Revenue Growth — Q4 and Full Year
Total company revenue of $539.1M in Q4 2025, up 15.9% YoY from $465.0M; excluding Nova and Pivot Q4 revenue was $493.8M (+6.2% YoY). Full year 2025 revenue of $2.2B, up 13.9% YoY from $1.9B; excluding acquisitions full year revenue was $2.0B (+6.4% YoY; +6.8% on a per-day basis).
Strong Volume Trends
Total patient visits per day increased 9.0% in Q4 to >51,000; workers' compensation visits +9.1% and employer services visits +9.4% in Q4. Full year visits per day rose 7.7% to >53,000; excluding Nova full-year visits per day increased 2.2%.
Rate Improvements
Revenue per visit grew 3.1% in Q4 (workers' compensation +4.1%, employer services +1.2%). Full-year revenue per visit increased 4.3% (workers' compensation +5.3%, employer services +2.7%).
Adjusted EBITDA and Margin Expansion
Adjusted EBITDA of $95.3M in Q4 2025, up 22.9% YoY from $77.5M; adjusted EBITDA margin improved 100 bps to 17.7% in Q4. Full-year adjusted EBITDA $431.9M (+14.6% YoY) with margin expanding to 20.0% from 19.8%.
On-Site Segment Acceleration
On-Site Health Clinics revenue of $36.2M in Q4 2025, up 112% YoY driven by Pivot acquisition; excluding Pivot, On-Site organic growth was 14.6% YoY in Q4. Full-year On-Site revenue $110.2M (+72% YoY; excl Pivot +11.6%).
Cash Flow and Free Cash Flow Strength
Q4 operating cash flow $118.7M vs $93.7M prior year. Q4 free cash flow $98.6M vs $77.0M prior year; full-year free cash flow $197.8M with free cash flow conversion at 114% of net income.
Operational Efficiencies
Cost of services improved (Q4 73.9% of revenue vs 74.2% prior year; full year 71.7% vs 72.2%). Q4 adjusted G&A (ex-addbacks) was 8.5% of revenue vs 9.4% prior year, reflecting staffing and efficiency gains.
Commercial and Clinical Validation
Clinical validation: analysis of >550,000 claims (2020–2025) showing Concentra-treated claims cost 25% lower and claim duration 65 fewer days vs non-Concentra providers. Patient satisfaction metrics at all-time highs; management reports capture of expected M&A synergies and strong de novo/M&A pipeline.