acquisition enables us to deliver screening programs with embedded AI solutions at scale in the UK and over time in other countries as well.
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We have developed a portfolio of proprietary technologies that stretch from patient-scheduling, to image storage and retrieval, to AI applications that aid in the interpretation of scans in certain fields. We intend to use our substantial investment in technology and AI to create differentiated service offerings in each phase of our business.
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Our Digital Health segment, DeepHealth, is a global leader in AI‑powered health informatics, offering a portfolio of 22 FDA‑cleared and 15 CE‑marked solutions. The radiology market is facing increasing clinical, financial, and operational pressures, driven in part by fragmented care delivery and the proliferation of AI tools developed in isolation.
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Furthermore, our tuition reimbursement program encourages team members at all levels of the enterprise to seek additional skills. 9 Sales and Marketing Our sales and marketing team employs a multi-pronged approach to marketing, including physician, payor and sports marketing programs, each of which are described below: Physician Marketing.
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This siloed environment places the burden on care teams to manually bridge workflow gaps, contributing to inefficiencies and rising costs. DeepHealth addresses these challenges through the DeepHealth OS, an enterprise‑wide platform that unifies clinical and operational intelligence.
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Medicare and Medicaid Fraud and Abuse – Stark Law.
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By integrating AI, workflow orchestration, and data management into a single operating system, DeepHealth enables health systems to streamline radiology operations, enhance diagnostic quality, and improve care coordination across the imaging value chain. Leverage our investment in AI and technology to enhance RadNet service .
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We continue to invest in proprietary technologies that strengthen RadNet’s core imaging operations and create differentiated service offerings. Our technology portfolio spans patient scheduling, image storage and retrieval, radiology information systems (RIS), picture archiving and communication systems (PACS), and advanced AI applications that support scan interpretation across multiple clinical domains.
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We are deploying these capabilities across RadNet to improve quality, consistency, and efficiency from patient intake through billing and collections.
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Current initiatives include: • Enhancing contact center operations through intelligent automation • Expanding remote scanning and technologist support capabilities • Integrating AI‑assisted image interpretation into clinical workflows • Optimizing scheduling, throughput, and resource utilization • Modernizing RIS and PACS infrastructure to support enterprise‑scale operations These investments are designed to reduce operating costs, improve patient and provider experience, and strengthen RadNet’s competitive position in each market we serve.
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Expanding our commercial footprint. We intend to continue scaling our commercial Digital Health business, building on a global customer base of more than 2,000 organizations. Our strategy is to expand adoption of our comprehensive portfolio across Enterprise Operations, Enterprise Imaging, and Clinical AI/Population Health.
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We plan to grow commercial revenue by: 6 • Increasing penetration within existing customer accounts • Expanding internationally in markets with rising imaging demand • Broadening our product suite to address additional clinical and operational use cases • Leveraging the DeepHealth OS platform to deliver integrated, enterprise‑wide solutions Through these initiatives, we aim to accelerate commercial growth, deepen customer relationships, and position RadNet as a leading provider of AI‑enabled imaging and operational intelligence solutions worldwide.
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While we are not aware of any such intentions or actions, we have only limited knowledge regarding the intentions or actions underlying those arrangements.
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Federal regulatory and law enforcement authorities have increased enforcement activities with respect to Medicare and Medicaid fraud and abuse regulations and other reimbursement laws and rules, including laws and regulations that govern our activities and the activities of the radiology practices.
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Such penalties would adversely affect our financial performance and our ability to operate our business. 13 Federal False Claims Act.
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These laws and regulations may require physicians and physician networks to meet minimum capital requirements and other safety and soundness requirements.

Item 1A. Risk Factors

Risk Factors — what could go wrong, per management

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Biggest changeThe future success and growth of our business depends on streamlined processes made available through information systems, global communications, internet activity and other network processes. 20 Our information technology system is vulnerable to damage or interruption from: • Cybersecurity attacks and breaches, ransomware and computer viruses, coordinated attacks by hackers, activist entities, organized criminal threat actors, and nation-state sponsored actors, seeking to disrupt operations or misappropriate information; • technology service provider outages and technology supply chain cyber-security weaknesses; • power losses, computer systems failures, internet and telecommunications or data network failures, operator negligence, improper operation by or supervision of employees, physical and electronic losses of data and similar events; • earthquakes, fires, floods and other natural disasters; and • acts of vandalism or theft, misplaced or lost data, programming or human errors and similar events.
Biggest changeOur information technology system is vulnerable to damage or interruption from: • Cybersecurity attacks and breaches, ransomware and computer viruses, coordinated attacks by hackers, activist entities, organized criminal threat actors, and nation-state sponsored actors, seeking to disrupt operations or misappropriate information; • technology service provider outages and technology supply chain cyber-security weaknesses; • power losses, computer systems failures, internet and telecommunications or data network failures, operator negligence, improper operation by or supervision of employees, physical and electronic losses of data and similar events; • earthquakes, fires, floods and other natural disasters; and • acts of vandalism or theft, misplaced or lost data, programming or human errors and similar events. 21 Cybersecurity threats are constantly changing, increasing the difficulty of successfully defending against them or implementing adequate preventive measures.
Under the terms of our management agreements, the radiology groups are required use their best efforts to provide medical services at our centers as well as any new centers that we open or acquire in their areas of operation.
Under the terms of our management agreements, the radiology groups are required to use their best efforts to provide medical services at our centers as well as any new centers that we open or acquire in their areas of operation.
If our operations are found to be in violation of any of the laws and regulations to which we or the radiology practices with which we contract are subject, we may be subject to penalties, including civil and criminal penalties, damages, fines and the curtailment of our operations.
If our operations are found to be in violation of any of the laws and regulations to which we or the radiology practices with which we contract are subject, we may be subject to penalties, including civil and criminal penalties, damages, fines and curtailment of our operations.
For example, the following circumstances may adversely affect our ability to obtain insurance at favorable rates: • we experience higher-than-expected professional liability, property and casualty, or other types of claims or losses; • we receive survey deficiencies or citations of higher-than-normal scope or severity; • we acquire especially troubled operations or facilities that present unattractive risks to current or prospective insurers; • insurers choose to stop operating or offering policies in certain states due to changes in economic conditions or laws; 28 • insurers tighten underwriting standards applicable to us or our industry; or • insurers or reinsurers are unable or unwilling to insure us or the industry at historical premiums and coverage levels.
For example, the following circumstances may adversely affect our ability to obtain insurance at favorable rates: • we experience higher-than-expected professional liability, property and casualty, or other types of claims or losses; • we receive survey deficiencies or citations of higher-than-normal scope or severity; • we acquire especially troubled operations or facilities that present unattractive risks to current or prospective insurers; • insurers choose to stop operating or offering policies in certain states due to changes in economic conditions or laws; • insurers tighten underwriting standards applicable to us or our industry; or • insurers or reinsurers are unable or unwilling to insure us or the industry at historical premiums and coverage levels.
Relatedly, reimbursement rate cuts may be pursued as a cost-saving measure by third party payors resulting from the implementation of 17 the federal No Surprises Act (H.R. 133) and similar insurer-provider payment dispute laws, which also may negatively impact our revenue. Certain of our services may require patients to pay out-of-pocket fees.
Relatedly, reimbursement rate cuts may be pursued as a cost-saving measure by third-party payors resulting from the implementation of the federal No Surprises Act (H.R. 133) and similar insurer-provider payment dispute laws, which also may negatively impact our revenue. Certain of our services may require patients to pay out-of-pocket fees.
These laws are enforced by state courts and regulatory authorities, each with broad discretion. A component of our business has been to enter into management agreements with radiology practices. We provide management, administrative, technical and other non-medical services to the radiology practices in exchange for a service fee typically based on a percentage of the practice’s revenue.
These laws are enforced by state courts and regulatory authorities, each with broad discretion. A component of our business has been to enter into management agreements with radiology practices. We provide management, administrative, technical and other non-medical services to the radiology practices in exchange for a service fee typically based on a percentage of the practice’s 26 revenue.
We cannot predict with certainty the impact that any particular federal and state 23 healthcare legislation or regulation will have on us, but such changes could impose new and/or more stringent regulatory requirements on our activities or result in reduced payment rates, any of which could adversely affect our business, financial condition, and results of operations.
We cannot predict with certainty the impact that any particular federal and state healthcare legislation or regulation will have on us, but such changes could impose new and/or more stringent regulatory requirements on our activities or result in reduced payment rates, any of which could adversely affect our business, financial condition, and results of operations.
Unless we can secure additional procedure volumes, increase utilization of our equipment, or change the overall mix of service procedures that we provide, a decline in reimbursement rates will reduce our net revenues and results of operations. If we fail to manage the complex and lengthy reimbursement process, our revenue, financial condition and results of operations could suffer.
Unless we can secure additional 18 procedure volumes, increase utilization of our equipment, or change the overall mix of service procedures that we provide, a decline in reimbursement rates will reduce our net revenues and results of operations. If we fail to manage the complex and lengthy reimbursement process, our revenue, financial condition and results of operations could suffer.
These fluctuations in our 18 operating results could cause our performance in any particular period to fall below the expectations of securities analysts or investors or guidance we have provided to the public, which could negatively affect the price of our common stock. If our contracted radiology practices terminate their agreements with us, our business could substantially diminish.
These fluctuations in our operating results could cause our performance in any particular period to fall below the expectations of securities analysts or investors or guidance we have provided to the public, which could negatively affect the price of our common stock. If our contracted radiology practices terminate their agreements with us, our business could substantially diminish.
If a sufficiently large number of these physicians and other third parties were to discontinue referring patients to us, our imaging procedure volume would decrease, which would reduce our net revenue and operating margins. 19 Further, commercial third-party payors have implemented managed care programs that could limit the ability of physicians to refer patients to us.
If a sufficiently large number of these physicians and other third parties were to discontinue referring patients to us, our imaging procedure volume would decrease, which would reduce our net revenue and operating margins. Further, commercial third-party payors have implemented managed care programs that could limit the ability of physicians to refer patients to us.
Furthermore, the healthcare laws and regulations applicable to us may be amended or interpreted in a manner that could have a material adverse effect on our business, prospects, results of operations and financial condition. We may be impacted by eligibility changes to government and private insurance programs.
Furthermore, the healthcare laws and regulations applicable to us may be amended or interpreted in a manner that could have a material adverse effect on our business, prospects, results of operations and financial condition. 24 We may be impacted by eligibility changes to government and private insurance programs.
Our centers are subject to periodic inspection by governmental and other authorities to assure continued compliance with the various standards necessary for licensure and certification. If any facility loses its certification under the Medicare 25 program, then the facility will be ineligible to receive reimbursement from the Medicare and Medicaid programs.
Our centers are subject to periodic inspection by governmental and other authorities to assure continued compliance with the various standards necessary for licensure and certification. If any facility loses its certification under the Medicare program, then the facility will be ineligible to receive reimbursement from the Medicare and Medicaid programs.
Thus, decreased revenue as a result of lower scan volumes, product mix, or reductions in reimbursement rates could result in lower margins, which would materially adversely affect the profitability of our business. Our substantial debt could adversely affect our financial condition and prevent us from fulfilling our obligations under our outstanding indebtedness.
Thus, decreased revenue as a result of lower scan volumes, product mix, or reductions in reimbursement rates could result in lower margins, which would materially adversely affect the profitability of our business. Our debt could adversely affect our financial condition and prevent us from fulfilling our obligations under our outstanding indebtedness.
We could incur significant costs and the diversion of our management’s attention in order to comply with current or future environmental and health and safety laws and regulations. Also, we cannot completely eliminate the risk of accidental contamination or injury from these hazardous materials.
We could incur significant costs and the diversion of our management’s attention in order to comply with current or future environmental and health and safety laws and regulations. Also, we cannot completely eliminate the risk of accidental 27 contamination or injury from these hazardous materials.
As a result, we do not anticipate declaring or paying any cash dividends or other distributions in the foreseeable future. Further, if we were to enter into a credit facility or issue debt securities or preferred stock in the future, we may become contractually restricted from paying dividends.
As a result, we do not anticipate declaring or paying any cash dividends or other distributions in the foreseeable future. Further, if we were to enter into a credit facility or issue debt securities or preferred stock in the future, we 30 may become contractually restricted from paying dividends.
The risks of our being found in violation of these laws and regulations is increased by the fact that many of them have not been fully interpreted by the regulatory authorities or the courts, and their provisions are open to a variety of interpretations.
The risks of our being found in violation of these laws and regulations are increased by the fact that many of them have not been fully interpreted by the regulatory authorities or the courts, and their provisions are open to a variety of interpretations.
If other states 16 adopt similar minimum wage increases, the effect on our cost of operations would be compounded. In addition, we expect that inflationary pressures will continue to impact our salaries, wages, benefits and other costs.
If other states adopt similar minimum wage increases, the effect on our cost of operations would be compounded. In addition, we expect that inflationary pressures will continue to impact our salaries, wages, benefits and other costs.
The future growth of our imaging business is partially dependent on our ability to continue to successfully integrate acquired businesses. Historically, we have experienced substantial growth through acquisitions that have increased our size, scope and geographic distribution of our imaging center business.
The future growth of our imaging business is partially dependent on our ability to continue to successfully integrate acquired businesses. 22 Historically, we have experienced substantial growth through acquisitions that have increased our size, scope and geographic distribution of our imaging center business.
If we are unable to successfully compete, our business and financial condition would be adversely affected. Technological change in our industry could reduce the demand for our services and require us to incur significant costs to upgrade our equipment.
If we are unable to successfully compete, our business and financial condition could be adversely affected. Technological change in our industry could reduce the demand for our services and require us to incur significant costs to upgrade our equipment.
We may become subject to professional malpractice liability, which could be costly and negatively impact our reputation and business. The physicians employed by our contracted radiology groups are from time to time subject to malpractice claims.
We may become subject to professional malpractice liability, which could be costly and negatively impact our reputation and business. 20 The physicians employed by our contracted radiology groups are from time to time subject to malpractice claims.
In some states, the law prohibits or limits insurance coverage for the risk of punitive damages arising from professional liability and general liability claims or litigation. Coverage for punitive damages is also excluded under some insurance policies.
In some states, the law prohibits or limits insurance coverage for the risk of punitive damages arising from professional liability and general liability claims or litigation. Coverage for punitive damages is also excluded under some insurance 29 policies.
Also, the various radiology groups’ ability to continue performing under the management agreements may be curtailed or eliminated due to the radiology groups’ own financial difficulties, loss of physicians or other circumstances.
Also, the various radiology groups’ ability to continue performing under the 19 management agreements may be curtailed or eliminated due to the radiology groups’ own financial difficulties, loss of physicians or other circumstances.
During the past three fiscal years, we have completed acquisitions that have added 63 centers to our fixed-site outpatient diagnostic imaging services. We may never realize expected synergies or capitalize on expected business opportunities in connection with an acquisition. Moreover, assumptions underlying estimates of expected cost savings may be inaccurate, or general industry and business conditions may deteriorate.
During the past three fiscal years, we have completed acquisitions that have added 35 centers to our fixed-site outpatient diagnostic imaging services. We may never realize expected synergies or capitalize on expected business opportunities in connection with an acquisition. Moreover, assumptions underlying estimates of expected cost savings may be inaccurate, or general industry and business conditions may deteriorate.
Increased expenses for the contracting radiological practices, including the Group, impacts our financial results because the management fee we receive from them, which is based on a percentage of their collections, is adjusted annually to take into account their expenses. Neither we, nor our contracted radiology practices, maintain insurance on the lives of any affiliated physicians.
Increased expenses for the contracting radiological practices, including the Group, impact our financial results because the management fee we receive from them, which is based on a percentage of their collections, is adjusted annually to take into account their expenses. Neither we, nor our contracted radiology practices, maintain insurance on the lives of any affiliated physicians.
During the period from January 1, 2021 through December 31, 2024, the trading price of our common stock fluctuated from a high of $93.65 per share to a low of $12.03 per share. In the past, we have experienced a drop in stock price following an announcement of disappointing earnings or earnings guidance.
During the period from January 1, 2021 through December 31, 2025, the trading price of our common stock fluctuated from a high of $93.65 per share to a low of $12.03 per share. In the past, we have experienced a drop in stock price following an announcement of disappointing earnings or earnings guidance.
Any such interruption in access, improper access, disclosure, modification, or other loss of information could result in legal claims or proceedings, liability or penalties under laws and regulations that protect the privacy of personal information, such as HIPAA, European data privacy regulations, such as the General Data Protection Regulation, or GDPR, US state privacy regulations, such as the California Consumer Privacy Act, or newly emerging US state health information privacy laws, such as those in Washington, Oregon, and Texas.
Any such interruption in access, improper access, disclosure, modification, or other loss of information could result in legal claims or proceedings, liability or penalties under laws and regulations that protect the privacy of personal information, such as HIPAA, European data privacy regulations, such as the General Data Protection Regulation, or GDPR, U.S. state privacy regulations, such as the California Consumer Privacy Act, or newly emerging U.S. state health information privacy laws, such as those in Washington, Oregon, and Texas.
In September 2023, we determined that an In-process Research and Development ("IPR&D") indefinite-lived intangible asset related to Aidence Holding B.V.'s Ai Veye Lung Nodule and Veye Clinic would not receive FDA authorization for sale in the US without a new submission and additional expenditures for rework in the original projected timeline.
In September 2023, we determined that an In-process Research and Development ("IPR&D") indefinite-lived intangible asset related to Aidence Holding B.V.'s Ai Veye Lung Nodule and Veye Clinic would not receive FDA authorization for sale in the U.S. without a new submission and additional expenditures for rework in the original projected timeline.
We have a substantial number of employees who are paid on a part-time or per diem basis. In 2024, California mandated minimum wage increases for certain industries, including ours. As a result, we will experience increased compensation costs for certain of our employees and vendors beginning in 2025.
We have a substantial number of employees who are paid on a part-time or per diem basis. In 2024, California mandated minimum wage increases for certain industries, including ours. As a result, we experienced increased compensation costs for certain of our employees and vendors beginning in 2025.
Our substantial indebtedness could also: • make it difficult for us to satisfy our payment obligations with respect to our outstanding indebtedness; • require us to dedicate a substantial portion of our cash flow from operations to payments on our debt, reducing the availability of our cash flow to fund working capital, capital expenditures, acquisitions and other general corporate purposes; • expose us to the risk of interest rate increases on our variable rate borrowings, including borrowings under our Barclays and Truist credit facilities; • increase our vulnerability to adverse general economic and industry conditions; • limit our flexibility in planning for, or reacting to, changes in our business and the industry in which we operate; • place us at a competitive disadvantage compared to our competitors that have less debt; and • limit our ability to borrow additional funds on terms that are satisfactory to us, or at all. 27 A restriction in our ability to make capital expenditures would restrict our growth and could adversely affect our business.
Our indebtedness could also: • make it difficult for us to satisfy our payment obligations with respect to our outstanding indebtedness; • require us to dedicate a substantial portion of our cash flow from operations to payments on our debt, reducing the availability of our cash flow to fund working capital, capital expenditures, acquisitions and other general corporate purposes; • expose us to the risk of interest rate increases on our variable rate borrowings, including borrowings under our Barclays and Truist Credit facilities; • increase our vulnerability to adverse general economic and industry conditions; • limit our flexibility in planning for, or reacting to, changes in our business and the industry in which we operate; • place us at a competitive disadvantage compared to our competitors that have less debt; and • limit our ability to borrow additional funds on terms that are satisfactory to us, or at all.
Forthuber, our Presidents and Chief Operating Officers, West Coast and East Coast, respectively, could hinder our ability to execute our business strategy and have a significant negative impact on our operations. We believe that they could not easily be replaced with executives of equal experience and capabilities, which would adversely affect our business.
Hames or Stephen M. Forthuber, our Presidents and Chief Operating Officers, West Coast and East Coast, respectively, could hinder our ability to execute our business strategy and have a significant negative impact on our operations. We believe that they could not easily be replaced with executives of equal experience and capabilities, which would adversely affect our business.
For the year ended December 31, 2024, approximately 24% and 3% of our net service fee revenue came from Medicare and various state Medicaid programs, respectively. A change in the applicable certification status of one of our centers could adversely affect our other centers and, in turn, us as a whole.
For the year ended December 31, 2025, approximately 25% and 3% of our net service fee revenue came from Medicare and various state Medicaid programs, respectively. A change in the applicable certification status of one of our centers could adversely affect our other centers and, in turn, us as a whole.
The additional expenditures, delay and reduction of US sales affected the estimated fair value of the related IPR&D intangible asset and resulted in impairment charges of $3.9 million.
The additional expenditures, delay and reduction of U.S. sales affected the estimated fair value of the related IPR&D intangible asset and resulted in impairment charges of $3.9 million.
From time to time those programs implement changes designed to contain healthcare costs, some of which have resulted in decreased reimbursement rates for diagnostic imaging services that impact our business. On November 1, 2024, CMS released the calendar year 2025 Medicare Physician Fee Schedule final rule, which governs Medicare payment for Radnet's services in CY 2025.
From time to time those programs implement changes designed to contain healthcare costs, some of which have resulted in decreased reimbursement rates for diagnostic imaging services that impact our business. On October 30, 2025, CMS released the calendar year 2026 Medicare Physician Fee Schedule final rule, which governs Medicare payment for Radnet's services in CY 2026.
We believe that technology advancements including AI will significantly impact diagnostic imaging services in the future.
We believe that technological advancements including AI will significantly impact diagnostic imaging services in the future.
We face various risks related to health epidemics and other outbreaks, that have emerged and could emerge in the future, including: • restrictions intended to slow the spread of outbreaks, including quarantines, government-mandated actions, stay-at-home orders and other restrictions, have led and may in the future lead to periods where our imaging procedure volumes drop significantly; • disruptions in supply chains can affect the cost and availability of reagents and other materials needed for certain procedures; • significant portions of our workforce may be unable to work due to illness, quarantines, facility closures, ineffective remote work arrangements or technology failures or limitations; • general economic downturns as a result of outbreaks may affect demand or pricing for our services; and • volatility in the global capital markets may result in a decrease in the price of our common stock, or an increase in our cost of capital.
We face various risks related to health epidemics and other outbreaks, which may have a material adverse effect on our business, financial condition, results of operations and cash flows. 17 We face various risks related to health epidemics and other outbreaks that have emerged, and could emerge in the future, including: • restrictions intended to slow the spread of outbreaks, including quarantines, government-mandated actions, stay-at-home orders and other restrictions, have led, and may in the future lead, to periods where our imaging procedure volumes drop significantly; • disruptions in supply chains can affect the cost and availability of reagents and other materials needed for certain procedures; • significant portions of our workforce may be unable to work due to illness, quarantines, facility closures, ineffective remote work arrangements or technology failures or limitations; • general economic downturns as a result of outbreaks may affect demand or pricing for our services; and • volatility in the global capital markets may result in a decrease in the price of our common stock, or an increase in our cost of capital.
For the year ended December 31, 2024, we derived approximately 7% of our total net revenue from capitation arrangements, and we expect to continue to derive a significant portion of our revenue from capitation arrangements in the future.
For the year ended December 31, 2025, we derived approximately 6% of our total net revenue from capitation arrangements, and we expect to continue to derive a significant portion of our revenue from capitation arrangements in the future.
The process of integrating the acquired business, technology, service and research and development component into our business and operations and entry into a new line of business in which we are inexperienced may result in unforeseen operating difficulties and expenditures.
In the future, we may acquire companies that create a new line of business. The process of integrating the acquired business, technology, service and research and development component into our business and operations and entry into a new line of business in which we are inexperienced may result in unforeseen operating difficulties and expenditures.
Our competitors include independent imaging operators, such as Akumin, Inc., and smaller regional operators, as well as hospitals, clinics and radiology groups that operate their own imaging equipment. Some of our competitors may have, now or in the future, access to greater financial resources than we do and may have access to newer, more advanced equipment.
Our competitors include independent imaging operators, private equity-backed chains, and smaller regional operators, as well as hospitals, clinics and radiology groups that operate their own imaging equipment. Some of our competitors may have, now or in the future, access to greater financial resources than we do and may have access to newer, more advanced equipment.
The failure to successfully manage these risks in the development and implementation of new lines of business could have a material, adverse effect on our business, financial condition, and results of operations. Additionally, we and our third parties leverage AI and machine learning tools to increase productivity and innovation.
The failure to successfully manage these risks in the development and implementation of new lines of business could have a material, adverse effect on our business, financial condition, and results of operations. Additionally, we leverage AI and machine learning tools to increase productivity and innovation. We also face potential risks from the use of AI and machine learning tools.
Any adverse regulatory action, depending on its magnitude, may restrict us from effectively marketing and selling our products and limit our ability to obtain future pre-market authorization, and could result in a substantial modification to our business practices and operations. State and federal anti-kickback and anti-self-referral laws may adversely affect income.
Any adverse regulatory action, depending on its magnitude, may restrict us from effectively marketing and selling our products and limit our ability to obtain future pre-market authorization, and could result in a substantial modification to our business practices and operations.
Any failure to make such improvements or any significant delay in the planned implementation of new or enhanced systems could render our systems obsolete or inadequate, in which case our service to our customers and our other business activities could suffer, and we could be more vulnerable to electronic breaches from outside sources. 21 Our success depends in part on our key personnel and loss of key executives could adversely affect our operations.
Any failure to make such improvements or any significant delay in the planned implementation of new or enhanced systems could render our systems obsolete or inadequate, in which case our service to our customers and our other business activities could suffer, and we could be more vulnerable to electronic breaches from outside sources.
Our success depends in part on our ability to attract and retain qualified senior and executive management, and managerial and technical personnel. The loss of the services of Dr. Howard G. Berger, our President and Chief Executive Officer, and Norman R. Hames or Stephen M.
Our success depends in part on our key personnel and loss of key executives could adversely affect our operations. Our success depends in part on our ability to attract and retain qualified senior and executive management, and managerial and technical personnel. The loss of the services of Dr. Howard G. Berger, our President and Chief Executive Officer, and Norman R.
Cybersecurity threats are constantly changing, increasing the difficulty of successfully defending against them or implementing adequate preventive measures. While we maintain multiple layers of security measures and are continuously enhancing our security technologies to address new threats, emerging and advanced cybersecurity threats, including coordinated attacks, require additional layers of security which may disrupt or impact efficiency of operations.
While we maintain multiple layers of security measures and are continuously enhancing our security technologies to address new threats, emerging and advanced cybersecurity threats, including coordinated attacks, require additional layers of security which may disrupt or impact efficiency of operations.
We operate in a capital intensive, high fixed-cost industry that requires significant amounts of capital to fund operations, particularly the initial start-up and development expenses of new diagnostic imaging centers and the acquisition of additional centers and new diagnostic imaging equipment.
A restriction in our ability to make capital expenditures would restrict our growth and could adversely affect our business. We operate in a capital intensive, high fixed-cost industry that requires significant amounts of capital to fund operations, particularly the initial start-up and development expenses of new diagnostic imaging centers and the acquisition of additional centers and new diagnostic imaging equipment.
Any action brought against us for violation of these laws or regulations, even if we successfully defend against it, could cause us to incur significant legal expenses and divert our management’s attention from the operation of our business.
Any action brought against us for violation of these laws or regulations, even if we successfully defend against it, could cause us to incur significant legal expenses and divert our management’s attention from the operation of our business. There may be changes in FDA’s regulatory requirements and policies, and we may not be able to comply with them.
There may be changes in FDA’s regulatory requirements and policies, and we may not be able to comply with them. 24 FDA’s policies regarding regulation of AI-ML-enabled software products are constantly evolving and developing. FDA typically communicates with the industry and the public through occasions such as presentations to the industry, or through FDA’s guidance documents.
FDA’s policies regarding regulation of AI-ML-enabled software products are constantly evolving and developing. FDA typically communicates with the industry and the public through occasions such as presentations to the industry, or through FDA’s guidance documents.
A downturn in the economic environment can also lead to increased risk of collection on our accounts receivable, impairment of goodwill, and increased risk of failure of financial institutions including insurance companies and derivatives counterparties. These and other economic events could materially adversely affect our business, results of operations, financial condition and stock price.
A downturn in the economic environment can also lead to increased risk of collection on our accounts receivable, impairment of goodwill, and increased risk of failure of financial institutions including insurance companies and derivatives counterparties.
To the extent we are unable to generate sufficient cash from our operations, funds are not available under our credit facilities or we are unable to structure or obtain financing through operating leases or long-term installment notes, we may be unable to meet the capital expenditure requirements necessary to support the maintenance and continued growth of our operations.
To the extent we are unable to generate sufficient cash from our operations, funds are not available under our credit facilities or we are unable to structure or obtain financing through operating leases or long-term installment notes, we may be unable to meet the capital expenditure requirements necessary to support the maintenance and continued growth of our operations. 28 We may be required to recognize an impairment of our goodwill, other intangible assets, or other long-lived assets, which could have an adverse effect on our financial position and results of operations.
Additionally, general political uncertainty, including any actions from a new administration in the United States could impact the healthcare industries in the United States. 15 Continued turbulence in domestic and international markets and economies may adversely affect our liquidity and financial condition.
Additionally, general political uncertainty, including any actions from a new administration in the United States could impact the healthcare industries in the United States. Continued turbulence in domestic and international markets and economies may adversely affect our liquidity and financial condition. Patients may transition work, leave insurance programs, or defer non-emergency procedures, which could reduce overall demand for our services.
We are required to perform impairment tests for goodwill and other indefinite-lived intangible assets annually and whenever events or circumstances indicate that it is more likely than not that impairment exists. We are also required to perform an impairment test of definite lived intangible or other long-lived assets when indicators of impairment are present.
When we acquire businesses we are generally required to allocate the purchase price to various assets including goodwill and other intangible assets. We are required to perform impairment tests for goodwill and other indefinite-lived intangible assets annually and whenever events or circumstances indicate that it is more likely than not that impairment exists.
We could also be required to disclose the breach publicly, which may damage our business reputation with our patients and vendors and cause a further material adverse effect on our results of operations, financial position, and cash flows. 26 Some of our imaging modalities use radioactive materials, which generate regulated waste and could subject us to liabilities for injuries or violations of environmental and health and safety laws.
We could also be required to disclose the breach publicly, which may damage our business reputation with our patients and vendors and cause a further material adverse effect on our results of operations, financial position, and cash flows.
Patients may transition work, leaving insurance programs, or defer non-emergency procedures, which could reduce overall demand for our services. A decline in global economic conditions could also have a significant impact on the financial condition and operations of our third party payors, contracting radiology groups, equipment manufacturers and other suppliers.
A decline in global economic conditions could also have a significant impact on the financial condition and operations of our third-party payors, contracting radiology groups, equipment manufacturers and other suppliers.
These budget deficits at the federal, state and local levels have decreased, and may continue to decrease, spending for health and human service programs, including Medicare and Medicaid, which are significant payor sources for our facilities.
During periods of high unemployment, governmental entities often experience budget deficits as a result of increased costs and lower than expected tax collections. These budget deficits at the federal, state and local levels have decreased, and may continue to decrease, spending on health and human service programs, including Medicare and Medicaid, which are significant payor sources for our facilities.
Future issuances of our common stock or rights to purchase our common stock could result in additional dilution to the percentage ownership of our stockholders and could cause the price of our common stock to fall. 29 To raise capital or for other strategic purposes, we may sell common stock, convertible securities or other equity securities in one or more transactions at prices and in a manner we determine from time to time.
To raise capital or for other strategic purposes, we may sell common stock, convertible securities or other equity securities in one or more transactions at prices and in a manner we determine from time to time.
There is no guarantee that we will receive the anticipated benefits from the investments we have made and may continue to make in the area of AI.
There is no guarantee that we will receive the anticipated benefits from the investments we have made and may continue to make in the area of AI. Any failure would result in reduced operating profits and the potential impairment of goodwill related to those investments, which would further impact our profitability.
Some of our imaging procedures use radioactive materials, which generate medical and other regulated wastes. For example, patients are injected with a radioactive substance before undergoing a PET scan. Storage, use and disposal of these materials and waste products present the risk of accidental environmental contamination and physical injury.
Some of our imaging modalities use radioactive materials, which generate regulated waste and could subject us to liabilities for injuries or violations of environmental and health and safety laws. Some of our imaging procedures use radioactive materials, which generate medical and other regulated wastes. For example, patients are injected with a radioactive substance before undergoing a PET scan.
The rapid development of AI tools could render obsolete certain technologies or tools we currently use, or otherwise provide competitors with a technological edge.
Due to the potential flaws in the use of AI, we could make incorrect decisions, including decisions that could bias certain individuals or classes of individuals and adversely impact their rights. The rapid development of AI tools could render obsolete certain technologies or tools we currently use, or otherwise provide competitors with a technological edge.
Various federal and state laws govern financial arrangements among healthcare providers.
State and federal anti-kickback and anti-self-referral laws may adversely affect income. 25 Various federal and state laws govern financial arrangements among healthcare providers.
We also use information technology systems and networks in our operations and supporting departments such as research and development, marketing, accounting, finance, and human resources.
We also use information technology systems and networks in our operations and supporting departments such as research and development, marketing, accounting, finance, and human resources. The future success and growth of our business depends on streamlined processes made available through information systems, global communications, internet activity and other network processes.
We also face potential risks from the use of AI and machine learning tools. Our, or our customers’ sensitive, proprietary, or confidential information could be leaked, disclosed, or revealed as a result of or in connection with employees’ or vendors’ use of generative AI technologies.
Our, or our customers’ sensitive, proprietary, or confidential information could be leaked, disclosed, or revealed as a result of or in connection with employees’ or vendors’ use of generative AI technologies. In addition, we may use AI outputs to inform certain decisions, and AI models may create incomplete, 23 inaccurate, or otherwise flawed outputs, some of which may appear correct.
We have been required to recognize impairment charges in the past, and may again.
We are also required to perform an impairment test of definite lived intangible or other long-lived assets when indicators of impairment are present. We have been required to recognize impairment charges in the past, and may again.
A worsening of the economic and employment conditions in the geographies in which we operate could materially affect our business and future results of operations. During periods of high unemployment, governmental entities often experience budget deficits as a result of increased costs and lower than expected tax collections.
These and other economic events could materially adversely affect our business, results of operations, financial condition and stock price. 16 A worsening of the economic and employment conditions in the geographies in which we operate could materially affect our business and future results of operations.
Removed
We face various risks related to health epidemics and other outbreaks, which may have a material adverse effect on our business, financial condition, results of operations and cash flows.
Added
Storage, use and disposal of these materials and waste products present the risk of accidental environmental contamination and physical injury.
Removed
Any failure would result in reduced operating profits and the potential impairment of goodwill related to those investments, which would further impact our profitability. 22 In the future we may acquire companies that create a new line of business.
Added
Our current indebtedness and any future indebtedness we incur could adversely affect our financial condition.
Removed
In addition, we may use AI outputs to inform certain decisions, and AI models may create incomplete, inaccurate, or otherwise flawed outputs, some of which may appear correct. Due to the potential flaws in the use of AI, we could make incorrect decisions, including decisions that could bias certain individuals or classes of individuals and adversely impact their rights.
Added
As of December 31, 2025 term loan indebtedness, excluding related discount, was $1,084.9 million, which $961.1 million was borrowed pursuant to the Barclays Revolving Credit Facility and the Barclays Term Loan and which includes $123.7 million borrowed pursuant to the Truist Revolving Credit Facility and the Truist Term Loan (as such capitalized terms are defined in the notes to our consolidated financial statements, and collectively, the "Barclays and Truist Credit Facilities") at our New Jersey Imaging joint venture.
Removed
Our current substantial indebtedness and any future indebtedness we incur could adversely affect our financial condition. We are highly leveraged. As of December 31, 2024 term loan indebtedness, excluding related discount, was $1,005.6 million, of which the Barclays credit facility term loans were $870.6 million and the Truist credit facility term loan was $135.0 million.
Added
The Company is neither a borrower or guarantor under the Truist Credit Facilities.
Removed
We may be required to recognize an impairment of our goodwill, other intangible assets, or other long-lived assets, which could have an adverse effect on our financial position and results of operations. When we acquire businesses we are generally required to allocate the purchase price to various assets including goodwill and other intangible assets.
Added
Future issuances of our common stock or rights to purchase our common stock could result in additional dilution to the percentage ownership of our stockholders and could cause the price of our common stock to fall.

Item 1C. Cybersecurity

Cybersecurity — threats and controls disclosure

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Biggest changeOur approach to designing, operating and measuring the effectiveness of our program leverages experienced internal resources, industry-recognized cybersecurity consultants, assessors, healthcare and industry-specific cybersecurity working groups and threat-intelligence platforms, federal law enforcement and CISA partnerships.
Biggest changeOur approach to designing, operating and measuring the effectiveness of our program leverages experienced internal resources, industry-recognized cybersecurity consultants, assessors, healthcare and industry-specific cybersecurity working groups and threat-intelligence platforms, federal law enforcement and the Cybersecurity and Infrastructure Security Agency (“CISA”) partnerships.
We use these resources and 30 partnerships, along with our internal expertise, to develop specialized insights pertinent to our business’s cyber-risk, and tailor our cybersecurity strategy to best safeguard our systems and data. We staff an internal cybersecurity team and maintain a third-party managed security operations center which in-concert provide 24x7x365 real-time detection and response.
We use these resources and partnerships, along with our internal expertise, to develop specialized insights pertinent to our business’s cyber-risk, and tailor our cybersecurity strategy to best safeguard our systems and data. We staff an internal cybersecurity team and maintain a third-party managed security operations center which in-concert provide 24x7x365 real-time detection and response.
Every employee is required to complete cyber-related training (including third-parties who access our systems) and successfully complete testing throughout the year in addition to monthly phishing tests. Furthermore, we require all system users to complete annual Patient Privacy and Patient Data Breach training and testing to meet RadNet compliance standards.
Every employee is required to complete cyber-related training (including third-parties who access our systems) and successfully 31 complete testing throughout the year in addition to monthly phishing tests. Furthermore, we require all system users to complete annual Patient Privacy and Patient Data Breach training and testing to meet RadNet compliance standards.
Governance RadNet is committed to appropriate cybersecurity governance and oversight. Our Cybersecurity and Data Protection Program is the principal responsibility of our Chief Information Officer and Chief Information Security Officer, each of whom have over 20 years of experience in information systems, including cybersecurity training and experience.
Governance RadNet is committed to appropriate cybersecurity governance and oversight. Our Cybersecurity and Data Protection Program is the principal responsibility of our Chief Information Officer ("CIO") and Chief Information Security Officer ("CISO"), each of whom have over 20 years of experience in information systems, including cybersecurity training and experience.
We benchmark and evaluate our Cybersecurity and Data Protection Program and data protection maturity against the NIST Cybersecurity Framework and the HIPAA Security Rule. Consistent with these frameworks, our program includes recurring third-party assessments and a vendor risk management program.
We benchmark and evaluate our Cybersecurity and Data Protection Program and data protection maturity against the National Institute of Standards & Technology ("NIST") Cybersecurity Framework and the HIPAA Security Rule. Consistent with these frameworks, our program includes recurring third-party assessments and a vendor risk management program.

Item 2. Properties

Properties — owned and leased real estate

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Biggest changeAt December 31, 2024, we operated directly or indirectly through joint ventures with hospitals, 398 centers located in Arizona, California, Delaware, Florida, Maryland, New Jersey, and New York. We lease the premises at which these facilities are located and do not have options to purchase the facilities we rent.
Biggest changeAt December 31, 2025, we operated directly or indirectly through hospital and health system joint ventures, 418 centers located in Arizona, California, Delaware, Florida, Maryland, Virginia, New Jersey, New York, and Texas. We lease the premises at which these facilities are located and do not have options to purchase the facilities we rent.
Our most common initial lease term varies in length from 5 to 15 years. Factoring in renewal options, we can have a total span of 10 to 35 years at the facilities we lease. We also lease smaller satellite X-Ray locations, usually for one year terms, that are renewable on mutual consent with the landlord.
Our most common initial lease term varies in length from 5 to 15 years. Factoring in renewal options, we can have a total span of 10 to 35 years at the facilities we lease. We also lease smaller satellite X-Ray locations, usually for one year terms, that are renewable on mutual 32 consent with the landlord.
Item 2. Properties 31 Our corporate headquarters is located in adjoining premises at 1508, 1510 and 1516 Cotner Avenue, Los Angeles, California 90025, and approximately 21,500 square feet is occupied under these leases, which including options, expire June 30, 2027.
Item 2. Properties Our corporate headquarters is located in adjoining premises at 1508, 1510 and 1516 Cotner Avenue, Los Angeles, California 90025, and approximately 21,500 square feet is occupied under these leases, which including options, expire June 30, 2037.
Rental increases can range from 1% to 10% on an annual basis, depending on the location and market conditions where we do business. As of December 31, 2024, total square footage operated directly or indirectly under lease, including medical office, administrative and warehouse locations, was approximately 2.7 million square feet.
Rental increases can range from 1% to 10% on an annual basis, depending on the location and market conditions where we do business. As of December 31, 2025, total square footage operated directly or indirectly under lease, including medical office, administrative and warehouse locations, was approximately 3.2 million square feet.
We also have a regional office of approximately 39,000 square feet in Baltimore, Maryland under a lease, which including options, expires September 30, 2028. In addition, we lease approximately 36,700 square feet of warehouse space nationwide, which expire at various dates, including options, through December 31, 2028.
We also have a regional office of approximately 35,400 square feet in Baltimore, Maryland under a lease, which including options, expires September 30, 2028. In addition, we lease approximately 35,000 square feet of warehouse space nationwide, which expire at various dates, including options, through December 31, 2028.

Item 3. Legal Proceedings

Legal Proceedings — active lawsuits and investigations

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Biggest changeIf one or more legal matters were resolved against us in a reporting period for amounts above management’s expectations, our financial condition and operating results could be materially adversely affected. Item 4. Mine Safety Disclosures Not applicable. 32 PART II
Biggest changeIf one or more legal matters were resolved against us in a reporting period for amounts above management’s expectations, our financial condition and operating results could be materially adversely affected. Item 4. Mine Safety Disclosures Not applicable. 33 PART II

Item 5. Market for Registrant's Common Equity

Market for Common Equity — stock, dividends, buybacks

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Biggest changeThis graph shall not be deemed incorporated by reference by any general statement incorporating by reference this Form 10-K into any filing under the Securities Act or under the Exchange Act, except to the extent that RadNet specifically incorporates this information by reference, and shall not otherwise be deemed filed under the Securities Act or the Exchange Act. 33 ANNUAL RETURN PERCENTAGE Years Ending Company / Index 12/31/20 12/31/21 12/30/22 12/29/23 12/31/24 RadNet, Inc.
Biggest changeThis graph shall not be deemed incorporated by reference by any general statement incorporating by reference this Form 10-K into any filing under the Securities Act or under the Exchange Act, except to the extent that RadNet specifically incorporates this information by reference, and shall not otherwise be deemed filed under the Securities Act or the Exchange Act. 34 ANNUAL RETURN PERCENTAGE Years Ending Company / Index 12/31/21 12/30/22 12/29/23 12/31/24 12/31/25 RadNet, Inc. 53.86 (37.46) 84.65 100.86 2.16 S&P 500 Index 26.89 (19.44) 24.23 23.31 16.39 S&P Health Care Sector 9.76 (19.87) 5.15 1.76 18.50 Base INDEXED RETURNS Years Ending Period Company / Index 12/31/20 12/31/21 12/30/22 12/29/23 12/31/24 12/31/25 RadNet, Inc. 100 153.86 96.22 177.67 356.87 364.59 S&P 500 Index 100 126.89 102.22 126.99 156.59 182.25 S&P Health Care Sector 100 109.76 87.95 92.48 94.10 111.51 Recent Sales of Unregistered Securities None
Stock Performance Graph The following graph compares the yearly percentage change in cumulative total stockholder return of our common stock during the period from 2019 to 2024 with (i) the cumulative total return of the S&P 500 index and (ii) the cumulative total return of the S&P 500 – Healthcare Sector index.
Stock Performance Graph The following graph compares the yearly percentage change in cumulative total stockholder return of our common stock during the period from 2021 to 2025 with (i) the cumulative total return of the S&P 500 index and (ii) the cumulative total return of the S&P 500 – Healthcare Sector index.
The comparison assumes $100 was invested on December 31, 2019 in our common stock and in each of the foregoing indices and the reinvestment of dividends through December 31, 2024. The stock price performance on the following graph is not necessarily indicative of future stock price performance.
The comparison assumes $100 was invested on December 31, 2020 in our common stock and in each of the foregoing indices and the reinvestment of dividends through December 31, 2025. The stock price performance on the following graph is not necessarily indicative of future stock price performance.
Item 5. Market for the Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities Principal Trading Market Our common stock is quoted on the NASDAQ Global Market under the symbol “RDNT”. Holders As of February 24, 2025, the number of holders of record of our common stock was 865.
Item 5. Market for the Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities Principal Trading Market Our common stock is quoted on the NASDAQ Global Market under the symbol “RDNT”. Holders As of February 27, 2026, the number of holders of record of our common stock was 875.
Removed
(3.60) 53.86 (37.46) 84.65 100.86 S&P 500 Index 16.26 26.89 (19.44) 24.23 23.31 S&P Health Care Sector 33.67 9.76 (19.87) 5.15 1.76 Base INDEXED RETURNS Years Ending Period Company / Index 12/31/19 12/31/20 12/31/21 12/30/22 12/29/23 12/31/24 RadNet, Inc. 100 96.40 148.33 92.76 171.28 344.04 S&P 500 Index 100 116.26 147.52 118.84 147.64 182.05 S&P Health Care Sector 100 133.67 146.72 117.56 123.62 125.79 Recent Sales of Unregistered Securities On March 27, 2024, we issued 95,019 shares of common stock to settle a milestone contingent liability as part of our purchase of Heart & Lung Imaging Limited.
Removed
The shares were ascribed a value of $4.6 million. The shares were issued without registration on the basis of the exemption for private placements provided by Section 4(a)(2) under the Securities Act. 34

Item 6. [Reserved]

Selected Financial Data — reserved (removed by SEC in 2021)

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Biggest changeWe made a fair value determination of the acquired assets and assumed liabilities and the following were recorded (in thousands): 37 2024 : Entity Date Acquired Total Purchase Consideration Property & Equipment Right of Use Assets Goodwill Intangible Assets Other Right of Use Liabilities Notes payable and other liabilities Antelope Valley Outpatient Imaging* 2/1/2024 3,530 2,793 563 687 50 — (563) — Grossman Imaging Center of CMH, LLC* 3/31/2024 10,343 1,717 6,304 8,500 280 56 (6,514) — Providence Health System - Southern California* 3/31/2024 7,369 1,378 3,441 5,991 — — (3,441) — Houston Medical Imaging, LLC* 4/1/2024 22,703 15,826 7,929 11,584 1,660 90 (8,089) (6,297) U.S.
Biggest changeWe made a fair value determination of the acquired assets and assumed liabilities and the following were recorded (in thousands): 2025: 37 Entity Date Acquired Total Consideration Property & Equipment Right of Use Assets Goodwill Intangible Assets Other Assets Right of Use Liabilities Finance lease HALO Centers LLC 1/2/2025 $ 4,200 587 3,238 3,563 50 — (3,238) — Hillcroft Medical Clinic 3/7/2025 $ 734 278 — 406 50 — — — North County Radiology Oceanside LLC 4/1/2025 $ 1,702 238 599 1,307 150 7 (599) — Faculty Physicians and Surgeons of LLUSM (Palm Imaging) 5/1/2025 $ 1,400 648 — 702 50 — — — California MSK MSO, LLC (OSS Burbank) 5/1/2025 $ 500 330 — 70 100 — — — HALO Centers LLC (Indian Wells) 5/1/2025 $ 7,850 1,714 2,439 6,072 50 15 (2,439) — Kolb Radiology P.C. 7/1/2025 $ 26,659 6,887 5,355 22,396 79 155 (6,125) (2,088) Schonholz and Drossman, LLP 9/1/2025 $ 30,101 2,921 5,566 26,790 295 95 (5,566) — Laser Assets, Inc.* 11/1/2025 $ 29,058 7,145 4,529 22,170 134 (32) (4,889) — Woodburn Nuclear Medicine, Ltd.* 11/1/2025 $ 29,705 1,658 4,292 27,902 1,105 — (5,252) — River Radiology, PLLC* 11/3/2025 $ 1,200 798 1,908 244 150 8 (1,908) — Total 133,109 23,204 27,925 111,622 2,213 248 (30,015) (2,088) *Fair Value Determination is preliminary and subject to change 2024 : 38 Entity Date Acquired Total Purchase Consideration Property & Equipment Right of Use Assets Goodwill Intangible Assets Other Right of Use Liabilities Notes payable and other liabilities Antelope Valley Outpatient Imaging 2/1/2024 3,530 2,793 563 687 50 — (563) — Grossman Imaging Center of CMH, LLC 3/31/2024 10,343 1,717 6,304 8,500 280 56 (6,514) — Providence Health System - Southern California 3/31/2024 7,369 1,378 3,441 5,991 — — (3,441) — Houston Medical Imaging, LLC 4/1/2024 22,703 15,826 7,929 11,584 1,660 90 (8,089) (6,297) U.S.
On November 1, 2022 we contributed eight of our imaging centers to ADRG of $12.7 million and recorded a loss of $0.5 million which was calculated as the difference between the transaction price and carrying value of such imaging centers which included equipment and other assets and an allocation of goodwill to such imaging centers.
On November 1, 2022 we contributed eight of our imaging centers to ADRG for $12.7 million and recorded a loss of $0.5 million which was calculated as the difference between the transaction price and carrying value of such imaging centers which included equipment and other assets and an allocation of goodwill to such imaging centers.
We recorded $4.5 million of the transaction price as an offset to due to affiliates while the remaining $8.3 million was recorded as investment in joint venture on our balance sheet. We accounted for the transaction as an adjustment to our equity investment for the value of the 39 assets contributed.
We recorded $4.5 million of the transaction price as an offset due to affiliates while the remaining $8.3 million was recorded as investment in joint venture on our balance sheet. We accounted for the transaction as an adjustment to our equity investment for the value of the assets contributed.
Joint venture investment contribution Santa Monica Imaging Group, LLC On April 1, 2017, we formed in conjunction with Cedars-Sinai Medical Center the Santa Monica Imaging Group, LLC ("SMIG"), consisting of two multi-modality imaging centers located in Santa Monica, California with RadNet holding a 40% economic interest and Cedars-Sinai Medical Center holding a 60% economic interest.
Joint venture investment contributions Santa Monica Imaging Group, LLC On April 1, 2017, we formed in conjunction with Cedars-Sinai Medical Center the Santa Monica Imaging Group, LLC ("SMIG"), consisting of two multi-modality imaging centers located in Santa Monica, California with RadNet holding a 40% economic interest and Cedars-Sinai Medical Center holding a 60% economic interest.
Additional Information Additional information concerning RadNet, Inc., including our consolidated subsidiaries, for each of the years ended December 31, 2024, 2023 and 2022 is included in the consolidated financial statements and notes thereto in this report.
Additional Information Additional information concerning RadNet, Inc., including our consolidated subsidiaries, for each of the years ended December 31, 2025, 2024, and 2023 is included in the consolidated financial statements and notes thereto in this report.
Years Ended December 31, 2024 2023 2022 REVENUE Service fee revenue 92.5 % 90.5 % 89.4 % Revenue under capitation arrangements 7.5 % 9.5 % 10.6 % Total service revenue 100.0 % 100.0 % 100.0 % OPERATING EXPENSES Cost of operations, excluding depreciation and amortization 86.4 % 86.3 % 88.4 % Lease abandonment charges 0.1 % 0.3 % — % Depreciation and amortization 7.5 % 7.9 % 8.1 % Gain on contribution of imaging centers into joint venture — % (1.0) % — % Loss on sale and disposal of equipment 0.1 % 0.1 % 0.2 % Severance costs 0.1 % 0.2 % 0.1 % Total operating expenses 94.3 % 93.9 % 96.8 % INCOME FROM OPERATIONS 5.7 % 6.1 % 3.2 % OTHER INCOME AND EXPENSES Interest expense 4.4 % 4.0 % 3.6 % Equity in earnings of joint ventures (0.8) % (0.4) % (0.7) % Non-cash change in fair value of interest rate swaps 0.4 % 0.5 % (2.8) % Debt restructuring and extinguishment expenses 0.6 % — % 0.1 % Other income (1.4) % (0.4) % 0.1 % Total other expenses 3.3 % 3.7 % 0.3 % INCOME BEFORE INCOME TAXES 2.5 % 2.4 % 3.0 % Provision for income taxes (0.3) % (0.5) % (0.7) % NET INCOME 2.1 % 1.8 % 2.3 % Net income attributable to noncontrolling interest 2.0 % 1.7 % 1.6 % NET INCOME ATTRIBUTABLE TO RADNET, INC.
Years Ended December 31, 2025 2024 2023 REVENUE Service fee revenue 93.8 % 92.5 % 90.5 % Revenue under capitation arrangements 6.2 % 7.5 % 9.5 % Total service revenue 100.0 % 100.0 % 100.0 % OPERATING EXPENSES Cost of operations, excluding depreciation and amortization 88.5 % 86.4 % 86.3 % Lease abandonment charges 0.4 % 0.1 % 0.3 % Depreciation and amortization 7.5 % 7.5 % 7.9 % Gain on contribution of imaging centers into joint venture — % — % (1.0) % Loss on sale and disposal of equipment 0.5 % 0.1 % 0.1 % Severance costs 0.2 % 0.1 % 0.2 % Total operating expenses 97.0 % 94.3 % 93.9 % INCOME FROM OPERATIONS 3.0 % 5.7 % 6.1 % OTHER INCOME AND EXPENSES Interest expense 3.4 % 4.4 % 4.0 % Equity in earnings of joint ventures (0.7) % (0.8) % (0.4) % Non-cash change in fair value of interest rate swaps 0.3 % 0.4 % 0.5 % Debt restructuring and extinguishment expenses — % 0.6 % — % Other income (1.6) % (1.4) % (0.4) % Total other expenses 1.5 % 3.3 % 3.8 % INCOME BEFORE INCOME TAXES 1.6 % 2.5 % 2.4 % Provision for income taxes (0.7) % (0.3) % (0.5) % NET INCOME 0.8 % 2.0 % 1.8 % Net income attributable to noncontrolling interest 1.7 % 2.0 % 1.7 % NET (LOSS) INCOME ATTRIBUTABLE TO RADNET, INC.
Accordingly, we believe that our current sources of funds will provide us with adequate liquidity during the 12-month period following December 31, 2024, as well as in the long-term.
Accordingly, we believe that our current sources of funds will provide us with adequate liquidity during the 12-month period following December 31, 2025, as well as in the long-term.
Acquisitions Imaging Center Segment Radiology Imaging Center Asset Acquisitions: During the years ended 2024 and 2023, we completed the acquisition of certain assets of the following entities, which either engage directly in the practice of radiology or associated businesses. The primary reason for these acquisitions was to strengthen our presence in many of our geographic markets.
Acquisitions Imaging Center Segment Radiology Imaging Center Asset Acquisitions: During the years ended 2025 and 2024, we completed the acquisition of certain assets of the following entities, which engage directly in the practice of radiology or associated businesses. The primary reason for these acquisitions was to strengthen our presence in many of our geographic markets.
We recorded $1.2 million in current assets, $2.7 million of IPR&D in intangible assets, and $1.5 million in current liabilities in connection with this transaction. In performing the purchase price allocation, we considered, among other factors, the intended future use of acquired assets, analysis of historical financial performance and estimates of future performance of the Kheiron business.
We recorded $1.2 million in current assets, $2.6 million of IPR&D in intangible assets, and $1.5 million in current liabilities in connection with this transaction. 40 In performing the purchase price allocation, we considered, among other factors, the intended future use of acquired assets, analysis of historical financial performance and estimates of future performance of the Kheiron business.
Critical Accounting Policies The Securities and Exchange Commission defines critical accounting estimates as those that are both most important to the portrayal of a company’s financial condition and results of operations and require management’s most difficult, subjective or complex judgment, often as a result of the need to make estimates about the effect of matters that are inherently uncertain and may change in subsequent periods.
Critical Accounting Policies The SEC defines critical accounting estimates as those that are both most important to the portrayal of a company’s financial condition and results of operations and require management’s most difficult, subjective, or complex judgment, often as a result of the need to make estimates about the effect of matters that are inherently uncertain and may change in subsequent periods.
The MD&A is provided as a supplement to, and should be read in conjunction with, our consolidated financial statements and the accompanying notes included in this annual report on Form 10-K. Overview We are a national provider of diagnostic imaging services in the United States.
The MD&A is provided as a supplement to, and should be read in conjunction with, our consolidated financial statements and the accompanying notes included in this annual report on Form 10-K. Overview We are a national provider of freestanding, fixed-site outpatient diagnostic imaging services in the United States.
Results of Operations The following table sets forth, for the periods indicated, the percentage that certain line items within the consolidated statements of operations bear to net revenue for the years 2024, 2023 and 2022.
Results of Operations 41 The following table sets forth, for the periods indicated, the percentage that certain line items within the consolidated statements of operations bear to net revenue for the years 2025, 2024, and 2023.
On February 23, 2024, we formed Tri Valley Imaging Group, LLC ("TVIG"), a partnership with Providence Health System - Southern California ("PHS"). The operation offers multi-modality services out of seven locations in Southern California.
Formation of majority owned subsidiaries Tri Valley Imaging Group, LLC. On February 23, 2024, we formed Tri Valley Imaging Group, LLC ("TVIG"), a partnership with Providence Health System - Southern California ("PHS"). The operation offers multi-modality services out of seven locations in Southern California.
The remaining $274.4 million of our Barclays revolving credit facility was available to draw upon as of December 31, 2024. We also had no balance under our $50.0 million Truist revolving credit facility as of December 31, 2024, and with no letters of credit reserved against the facility, the full amount was available to draw upon.
The remaining $273.0 million of our Barclays Revolving Credit Facility was available to draw upon as of December 31, 2025. We also had no balance under our $50.0 million Truist Revolving Credit Facility as of December 31, 2025, and with no letters of credit reserved against the facility, the full amount was available to draw upon.
The fair value of the 2019 swaps as of December 31, 2024 was a net asset of $7.1 million compared to a net asset of $15.1 million December 31, 2023, resulting in a loss $8.0 million during the year ended December 31, 2024.
The fair value of the 2019 swaps as of December 31, 2025 was a net asset of $0.0 million compared to a net asset of $7.1 million as of December 31, 2024, resulting in a loss $7.1 million during the year ended December 31, 2025.
The following is a reconciliation of the nearest comparable GAAP financial measure, net income, to Adjusted EBITDA for the years ended December 31, 2024, 2023, and 2022, respectively (in thousands): 50 Years Ended December 31, 2024 2023 2022 Net Income Attributable To Radnet, Inc.
The following is a reconciliation of the nearest comparable GAAP financial measure, net income, to Adjusted EBITDA for the years ended December 31, 2025, 2024, and 2023, respectively (in thousands): 48 Years Ended December 31, 2025 2024 2023 Net (Loss) Income Attributable To Radnet, Inc.
During the year ended December 31, 2024, interest rates were above the arranged rates in our 2019 Swaps for most of the year and we received $13.1 million in cash payments from our 2019 swap counterparties, which were reported as a component of interest expense.
During the year ended December 31, 2025, interest rates were above the arranged rates in our 2019 Swaps for most of the year and we received $7.9 million in cash payments from our 2019 swap counterparties, which were reported as a component of interest expense.
As noncontrolling interests only represent a portion of our imaging center business, and excludes our Digital Health which generated losses of $21.2 million in 2023, we do not expect changes in net income attributable to noncontrolling interests to correlate with changes in consolidated operating income or pretax income.
As noncontrolling interests only represent a portion of our imaging center business, and excludes our Digital Health segment which generated losses of $30.3 million in 2025, we do not expect changes in net income attributable to noncontrolling interests to correlate with changes in consolidated operating income or pretax income.
In addition to our imaging business, we established a Digital Health business segment in our 2024 fiscal year, which combines our former Artificial Intelligence (“AI”) business segment with our eRad, Inc. business. Our digital health segment develops and delivers AI-powered health informatics solutions to drive quality, efficiency, and outcomes in imaging and radiology.
In addition to our imaging business, we established a Digital Health business segment during our 2024 fiscal year, which combines our former AI businesses with our eRad, Inc. business. Our Digital Health segment develops and delivers AI-powered health informatics solutions to improve quality, efficiency, and diagnostic outcomes in diagnostic imaging and radiology.
During the end of 2023, we experienced lower utilization at two imaging centers. As a result, we abandoned the leases related to these locations at the end of 2023 and diverted the patients to our other sites in the area. We recorded a charge of approximately $5.1 million in December 2023 related to lease facilities abandonment.
During year ended 2025, we experienced lower utilization at seven imaging centers. As a result, we abandoned the leases related to these locations at the end of 2025 and diverted the patients to our other sites in the area. We recorded a charge of approximately $8.6 million in December 2025 related to lease facilities abandonment.
Senior Credit Facilities: We maintain secured credit facilities with Barclays Bank PLC and with Truist Bank. On April 18, 2024, we refinanced our Barclays credit facility, replacing the prior facility with an $875.0 million term loan and a $282.0 million revolving credit facility.
On April 18, 2024, we refinanced our Barclays Credit Facility, replacing the prior facility with an $875.0 million term loan and a $282.0 million revolving credit facility.
As it relates to the Group (as defined in Note 1 Nature of Business included in the notes to our consolidated financial statements), this service fee revenue includes payments for both the professional medical interpretation revenue recognized by them as well as the payment for all other aspects related to our providing the imaging services, for which we earn management fees.
As it relates to the Group (as defined in Item 1 of this Form 10-K), this service fee revenue includes payments for both the professional medical interpretation revenue recognized by them as well as the payment for all other aspects related to our providing the imaging services, for which we earn management fees.
On March 31, 2024, Community Memorial Health System purchased an economic interest of Ventura County Imaging Group ("VGIC") for a consideration of $5.1 million. As a result of the transaction, we retained 47.5% controlling economic interest in VGIC. Los Angeles Imaging Group, LLC. On September 1, 2023, we formed our wholly-owned subsidiary, Los Angeles Imaging Group, LLC ("LAIG").
On March 31, 2024, Community Memorial Health System purchased an economic interest of Ventura County Imaging Group ("VGIC") for a consideration of $5.1 million. As a result of the transaction, we retained 47.5% controlling economic interest in VGIC . Pacific Diagnostic Imaging Group, LLC.
The following table summarizes key balance sheet data as of December 31, 2024 and December 31, 2023 and income statement data for the year ended December 31, 2024, 2023 and 2022 (in thousands): Balance Sheet Data as of December 31, 2024 2023 2022 Cash and cash equivalents $ 740,020 $ 342,570 Accounts receivable 185,821 163,707 Working capital (exclusive of current operating lease liability) 596,158 197,805 Stockholders' equity 1,133,410 813,359 Income Statement data for the years ended December 31, Total revenue $ 1,829,664 $ 1,616,630 $ 1,430,061 Net income attributable to RadNet common stockholders 2,793 3,044 10,650 We operate in a capital intensive, high fixed-cost industry that requires significant amounts of capital to fund operations.
The following table summarizes key balance sheet data as of December 31, 2025 and December 31, 2024 and income statement data for the years ended December 31, 2025, 2024 and 2023 (in thousands): Balance Sheet Data as of December 31, 2025 2024 Cash and cash equivalents $ 767,215 $ 740,020 Accounts receivable 200,317 185,821 Working capital (exclusive of current operating lease liability) 507,298 596,158 Stockholders' equity 1,355,886 1,133,410 Income Statement data for the years ended December 31, 2025 2024 2023 Total revenue $ 2,040,210 $ 1,829,664 $ 1,616,630 Net (loss) income attributable to RadNet, Inc. common stockholders (18,652) 2,793 3,044 We operate in a capital intensive, high fixed-cost industry that requires significant amounts of capital to fund operations.
As of December 31, 2024, we operated directly or indirectly through joint ventures with hospitals, 398 centers located in Arizona, California, Delaware, Florida, Maryland, New Jersey, New York and Texas.
As of December 31, 2025, we operated directly or indirectly through hospital and health system joint ventures, 418 centers located in Arizona, California, Delaware, Florida, Maryland, Virginia, New Jersey, New York, and Texas.
As it relates to other centers, this service fee revenue is earned through providing the use of our diagnostic imaging equipment and the provision of technical services as well as providing administration services such as clerical and administrative personnel, bookkeeping and accounting services, billing and collection, provision of medical and office supplies, secretarial, reception and transcription services, maintenance of medical records, and advertising, marketing and promotional activities. 54 Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payors.
As it relates to other centers, this service fee revenue is earned through providing the use of our diagnostic imaging equipment and the provision of technical services as well as providing administration services such as clerical and administrative personnel, bookkeeping and accounting services, billing and collection, provision of medical and office supplies, secretarial, reception and transcription services, maintenance of medical records, digital health support services, and advertising, marketing, and promotional activities.
At December 31, 2022, our consolidated subsidiaries included 318 centers of which 81 were not wholly-owned.
At December 31, 2024, our consolidated subsidiaries included 345 centers of which 100 were not wholly-owned.
Adjusted EBITDA Our Adjusted EBITDA metric removes non-cash and non-recurring charges that occur in the affected period and provides a basis for measuring the Company’s core financial performance against other periods.
We believe that, in addition to GAAP metrics, non-GAAP metrics such as Adjusted EBITDA assist us in measuring our core operations from period to period. Adjusted EBITDA Our Adjusted EBITDA metric removes non-cash and non-recurring charges that occur in the affected period and provides a basis for measuring the Company’s core financial performance against other periods.
A significant contributor to the change in product mix was the increase in PETHC procedures related to prostate cancer and suspect Alzheimer’s studies, which are included in advanced modality imaging procedures.
A significant contributor to this shift was the increase in PET CT procedures related to prostate cancer and Alzheimer’s-related studies, which are included within advanced modality imaging procedures.
Operating Expenses Total operating expenses for the year ended December 31, 2024 increased approximately $178.6 million, or 12.2%, from $1.47 billion for the year ended December 31, 2023 to $1.64 billion for the year ended December 31, 2024, primarily due to increase in procedures volumes.
Operating Expenses Total Imaging Center operating expenses for the year ended December 31, 2025 increased approximately $221.1 million, or 13.2%, from $1.67 billion for the year ended December 31, 2024 to $1.89 billion for the year ended December 31, 2025, primarily due to increase in procedures volumes.
Services are generally provided pursuant to one-year contracts with healthcare providers. We continuously monitor collections from our payors and maintain an allowance for credit losses based upon specific payor collection issues that we have identified and our historical experience.
We continuously monitor 52 collections from our payors and maintain an allowance for credit losses based upon specific payor collection issues that we have identified and our historical experience.
Our service fee revenue, net of contractual allowances and discounts, implicit price concessions, and revenue under capitation arrangements for the years ended December 31, 2024, 2023 and 2022 are summarized in the following table (in thousands): 36 In Thousands 2024 2023 2022 Commercial insurance $ 1,018,327 $ 879,792 $ 769,753 Medicare 410,072 356,506 305,031 Medicaid 44,736 42,302 37,530 Workers' compensation/personal injury 43,666 46,406 50,333 Other payors 104,888 87,675 65,911 Management fee revenue 24,676 17,936 22,235 Other revenue 46,724 32,580 27,223 Revenue under capitation arrangements 136,575 153,433 152,045 Total revenue $ 1,829,664 $ 1,616,630 $ 1,430,061 Our revenue is not always consistent across each quarter .
Our total revenue for the years ended December 31, 2025, 2024 and 2023 is summarized in the following table (in thousands): 36 In Thousands 2025 2024 2023 Commercial insurance $ 1,130,114 $ 1,018,327 $ 879,792 Medicare 476,987 410,072 356,506 Medicaid 51,736 44,736 42,302 Workers' compensation/personal injury 44,700 43,666 46,406 Other payors 118,599 104,888 87,675 Management fee revenue 27,516 24,676 17,936 Other revenue 65,021 46,724 32,580 Revenue under capitation arrangements 125,537 136,575 153,433 Total revenue $ 2,040,210 $ 1,829,664 $ 1,616,630 Our revenue is not always consistent across each quarter.
The following table shows our imaging centers in operation at year end and revenues for the years ended December 31, 2024, 2023 and 2022: Years Ended December 31, 2024 2023 2022 Centers in operation 398 366 357 Imaging Center revenue (millions) $ 1,830 $ 1,617 $ 1,430 Our revenue is derived from a diverse mix of payors, including private payors and commercial insurance companies, managed care capitated payors, and government payors such as Medicare and Medicaid.
Years Ended December 31, 2025 2024 2023 Centers in operation 418 398 366 Total consolidated revenue $ 2,040 $ 1,830 $ 1,617 Our revenue is derived from a diverse mix of payors, including private payors and commercial insurance companies, managed care capitated payors, and government payors such as Medicare and Medicaid.
Joint venture investment contributions to Arizona Diagnostic Radiology Group During the years ended December 31, 2024 and 2023, we made additional equity contributions of $1.4 million and $2.4 million, respectively, to Arizona Diagnostic Radiology Group ("ADRG", our joint venture with Dignity Health).
Arizona Diagnostic Radiology Group During the years ended December 31, 2025 and 2024, we made additional equity contributions of $20.5 million and $1.4 million, respectively, to Arizona Diagnostic Radiology Group ("ADRG", our joint venture with Dignity Health). On June 12, 2025, we executed a $17.0 million promissory note with Dignity Health, a related party and joint venture member of ADRG.
The $12.2 million increase in cash provided by operating activities for the year ended December 31, 2024 compared to December 31, 2023 was primarily driven by an increase in income from operations. Cash used in investing activities for the year ended December 31, 2024 increased from December 31, 2023 by $31.6 million.
The $65.8 million increase in cash provided by operating activities for the year ended December 31, 2025 compared to December 31, 2024 was primarily driven by favorable changes in working capital. 50 Cash used in investing activities for the year ended December 31, 2025 increased from the year ended December 31, 2024 by $110.8 million.
Common Stockholders $ 2,793 $ 3,044 $ 10,650 Income taxes 6,026 8,473 9,361 Interest expense 79,849 64,483 50,841 Severance costs 1,902 3,778 946 Depreciation and amortization 137,838 128,391 115,877 Non-cash employee stock-based compensation 29,833 26,785 23,770 Loss on sale and disposal of equipment and other 2,276 2,187 2,529 Non-cash change in fair value of interest rate hedge 8,006 8,185 (39,621) Other (income) expenses (24,916) (6,354) 1,833 Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI 14,995 1,308 — Lease abandonment charges 2,478 5,146 — Gain on contribution of imaging centers into joint venture — (16,808) — Loss on extinguishment of debt and related expenses 11,292 — 731 Legal settlements — — 2,197 Change in estimate related to refund liability — — 8,089 Non-cash change to contingent consideration 1,974 (4,075) 47 Acquisition related non-cash intangible adjustment — 3,950 — Non-operational rent expenses 4,233 3,629 4,297 Acquisition transaction costs 880 222 927 Adjusted EBITDA - Radnet, Inc. $279,459 $232,344 $192,474 NOTE Adjusted EBITDA - Imaging Center Segment 264,901 225,846 190,695 Adjusted EBITDA - Digital Health Segment $ 14,558 $ 6,498 $ 1,779 The following table is a reconciliation of GAAP net income for our Digital Health Segment to Adjusted EBITDA for the years ended December 31, 2024, 2023 and 2022 respectively. 51 Year Ended December 31, 2024 2023 2022 Segment net loss $ (19,925) $ (5,154) $ (6,476) Stock Compensation 2,971 2,211 2,782 Depreciation & Amortization 10,696 8,250 6,852 Other operating loss 19 (4) 23 Other income 5,419 4,537 1,920 Severance 807 1,805 20 Income taxes (424) (1,906) (3,342) Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI 14,995 — — Non-cash change to contingent consideration — (7,191) — Acquisition related to non-cash intangible adjustment — 3,950 — Adjusted EBITDA - Digital Health Segment $ 14,558 $ 6,498 $ 1,779 Liquidity and Capital Resources The cash we generate from our core operations enables us to fund ongoing operations, our research and development for new products and technologies including our investment in AI, and acquisition or expansion of imaging centers.
Common Stockholders $ (18,652) $ 2,793 $ 3,044 Income taxes 14,862 6,026 8,473 Interest expense 69,913 79,849 64,483 Severance costs 3,145 1,902 3,778 Depreciation and amortization 152,127 137,838 128,391 Non-cash employee stock-based compensation 54,601 29,833 26,785 Loss on sale and disposal of equipment and other 9,658 2,276 2,187 Non-cash change in fair value of interest rate hedge 7,112 8,006 8,185 Other (income) expenses (32,066) (24,916) (6,354) Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI 20,155 14,995 1,308 Lease abandonment charges 8,563 2,478 5,146 Gain on contribution of imaging centers into joint venture — — (16,808) Loss on extinguishment of debt and related expenses — 11,292 — Non-cash change to contingent consideration 110 1,974 (4,075) Acquisition related non-cash intangible adjustment — — 3,950 Non-operational rent expenses 3,247 4,233 3,629 Acquisition transaction costs 7,446 880 222 Adjusted EBITDA - Radnet, Inc. $300,221 $279,459 $232,344 NOTE Adjusted EBITDA - Imaging Center Segment 284,710 264,901 225,846 Adjusted EBITDA - Digital Health Segment $ 15,511 $ 14,558 $ 6,498 The following table is a reconciliation of GAAP net income for our Digital Health Segment to Adjusted EBITDA for the years ended December 31, 2025, 2024 and 2023 respectively.
The portfolio of software solutions is anchored by eRad, Inc.'s RIS/PACS, informatics designed specifically for outpatient radiology and DeepHealth OS, a cloud-native operating system that helps operate all aspects of the radiology service line from scheduling and patient preparation to technologist workflow to interpretation and referral management.
The portfolio of AI and software solutions is anchored by Enterprise Operations solutions (traditionally knowns as RIS), Enterprise Imaging solutions (traditionally known as PACS), and Clinical AI solutions, enabled by the DeepHealth OS, a cloud-native operating system that connects critical aspects of the radiology service line from scheduling and patient preparation to technologist workflow to interpretation and referral management.
Revenue under capitation arrangements is recognized in the period in which we are obligated to provide services to plan enrollees under contracts with various health plans. ACCOUNTS RECEIVABLE – Substantially all of our accounts receivable are due under fee-for-service contracts from third party payors, such as insurance companies and government-sponsored healthcare programs, or directly from patients.
ACCOUNTS RECEIVABLE – Substantially all of our accounts receivable are due under fee-for-service contracts from third-party payors, such as insurance companies and government-sponsored healthcare programs, or directly from patients. Services are generally provided pursuant to one-year contracts with healthcare providers.
Included in our consolidated balance sheet at December 31, 2024 are $992.0 million of total term loan debt (net of unamortized discounts of $13.7 million) displayed below in thousands: Face Value Discount Total Carrying Value Barclays Term Loans $ 870,625 $ (12,929) $ 857,696 Truist Term Loan 135,000 (726) 134,274 Total Term Loans $ 1,005,625 $ (13,655) $ 991,970 We had no outstanding balance under our $282.0 million Barclays revolving credit facility as of December 31, 2024 and had reserved $7.6 million for certain letters of credit.
Included in our consolidated balance sheet at December 31, 2025 are $1,072.6 million of total term loan debt (net of unamortized discounts of $12.2 million) displayed below in thousands: Face Value Discount Total Carrying Value Barclays Term Loans $ 961,119 $ (11,759) $ 949,360 Truist Term Loan 123,750 (462) 123,288 Total Term Loans $ 1,084,869 $ (12,221) $ 1,072,648 We had no outstanding balance under our $282.0 million Barclays Revolving Credit Facility as of December 31, 2025 and had reserved $9.0 million for certain letters of credit.
The following table sets forth our cost of operations and total operating expenses for the year ended December 31, 2024 and 2023 (in thousands): Years Ended December 31, 2024 2023 Salaries and professional reading fees, excluding stock-based compensation $ 984,281 $ 853,327 Stock-based compensation 26,863 24,574 Building and equipment rental 121,514 117,405 Medical supplies 103,189 86,213 Other operating expenses * 275,587 271,672 Cost of operations 1,511,434 1,353,191 Depreciation and amortization 127,142 120,141 Gain on contribution of imaging centers into joint venture — (16,808) Lease abandonment charges 2,478 5,146 Loss on sale and disposal of equipment 2,257 2,191 Severance costs 1,095 1,973 Total operating expenses $ 1,644,406 $ 1,465,834 * Includes billing fees, office supplies, repairs and maintenance, insurance, business tax and license, outside services, telecommunications, utilities, marketing, travel and other expenses.
The following table sets forth our cost of operations and total operating expenses for the years ended December 31, 2025 and 2024 (in thousands): 43 Years Ended December 31, 2025 2024 Salaries and professional reading fees, excluding stock-based compensation $ 1,083,550 $ 984,280 Stock-based compensation 44,674 26,863 Building and equipment rental 127,798 121,514 Medical supplies 126,126 103,189 Other operating expenses * 355,225 303,952 Cost of operations 1,737,373 1,539,798 Depreciation and amortization 136,297 127,142 Lease abandonment charges 8,563 2,478 Loss on sale and disposal of equipment 9,821 2,257 Severance costs 1,797 1,095 Total operating expenses $ 1,893,851 $ 1,672,770 * Includes billing fees, office supplies, repairs and maintenance, insurance, business tax and license, outside services, telecommunications, utilities, marketing, travel and other expenses.
Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. Revenues related to uninsured patients and copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts).
Our revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payors. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements.
Stock-based compensation Stock-based compensation increased $3.6 million, or 17.1%, to approximately $24.6 million for the year ended December 31, 2023 compared to $21.0 million for the year ended December 31, 2022.
Stock-based compensation Stock-based compensation increased $17.8 million, or 66.3%, to approximately $44.7 million for the year ended December 31, 2025 compared to $26.9 million for the year ended December 31, 2024.
In Thousands Year Ended December 31, Lease abandonment charges 2024 2023 $ Increase/(Decrease) % Change Total $2,478 5,146 $(2,668) — Same Center $1,518 4,089 $(2,571) — Excluded 960 1,057 — — Interest expense 43 In Thousands Year Ended December 31, Interest Expense 2024 2023 $ Increase/(Decrease) % Change Total Interest Expense $79,849 $64,483 $15,366 23.8% Interest related to derivatives* $(762) $(9,752) Interest related to amortization** $2,276 $2,987 Adjusted Interest Expense*** $78,335 $71,248 $7,087 9.9% *Includes payments from 2019 swaps **Includes noncash amortization of deferred loan costs and discount on issuance of debt ***Includes interest related to our term loans, revolving credit line, notes, and other The increase in interest expense was the result in the general increase in term loan debt due to the refinancing of our Barclays credit facility in April 2024, partially offset by lower interest rates compared to the same period in the prior year.
Consolidated Interest expense In Thousands Years Ended December 31, Interest Expense 2025 2024 $ Increase/(Decrease) % Change Total Interest Expense $69,913 $79,849 ($9,936) (12.4)% Interest related to derivatives* 5,004 762 Interest related to amortization** (3,014) (2,276) Adjusted Interest Expense*** $71,903 $78,335 $(6,433) (8.2)% *Includes payments from 2019 swaps, inclusive of amortization of other comprehensive income **Includes noncash amortization of deferred loan costs and discount on issuance of debt ***Includes interest related to our term loans, revolving credit line, notes, and other The decrease in interest expense was primarily due to the repricing transaction of our Barclays Revolving Credit Facility (as defined in the notes to our consolidated financial statements) in the fourth quarter of 2024, which resulted in lower interest rates compared to the same period in the prior year.
Further, we are using AI to develop solutions that employ machine learning to assist radiologists and other clinicians in interpreting images and improving radiologist efficiency and patient care. These AI solutions will initially be focused in the fields of screening for breast, prostate, lung and colon cancers.
We are using AI to develop solutions to assist radiologists and other clinicians in interpreting images and improving radiologist efficiency and patient care.
Purchases of imaging centers during the period was $43.7 million, a $31.6 million increase from the prior period. Capital expenditures for property and equipment during the period was $188.1 million, a $11.5 million increase from the prior period.
Purchases of imaging centers and other acquisitions during the period was $133.4 million, a $89.8 million increase from the prior period. Cash payments for capital expenditures on property and equipment during the period was $213.3 million, a $25.2 million increase from the prior period.
The decrease in equity in earnings from unconsolidated joint ventures was due to the formation of Arizona Diagnostic Radiology Group in November 2022, which operated at a net loss in 2023. 48 Net income attributable to noncontrolling interests At December 31, 2023, our consolidated subsidiaries operated 321 imaging centers of which 85 were not wholly-owned and thus a portion of their operating results were attributable to noncontrolling interests.
Equity in earnings from unconsolidated joint ventures For the year ended December 31, 2025 we recognized equity in earnings from unconsolidated joint ventures of $14.9 million versus $14.5 million for the year ended December 31, 2024, an increase of $0.4 million or 2.8%. 47 Net income attributable to noncontrolling interests As of December 31, 2025, our consolidated subsidiaries operated 368 imaging centers of which 101 were not wholly-owned and thus a portion of their operating results were attributable to noncontrolling interests.
We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect. Under capitation arrangements with various health plans, we earn a per-enrollee amount each month for making available diagnostic imaging services to all plan enrollees under the capitation arrangement.
Under capitation arrangements with various health plans, we earn a per-enrollee amount each month for making available diagnostic imaging services to all plan enrollees under the capitation arrangement. Revenue under capitation arrangements is recognized in the period in which we are obligated to provide services to plan enrollees under contracts with various health plans.
Upon the conclusion of the measurement period or final determination of the values of assets acquired or liabilities assumed, whichever comes first, any subsequent adjustments are recorded to our consolidated statements of operations. GOODWILL AND INDEFINITE LIVED INTANGIBLES – Goodwill totaled $710.7 million and $679.5 million as of December 31, 2024 and December 31, 2023, respectively.
Upon the conclusion of the measurement period or final determination of the values of assets acquired or liabilities assumed, whichever comes first, any subsequent adjustments are recorded to our consolidated statements of operations. Recent Accounting Standards See Note 3, Recent Accounting Standards, in the notes accompanying the consolidated financial statements included in this report for further information.
Cash provided by financing activities for the year ended December 31, 2024 resulted from a secondary public offering of our common stock and a refinancing of our Barclays credit facility.
Cash provided by financing activities for the year ended December 31, 2025 decreased by $325.7 million compared to the year ended December 31, 2024. Financing activity in 2024 included a public equity offering that generated $218.4 million in net proceeds and a refinancing of the Barclays Revolving Credit Facility that resulted in an additional $167.9 million of cash.
Additional segment operating and non-operating expenses: 42 In Thousands Year Ended December 31, 2024 2023 $ Increase/(Decrease) % Change Depreciation and Amortization $127,142 $120,141 $7,001 5.8% Loss on disposal of equipment and other $2,257 $2,191 $66 3.0% Gain on contribution of imaging centers into joint venture $0 (16,808) $16,808 nm Non-cash change in fair value of interest rate swaps $8,006 $8,185 ($179) (2.2)% Other income ($19,043) ($10,891) ($8,152) 74.9% Severance $1,095 $1,973 ($878) (44.5)% nm=not meaningful The increase in depreciation expense was due to higher depreciable asset base, mainly driven by our expanded locations.
Additional segment operating and non-operating expenses: In Thousands Years Ended December 31, 2025 2024 $ Increase/(Decrease) % Change Depreciation and Amortization $136,297 $127,142 $9,155 7.2% Loss on disposal of equipment and other $9,821 $2,257 $7,564 335.1% Other income ($32,066) ($30,336) ($1,730) 5.7% Debt restructuring and extinguishment expenses $— $11,292 ($11,292) (100.0)% Severance $1,797 $1,095 $702 64.1% The increase in depreciation expense was due to higher depreciable asset base, mainly driven by our expanded locations.
Lease abandonment charges We closely monitor patient levels at our imaging centers and occasionally divest or shut down centers to maximize utilization rates. During the end of 2024, we experienced lower utilization at seven imaging centers.
Lease abandonment charges In Thousands Years Ended December 31, 2025 2024 $ Increase/(Decrease) % Change Lease abandonment charges $8,563 2,478 $6,085 246 % We closely monitor patient levels at our imaging centers and occasionally divest or shut down centers to maximize utilization rates. We may abandon low utilization leases and divert the patients to nearby centers.
We and our subsidiaries or affiliates may from time to time, in our sole discretion, purchase, repay, redeem or retire any of our outstanding debt or equity securities in privately negotiated or open market transactions, by tender offer or otherwise. 52 Sources and Uses of Cash The following table summarizes key components of our sources and uses of cash for the years ended December 31, 2024, 2023 and 2022, respectively, in thousands: Cash Flow Data 2024 2023 2022 Cash provided by operating activities $ 233,023 $ 220,863 $ 146,417 Cash used in investing activities (233,070) (201,470) (246,949) Cash provided by financing activities 397,950 195,635 93,647 Cash provided by operating activities for the year ended December 31, 2024 included $289.5 million in net income reconciling adjustments offset by a $56.5 million change in assets and liabilities.
Sources and Uses of Cash The following table summarizes key components of our sources and uses of cash for the years ended December 31, 2025, 2024 and 2023, respectively, in thousands: Cash Flow Data 2025 2024 2023 Cash provided by operating activities $ 298,820 $ 233,023 $ 220,863 Cash used in investing activities (343,865) (233,070) (201,470) Cash provided by financing activities 72,207 397,950 195,635 Cash provided by operating activities for the year ended December 31, 2025 included $308.6 million of net income, adjusted for non-cash items such as depreciation and amortization, non-cash lease expense, stock-based compensation and deferred taxes, offset by a $9.8 million change in assets and liabilities.
For the year ended December 31, 2023, we recognized net income attributable to noncontrolling interests of $27.3 million versus $23.0 million for the year ended December 31, 2022, an increase of $4.3 million.
For the year ended December 31, 2025, we recognized net income attributable to noncontrolling interests of $35.7 million versus $36.0 million for the year ended December 31, 2024, a decrease of $0.3 million. Non-GAAP Financial Measures We use both GAAP and non-GAAP metrics to measure our financial results.
See Note 4, Business Combinations and Related Activity, in the notes accompanying our consolidated financial statements included in this report, for a more detailed discussion of these acquisitions. Digital Health Segment Our Digital segment develops and deploys clinical applications to enhance interpretation of medical images and improve patient outcomes with a current emphasis on breast, prostate, and lung cancer diagnostics.
The lease abandonment charges include the impairment of associated right-of-use assets of $6.7 million and write off of related leasehold improvements of approximately $1.9 million. Digital Health Segment Our Digital Health segment develops and deploys clinical applications to enhance interpretation of medical images and improve patient outcomes with a current emphasis on breast, prostate, and lung cancer diagnostics.
The increase in PETHC procedures related to prostate cancer and suspected Alzheimer studies also raised medical supplies expense due to the requirement for high-cost isotope tracers.
The growth in PET/CT procedures, particularly for prostate cancer and suspected Alzheimer’s studies, drove higher utilization of high-cost isotope tracers, contributing to the increase. In addition, price increases for these tracers further elevated medical supplies expense compared to the prior year.
Imaging, Inc.* 6/1/2024 4,200 4,025 5,597 — 175 — (5,597) — Global Imaging LLP* 9/1/2024 2,900 1,266 — 1,584 50 — — — Stanislaus Surgical Hospital, LLC* 9/16/2024 3,000 503 1,468 2,382 100 15 (1,468) — Pink Perception, LLC* 10/7/2024 4,000 494 407 3,306 200 — (407) — AV Imaging PLLC* 11/1/2024 1,000 287 — 663 50 — — — Total $ 59,045 $ 28,289 $ 25,709 $ 34,697 $ 2,565 $ 161 $ (26,079) $ (6,297) *Fair Value Determination is Final 2023 : Entity Date Acquired Total Consideration Property & Equipment Right of Use Assets Goodwill Intangible Assets Other Right of Use Liabilities C.C.D.G.L.R. & S Services Inc.* 1/1/2023 3,500 435 1,689 3,015 50 — (1,689) Southern California Diagnostic Imaging, Inc.* 1/1/2023 1,815 466 1,184 1,272 50 27 (1,184) Inglewood Imaging Center, LLC* 2/1/2023 2,600 877 1,188 1,658 50 15 (1,188) Ramapo Radiology Associates, P.C.* 2/1/2023 2,000 1,663 3,775 229 100 8 (3,775) Madison Radiology Medical Group, Inc.* 4/1/2023 250 100 — 150 — — — Delaware Diagnostic Imaging, P.A.* 8/1/2023 600 401 337 149 50 — (337) Total $10,765 $3,942 $8,173 $6,473 $300 $50 $(8,173) *Fair Value Determination is Final Digital Health Segment Kheiron Medical Technologies LTD On October 14, 2024, we acquired a all of the equity interest in Kheiron Medical Technologies LTD (“Kheiron”), which uses deep learning AI to help radiologists detect breast cancer. 38 Kheiron’s operations are included in our Digital Health segment for reporting purposes.
Imaging, Inc. 6/1/2024 4,200 4,025 5,597 — 175 — (5,597) — Global Imaging LLP 9/1/2024 2,900 1,266 — 1,584 50 — — — Stanislaus Surgical Hospital, LLC 9/16/2024 3,000 503 1,468 2,382 100 15 (1,468) — Pink Perception, LLC 10/7/2024 4,000 494 407 3,306 200 — (407) — AV Imaging PLLC 11/1/2024 1,000 287 — 663 50 — — — Total $ 59,045 $ 28,289 $ 25,709 $ 34,697 $ 2,565 $ 161 $ (26,079) $ (6,297) Digital Health Segment See-Mode Technologies On June 2, 2025, through our wholly owned subsidiary DH AI International Holdings, B.V, we acquired all of the equity interest in See-Mode Technologies (“See-Mode”), a medical technology company focused on using artificial intelligence to enhance ultrasound-based diagnostics.
Same center total procedure volume grew at an overall rate of 3.2% which was comprised of a 1.7% increase in routine imaging and an 8.1% increase in advanced modality imaging procedures. The increase in revenue was largely attributable to product mix, as advanced imaging was a greater portion of overall procedures.
The increase in revenue was largely attributable to the procedural volume growth, increased reimbursement from commercial and capitated payors and favorable changes in product mix, as advanced imaging represented a greater proportion of total procedures.
Additionally, we are continuing to face inflation in employee wage rates as we compete for talent in a tight labor market, further impacted by the October 2024 increase in California's minimum wage for healthcare workers.
We also continued to experience wage inflation across the board, driven by a competitive labor market and the October 2024 increase in California’s minimum wage for healthcare workers. Additionally, higher workers’ compensation insurance premiums contributed to the overall rise in staffing costs.
See the Derivative Instruments section of Note 2, Summary of Significant Accounting Policies, in the notes accompanying the consolidated financial statements included in this report and Item 7A — "Quantitative and Qualitative Disclosure About Market Risk" below for more details on our derivative transactions.
For more information on our secured credit facilities see Note 8, Credit Facilities and Notes Payable, in the notes accompanying our consolidated financial statements in this report.
The breakdown of revenue and expenses of the segment for the year ended December 31, 2024, 2023 and 2022 are as follows: In Thousands Year Ended December 31, 2024 2023 2022 2024 vs 2023 $ change 2023 vs 2022 $ change Revenue $ 65,706 $ 49,576 $ 38,058 $ 16,130 $ 11,518 Salaries and Wages 26,569 25,272 21,812 1,297 3,460 Stock Compensation 2,971 2,211 2,782 760 (571) Other operating 24,579 14,565 14,467 10,014 98 Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI 14,995 — — 14,995 — Depreciation & Amort. 10,696 8,250 6,852 2,446 1,398 Other operating loss (gain) 19 (4) 23 23 (27) Severance 807 1,805 20 (998) 1,785 Total operating expenses 80,636 52,099 45,956 28,537 6,143 Loss from operations (14,930) (2,523) (7,898) (12,407) 5,375 Other expense (income) 5,419 4,537 1,920 882 2,617 Income before taxes (20,349) (7,060) (9,818) (13,289) 2,758 Income taxes (424) (1,906) (3,342) 1,482 1,436 Segment net loss (19,925) (5,154) (6,476) (14,771) 1,322 Year Ended December 31, 2024 Compared to the Year Ended December 31, 2023 49 Revenues for the Digital Health segment increased as a result of core growth in our eRad PICS business, the rollout in 2023 of our Deephealth OS, and continued rollout of our Enhanced Breast Cancer Detection solutions across additional facilities.
The breakdown of revenue and expenses of the segment for the years ended December 31, 2025 and 2024 are as follows: In Thousands Years Ended December 31, 2025 2024 $ change Revenue $ 92,691 $ 65,706 $ 26,985 Salaries and Wages 45,207 26,569 18,638 Stock Compensation 9,927 2,971 6,956 Other operating 32,683 24,578 8,105 Non-Capitalized R&D - DeepHealth Cloud OS & Generative AI 20,155 14,995 5,160 Depreciation & Amort. 15,831 10,696 5,135 Other operating (gain) loss (163) 19 (182) Severance 1,348 807 541 Total operating expenses 124,988 80,635 44,353 Loss from operations (32,297) (14,929) (17,368) Year Ended December 31, 2025 Compared to the Year Ended December 31, 2024 For the year ended December 31, 2025 , Digital Health segment revenues increased $27.0 million or 41.1% , to $92.7 million , compared to $65.7 million for the year ended December 31, 2024 .
Removed
Our DeepHealth, Inc. subsidiary received FDA clearance for use of its SaigeQ "triage"/workflow product, SaigeDX advanced diagnostic product and Saige-Density breast density assessment software for screening breast mammography, which we have begun to roll out in certain markets as an Enhanced Breast Cancer Detection solution.
Added
Our Clinical AI solutions currently cover the fields of diagnosis and screening in the domain of breast, prostate, lung, thyroid, and brain. Across our portfolio of AI solutions, we have 22 FDA clearances and 15 CE marks. Our Digital Health segment provides these solutions to RadNet and to over 2000 customers in the U.S. and outside of the U.S.
Removed
Our Aidence Holding B.V. subsidiary is developing solutions for interpretation of chest and lung CT scans for lung cancer screening.
Added
As part of our continued strategic expansion in Digital Health, we recently completed three acquisitions: iCAD, Inc., an AI-powered breast health solutions company; See-Mode Technologies, which enhances ultrasound-based diagnostics through artificial intelligence; and CIMAR (UK) Limited, which provides cloud-based medical image storage, PACS, and AI-enabled imaging workflow solutions.
Removed
The Aidence Holding B.V. subsidiary has received the CE marking for these solutions and has existing customers in seven European countries, with its largest concentration in the United Kingdom, and plans to submit an application for FDA clearance to sell in the United States.
Added
We are currently integrating these businesses into our Digital Health segment The following table presents the total number of imaging centers in operation at year end, including both consolidated and non-consolidated centers, and our consolidated revenues for the years ended December 31, 2025, 2024 and 2023. Revenue from non-consolidated centers is not included in consolidated revenues.
Removed
Our Quantib B.V. subsidiary is primarily focused on interpretation of prostate MRI for widespread prostate cancer screening. Quantib’s prostate MRI post-processing software has both FDA clearances and European CE marking. Our digital health segment provides these solutions to RadNet and to over 400 customers in the United States and Europe.
Added
See-Mode’s operations are included in our Digital Health segment for reporting purposes.
Removed
The valuation of assets acquired and liabilities assumed has not yet been finalized as of December 31, 2024, fair value determination is preliminary and subject to change. Subsidiary activity Formation of majority owned subsidiaries Tri Valley Imaging Group, LLC.
Added
The transaction was accounted for as the acquisition of a business with a total purchase consideration of approximately of $28.9 million, including: (i) cash of $17.9 million, (ii) a holdback of $2.0 million cash to be released 18 months after acquisition, and (iii) contingent consideration with a fair value of $9.0 million related to three performance milestones payable 50% in cash and 50% in shares of our common stock.
Removed
The operation offers multi-modality imaging services out of three locations in Los Angeles, California. We contributed the operations of 3 centers to the subsidiary. Cedars-Sinai Medical Center purchased from us a 35% noncontrolling economic interest in LAIG for a cash payment of $5.9 million. As a result of the transaction, we retain a 65% controlling economic interest in LAIG.
Added
We recorded $0.2 million in other net assets, $5.5 million in developed technology, $5.4 million in IPR&D, $20.0 million in goodwill, and $2.2 million in deferred tax liabilities in connection with this transaction.
Removed
COMMON STOCKHOLDERS 0.2 % 0.2 % 0.6 % Imaging Center Segment Year Ended December 31, 2024 Compared to the Year Ended December 31, 2023 We grow our imaging center business through a combination of organic growth as well as acquisitions and joint ventures.
Added
In performing the purchase price allocation, we considered, among other factors, the intended future use of the acquired assets, the historical financial performance, and estimates of the future performance of the See-Mode business. iCAD, Inc. On July 17, 2025, we completed the acquisition of all of the outstanding equity interests of iCAD, Inc.
Removed
In the discussion below, the "same center" metrics are based on imaging centers that were in operation throughout the period of January 1, 2023 through December 31, 2024. Excluded amounts relate to imaging centers that were acquired or divested between January 1, 2023 through December 31, 2024.
Added
(“iCAD”), a global leader in AI-powered breast health solutions. The acquisition integrates iCAD’s commercial, technology, and regulatory capabilities with those of DeepHealth, our wholly owned subsidiary within the Digital Health segment. The transaction strengthens DeepHealth’s position as an industry leader in AI-enabled breast cancer image interpretation and workflow optimization and expands its global market reach.
Removed
Total Revenue 40 In Thousands Year Ended December 31, Revenue 2024 2023 $ Increase/(Decrease) % Change Total Revenue $1,763,958 $1,567,054 $196,904 12.6% Same Center Revenue $1,644,721 $1,498,160 $146,561 9.8% Excluded $119,237 $68,894 — — Our 9.8% increase in same center revenue over the same period last year was driven by increases in fees charged per imaging procedure and an increase in procedures volumes.
Added
The transaction was accounted for as the acquisition of a business and was completed through an all-stock exchange, with total purchase consideration of approximately $110.7 million based on the fair value of our common stock issued to iCAD shareholders and the fair value of our options issued in exchange for outstanding iCAD options.
Removed
Salaries and professional reading fees, excluding stock-based compensation and severance In Thousands Year Ended December 31, Salaries and Professional Fees 2024 2023 $ Increase/(Decrease) % Change Total $984,281 $853,327 $130,954 15.3% Same Center $929,364 $823,015 $106,349 12.9% Excluded $54,917 $30,312 — — 41 Consistent with the higher procedure volumes noted above, our staffing levels were adjusted to support the influx of patients seeking radiology procedures.
Added
We allocated the purchase price to the assets acquired and liabilities assumed based on their estimated fair values, which resulted in the recognition of goodwill of approximately $36.6 million, primarily reflecting expected synergies from integrating iCAD’s technology portfolio, established customer relationships, and assembled workforce.

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Item 7. Management's Discussion & Analysis

Management's Discussion & Analysis (MD&A) — revenue / margin commentary

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Biggest changeItem 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations 36 Item 7A. Quantitative and Qualitative Disclosures About Market Risk 55 Item 8. Financial Statements and Supplementary Data 57 Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 97
Biggest changeItem 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations 36 Item 7A. Quantitative and Qualitative Disclosures About Market Risk 53 Item 8. Financial Statements and Supplementary Data 54 Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 98

Item 7A. Quantitative and Qualitative Disclosures About Market Risk

Market Risk — interest-rate, FX, commodity exposure

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Biggest changeAt December 31, 2024, we had $135.0 million outstanding subject to an adjusted SOFR election on our Trust term loan. At December 31, 2024, our effective SOFR rate plus applicable margin was 5.93%.
Biggest changeOn December 31, 2025, we had $123.7 million outstanding subject to an adjusted SOFR election on our Truist Term Loan. On December 31, 2025, our effective SOFR rate plus applicable margin was 5.27%.
Item 7A. Quantitative and Qualitative Disclosures About Market Risk 55 Foreign Currency Exchange Risk. We generate substantially all of our revenues and incur substantially all of our expenses in United States dollars. As a result, our financial results are unlikely to be materially affected by changes in foreign currency exchange rates or weak economic conditions in foreign markets.
Item 7A. Quantitative and Qualitative Disclosures About Market Risk Foreign Currency Exchange Risk. We generate substantially all of our revenues and incur substantially all of our expenses in United States dollars. As a result, our financial results are unlikely to be materially affected by changes in foreign currency exchange rates or weak economic conditions in foreign markets.
Accordingly, our interest expense and consequently, our earnings, are affected by changes in short term interest rates. We purchased the 2019 swaps to mitigate interest rate risk on a portion of our outstanding term loan debt, as described below. We can elect SOFR or Alternative Base Rate interest rate options on amounts outstanding under the Barclay's term loan.
Accordingly, our interest expense, and consequently our earnings, are affected by changes in short term interest rates. We purchased the 2019 swaps to mitigate interest rate risk on a portion of our outstanding term loan debt, as described below. We can elect SOFR or Alternative Base Rate interest rate options on amounts outstanding under the Barclays Term Loan.
At the present time, we do not have any foreign currency exchange contracts to mitigate this risk. At December 31, 2024, a hypothetical 1% decline in the currency exchange rates between the U.S. dollar against these currencies, would have resulted in an annual increase of approximately $0.4 million in operating expenses. Interest Rate Sensitivity.
At the present time, we do not have any foreign currency exchange contracts to mitigate this risk. On December 31, 2025, a hypothetical 1% decline in the currency exchange rates between the U.S. dollar against the above-mentioned currencies, would have resulted in an annual increase of approximately $0.4 million in operating expenses. Interest Rate Sensitivity.
A hypothetical 1% increase in the adjusted SOFR rates under the Truist credit facility would result in an increase of approximately $1.4 million in annual interest expense and a corresponding decrease in income before taxes. 56
A hypothetical 1% increase in the adjusted SOFR rates under the Truist Credit Facility would result in an increase of approximately $1.2 million in annual interest expense and a corresponding decrease in income before taxes. 53
A hypothetical 1% increase in the SOFR rates under the Barclay's credit facility would result in an increase of $4.7 million in annual interest expense and a corresponding decrease in income before taxes. We can elect SOFR or Base Rate interest rate options on amounts outstanding under the Truist credit facility.
A hypothetical 1% increase in the SOFR rates under the Barclays Credit Facility would result in an increase of $5.6 million in annual interest expense and a corresponding decrease in income before taxes. We can elect SOFR or Base Rate interest rate options on amounts outstanding under the Truist Credit Facility.
At December 31, 2024, after giving effect to the $400 million notional amount of our 2019 swaps, we had $470.6 million outstanding subject to a SOFR election on our Barclay's term loan, at an effective rate plus applicable margin of 6.77%.
On December 31, 2025, after giving effect to the $400 million notional amount of our 2019 swaps, we had $561.1 million outstanding subject to a SOFR election on our Barclays Term Loan, at an effective rate plus applicable margin of 6.07%.

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