Heartflow, Inc.
For the period ended Jun 30, 2026. Filed Aug 13, 2026.
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A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.
Jun 30, 2026 · Filed Aug 13, 2026
What changed in Management’s Discussion and Analysis?
Read the current filingPrevious report: 10-Q
Period ended 2026-03-31; filed 2026-05-14.
0001464521-26-000071
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsCurrent report: 10-Q
Period ended 2026-06-30; filed 2026-08-13.
0001464521-26-000131
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsThe baseline is this issuer’s latest earlier reporting period of the same form that was filed before the current report. A previous 10-Q is a different quarter, not a year-over-year comparison. Amendments are excluded.
Compared 103 previous paragraphs and 111 current paragraphs.
69 unchanged; 27 reworded; 9 added; 6 removed; 1 previous and 6 current paragraphs rearranged.
Tables are not compared: 3 previous and 4 current tables excluded. Dates, whitespace, punctuation and numbering changes are ignored; changes to financial figures remain significant.
A changed paragraph is not evidence that risk increased or decreased. An unchanged paragraph does not establish that risk stayed the same.
Added paragraphs (9)
Current report
$0.2 million in software-related costs. Personnel and related expenses included $2.7 million and $0.4 million of stock-based compensation costs during the three months ended June 30, 2026 and 2025, respectively.
Current report
Comparison of Six Months Ended June 30, 2026 and 2025
Current report
The following table summarizes our results of operations for the six months ended June 30, 2026 and 2025:
Current report
Revenue increased $36.1 million, or 45%, to $116.7 million during the six months ended June 30, 2026, compared to $80.6 million during the six months ended June 30, 2025. The increase in revenue was primarily attributable to a 71% increase in revenue case volume, partially offset by a reduction in average sales price due to a higher percentage of revenue cases generated from clinic and office-based accounts and an increase in volume rebates. Revenue case volume for the six months ended June 30, 2026, benefited from the continued commercialization and account adoption of Heartflow Plaque Analysis. This growth was driven in part by expanded reimbursement coverage under CPT code 75577, which became effective on January 1, 2026.
Current report
Research and development expenses
Current report
Selling, general and administrative expenses
Current report
Selling, general and administrative expenses increased $24.4 million, or 39%, to $87.4 million during the six months ended June 30, 2026, compared to $63.0 million during the six months ended June 30, 2025. The increase in selling, general and administrative expenses was primarily attributable to an increase of $17.2 million in personnel and related expenses directly associated with an increase in headcount, $3.8 million in professional fees, including legal, audit and consulting fees, $1.5 million in computer hardware and software-related costs, $0.9 million in travel expenses, $0.9 million in advertising and other promotional expenses, and $0.5 million in net amortization of capitalized acquisition and commissions costs, partially offset by a decrease of $0.9 million in direct and allocated facilities and IT overhead costs. Personnel and related expenses included $9.3 million and $3.7 million of stock-based compensation costs for the six months ended June 30, 2026 and 2025, respectively.
Current report
Provision for income taxes was $45,000 for the six months ended June 30, 2026, compared to $59,000 for the six months ended June 30, 2025, which was related to our foreign taxes.
Current report
Net cash provided by (used in) investing activities
Removed paragraphs (6)
Previous report
Interest income (expense), net
Previous report
Other expense, net
Previous report
Provision for income taxes
Previous report
Interest income (expense), net
Previous report
Other expense, net
Previous report
Provision for income taxes
Reworded paragraphs (27)
Previous wording
We provide software and artificial intelligence (“AI”) designed to deliver a more accurate and clinically effective non-invasive solution for diagnosing and managing coronary artery disease (“CAD”), a leading cause of death worldwide. As of March 31, 2026, our Heartflow Platform has been used to assess CAD in more than 650,000 patients, including 219,000 in 2025 alone. We believe that we are the most widely adopted AI-powered test for CAD. Our novel platform leverages AI and advanced computational fluid dynamics to create a personalized 3D model of a patient’s heart from a single coronary computed tomography angiography (“CCTA”), a specialized type of scan that provides detailed images of the heart’s arteries. Our Heartflow Platform delivers actionable insights on blood flow, stenosis, plaque volume and plaque composition thereby overcoming the limitations of traditional non-invasive imaging tests which rely on indirect measures of coronary disease and lead to higher false negative and false positive rates as demonstrated by our PRECISE trial. We believe the differentiated accuracy and clinical utility of our Heartflow Platform, along with its ability to enhance workflows, will continue to support our growth and advance the “CCTA + Heartflow” pathway as the definitive standard for the non-invasive diagnosis and management of CAD.
Current wording
We provide software and artificial intelligence (“AI”) designed to deliver a more accurate and clinically effective non-invasive solution for diagnosing and managing coronary artery disease (“CAD”), a leading cause of death worldwide. As of June 30, 2026, our Heartflow Platform has been used to assess CAD in more than 750,000 patients, including 219,000 in 2025 alone. We believe that we are the most widely adopted AI-powered test for CAD. Our novel platform leverages AI and advanced computational fluid dynamics to create a personalized 3D model of a patient’s heart from a single coronary computed tomography angiography (“CCTA”), a specialized type of scan that provides detailed images of the heart’s arteries. Our Heartflow Platform delivers actionable insights on blood flow, stenosis, plaque volume and plaque composition thereby overcoming the limitations of traditional non-invasive imaging tests which rely on indirect measures of coronary disease and lead to higher false negative and false positive rates as demonstrated by our PRECISE trial. We believe the differentiated accuracy and clinical utility of our Heartflow Platform, along with its ability to enhance workflows, will continue to support our growth and advance the “CCTA + Heartflow” pathway as the definitive standard for the non-invasive diagnosis and management of CAD.
Previous wording
We have experienced considerable revenue growth since we began commercializing the Heartflow Platform in 2015, driven primarily by growth in our account base and increasing test volumes at accounts in our installed base. For the three months ended March 31, 2026 and 2025, we recognized revenue of $52.6 million and $37.2 million, respectively. Substantially all of our revenue is generated on a “pay-per-click” basis each time a physician chooses to review either our Heartflow FFRCT Analysis, Heartflow Plaque Analysis, or both, and we recognize usage-driven fee revenue upon delivery of the requested analysis to the physician. Heartflow FFRCT Analysis has served as our commercial foundation, representing 98% of our total cumulative revenue as of March 31, 2026. In the second half of 2023, we initiated limited market education efforts for Heartflow Plaque Analysis, our second commercial product, and we expect to broaden our market education efforts as payor coverage for Heartflow Plaque Analysis increases. Heartflow Plaque Analysis is currently covered byfive of the seven MACs with the remaining MACs providing coverage on a case-by-case basis and by a majority of commercial payors. Our Heartflow RoadMap Analysis is generally provided as a workflow efficiency tool to drive customer retention and loyalty and is not a stand-alone product.
Current wording
We have experienced considerable revenue growth since we began commercializing the Heartflow Platform in 2015, driven primarily by growth in our account base and increasing test volumes at accounts in our installed base. For the three months ended June 30, 2026 and 2025, we recognized revenue of $64.1 million and $43.4 million, respectively, and for the six months ended June 30, 2026 and 2025, we recognized revenue of $116.7 million and $80.6 million, respectively. Substantially all of our revenue is generated on a “pay-per-click” basis each time a physician chooses to review either our Heartflow FFRCT Analysis, Heartflow Plaque Analysis, or both, and we recognize usage-driven fee revenue upon delivery of the requested analysis to the physician. Heartflow FFRCT Analysis has served as our commercial foundation, representing substantially all of our total cumulative revenue to-date. Beginning in the fourth quarter of 2025, we increased our commercialization efforts for Heartflow Plaque Analysis in anticipation of expanded reimbursement coverage under CPT code 75577, which became effective on January 1, 2026. Heartflow Plaque Analysis is currently covered byfive of the seven Medicare Administrative Contractors (“MACs”) with the remaining MACs providing coverage on a case-by-case basis and by a majority of commercial payors. Our Heartflow RoadMap Analysis is generally provided as a workflow efficiency tool to drive customer retention and loyalty and is not a stand-alone product.
Previous wording
Prior to our initial public offering (“IPO”), we primarily funded our operations with proceeds from sales of shares of our redeemable convertible preferred stock, common stock and convertible promissory notes, borrowings under our term loans and revenue received from our customers. As of March 31, 2026, we had $254.9 million in cash, cash equivalents and investments.
Current wording
Prior to our initial public offering (“IPO”), we primarily funded our operations with proceeds from sales of shares of our redeemable convertible preferred stock, common stock and convertible promissory notes, borrowings under our term loans and revenue received from our customers. As of June 30, 2026, we had $246.8 million in cash, cash equivalents and investments.
Previous wording
On August 11, 2025, we completed our IPO, in which we issued and sold 19,166,667 shares of our common stock, which includes an additional 2,500,000 shares of common stock purchased by the underwriters pursuant to their option to purchase additional shares, at a price to the public of $19.00 per share. The cash proceeds from our IPO were approximately $332.4 million, net of underwriting discounts and commissions and offering costs of $31.8 million.
Current wording
On August 11, 2025, we completed our IPO, in which we issued and sold 19,166,667 shares of our common stock, which included an additional 2,500,000 shares of common stock purchased by the underwriters pursuant to their option to purchase additional shares, at a price to the public of $19.00 per share. The cash proceeds from our IPO were approximately $332.4 million, net of underwriting discounts and commissions and offering costs of $31.8 million.
Previous wording
We have incurred significant operating losses and negative cash flows since our inception, and we expect to continue to incur losses as we grow and transition to now operating as a public company. Our net loss for the three months ended March 31, 2026 and 2025 was $27.4 million and $32.3 million, respectively.
Current wording
We have incurred significant operating losses and negative cash flows since our inception, and we expect to continue to incur losses as we grow and continue transitioning to now operating as a public company. Our net loss for the three months ended June 30, 2026 and 2025 was $15.7 million and $9.2 million, respectively, and $43.1 million and $41.5 million for the six months ended June 30, 2026 and 2025, respectively.
Previous wording
•Seasonality we experience throughout the year, including due to staff availability, vacations, weather and other macro economic events.
Current wording
•Seasonality we experience throughout the year, in particular during the second half of the year, including due to staff availability, vacations, weather and other macroeconomic events.
Previous wording
Substantially all of our revenue comprises usage-driven fees from accounts who order either our Heartflow FFRCT Analysis or our Heartflow Plaque Analysis, or both. We recognize usage-driven fee revenue upon delivery of the requested analysis to the physician. Key factors that drive our revenue include revenue case growth from our installed base and the success of our sales force in expanding adoption of the Heartflow Platform to new accounts and expanding the utilization of our system by accounts in our installed base. We consider an account that has our Heartflow solution deployed with the ability to send us CCTA images for processing as being part of our installed base. New accounts generally take 12 months to reach steady state revenue case volumes. New accounts typically ramp to FFRCT utilization close to full patient applicability in the first year and remain at this level consistently. Our Heartflow FFRCT Analysis is indicated for patients with stenosis levels between 40% and 90%, and we believe approximately 33% of patients have this level of stenosis. Revenue cases generated from clinic or office-based accounts typically carry a lower pricing than hospital-based accounts. We expect the percentage of our revenue cases generated from clinic or office-based accounts to continue to increase over time. The percentage of our U.S. revenue cases attributable to office and clinic-based accounts was 36% and 30% for the three months ended March 31, 2026 and 2025, respectively.
Current wording
Substantially all of our revenue comprises usage-driven fees from accounts who order either our Heartflow FFRCT Analysis or our Heartflow Plaque Analysis, or both. We recognize usage-driven fee revenue upon delivery of the requested analysis to the physician. Key factors that drive our revenue include revenue case growth from our installed base, the success of our sales force in expanding adoption of the Heartflow Platform to new accounts and expanding the utilization of our system by accounts in our installed base. We consider an account that has our Heartflow solution deployed with the ability to send us CCTA images for processing as being part of our installed base. New accounts generally take 12 months to reach steady state FFRCT revenue case volumes. New accounts typically ramp to FFRCT utilization close to full patient applicability in the first year and remain at this level consistently. Our Heartflow FFRCT Analysis is indicated for patients with stenosis levels between 40% and 90%, and we believe approximately 33% of patients have this level of stenosis. We have also recently increased the number of accounts activated for Heartflow Plaque Analysis. Our Heartflow Plaque Analysis is applicable to approximately 60% of CCTAs, providing a substantially broader eligible utilization opportunity at each account. Plaque utilization is in the early stages of ramping, driven by both new account activations and expanding use within accounts already activated. We believe that Plaque Analysis utilization of eligible CCTAs will grow over time as physicians adopt it for a broader range of patients. Our Heartflow Plaque Analysis is indicated for patients with stenosis levels between 1% and 69%, and we believe approximately 60% of patients have this level of stenosis. Revenue cases generated from clinic or office-based accounts typically carry a lower pricing than hospital-based accounts. We expect the percentage of our revenue cases generated from clinic or office-based accounts to continue to increase over time.
Previous wording
While a single customer may include multiple accounts, no single customer accounted for 10% or more of our revenue during the three months ended March 31, 2026 and 2025. However, the decision-making function for some of these accounts is concentrated in a relatively small number of customers, such that the loss of one customer could result in a disproportionate loss across our accounts. As we expand the adoption of the Heartflow Platform, we expect a majority of new accounts to come from new customers, decreasing our customer concentration risk.
Current wording
While a single customer may include multiple accounts, no single customer accounted for 10% or more of our revenue during the three and six months ended June 30, 2026 and 2025. However, the decision-making function for some of these accounts is concentrated in a relatively small number of customers, such that the loss of one customer could result in a disproportionate loss across our accounts. As we expand the adoption of the Heartflow Platform, we expect a majority of new accounts to come from new customers, decreasing our customer concentration risk.
Previous wording
Research and development expenses are incurred in connection with the advancement of the Heartflow Platform with the goal to introduce products, features and improvements aimed at increasing the value proposition for our customers by expanding its applicability to additional disease states and patient populations. Research and development expenses consist primarily of engineering, product development, consulting services, clinical studies to develop and support our products, regulatory activities, medical affairs, and other costs associated with products and technologies that are in development. Research and development expenses consist of personnel and related expenses, including stock-based compensation costs, clinical trials, third-party consulting costs, the portion of the costs incurred by our production team to support clinical trials and research and development efforts, and allocated overhead, including facilities expenses, equipment and depreciation. Our research and development team is comprised of PhD research scientists with expertise in AI-based algorithms and medical imaging, alongside software engineers skilled in cloud architecture, AI algorithms, machine and deep learning and 3D visualization, as well as product managers and designers who ensure optimal customer experience and design. We record research and development expenses in the periods in which they are incurred. We expect our research and development expenses to increase as we conduct clinical studies for expanded indications for useor to expand the addressable market populations for our productsand to hire additional personnel to develop new product offerings and product enhancements. For example, in the second half of 2026, we expect to begin enrollment in three randomized clinical trials focused on high-risk asymptomatic sub populations to expand the addressable market for our products.
Current wording
Research and development expenses are incurred in connection with the advancement of the Heartflow Platform with the goal to introduce products, features and improvements aimed at increasing the value proposition for our customers by expanding its applicability to additional disease states and patient populations. Research and development expenses consist primarily of engineering, product development, consulting services, clinical studies to develop and support our products, regulatory activities, medical affairs, and other costs associated with products and technologies that are in development. Research and development expenses consist of personnel and related expenses, including stock-based compensation costs, clinical trials, third-party consulting costs, the portion of the costs incurred by our production team to support clinical trials and research and development efforts, and allocated overhead, including facilities expenses, equipment and depreciation. Our research and development team is comprised of PhD research scientists with expertise in AI-based algorithms and medical imaging, alongside software engineers skilled in cloud architecture, AI algorithms, machine and deep learning and 3D visualization, as well as product managers and designers who ensure optimal customer experience and design. We record research and development expenses in the periods in which they are incurred. We expect our research and development expenses to increase as we conduct clinical studies for expanded indications for useor to expand the addressable market populations for our productsand to hire additional personnel to develop new product offerings and product enhancements. For example, in the second half of 2026, we expect to begin enrollment in three randomized clinical trials focused on high-risk asymptomatic subpopulations to expand the addressable market for our products.
Previous wording
Revenue increased $15.4 million, or 41%, to $52.6 million during the three months ended March 31, 2026, compared to $37.2 million during the three months ended March 31, 2025. The increase in revenue was primarily attributable to a 67% increase in revenue case volume, partially offset by a reduction in average sales price due to a higher percentage of revenue cases generated from clinic and office-based accounts and an increase in volume rebates.
Current wording
Revenue increased $20.7 million, or 48%, to $64.1 million during the three months ended June 30, 2026, compared to $43.4 million during the three months ended June 30, 2025. The increase in revenue was primarily attributable to a 74% increase in revenue case volume, partially offset by a reduction in average sales price due to a higher percentage of revenue cases generated from clinic and office-based accounts and an increase in volume rebates. Revenue case volume for the three months ended June 30, 2026, benefited from the continued commercialization and account adoption of Heartflow Plaque Analysis. This growth was driven in part by expanded reimbursement coverage under CPT code 75577, which became effective on January 1, 2026.
Previous wording
Cost of revenue increased $1.1 million, or 13%, to $10.4 million during the three months ended March 31, 2026, compared to $9.3 million during the three months ended March 31, 2025. This increase was attributable to an increase of $2.0 million in personnel and related expenses, $0.3 million in third-party hosting fees, $0.2 million in royalties, and $0.1 million in computer hardware expenses, partially offset by a net increase of $1.5 million in capitalized and amortized contract fulfillment costs. Personnel and related expenses included $0.1 million of stock-based compensation costs during each of the three months ended March 31, 2026 and 2025. Gross margin for the three months ended March 31, 2026 increased to 80% as compared to 75% for the three months ended March 31, 2025. The gross margin increase during the three months ended March 31, 2026 was primarily attributable to our increase in revenue case volume and improved production team productivity driven by AI efficiency initiatives, partially offset by our continued investment in the hiring and training of additional personnel in our production team to support our increasing revenue case volume. Although we expect to continue to invest in the hiring and training of additional personnel in our production team, we expect our gross margin will continue to increase over the long term.
Current wording
Cost of revenue increased $0.3 million, or 2%, to $10.9 million during the three months ended June 30, 2026, compared to $10.6 million during the three months ended June 30, 2025. This increase was primarily attributable to an increase of $0.1 million in personnel and related expenses, $0.4 million in third-party hosting fees, and $0.3 million in royalties, partially offset by a decrease of $0.2 million in computer hardware expenses and a net increase of $0.2 million in capitalized and amortized contract fulfillment costs. Personnel and related expenses included $0.2 million and $45,000 of stock-based compensation costs during the three months ended June 30, 2026 and 2025, respectively. Gross margin for the three months ended June 30, 2026 increased to 83% as compared to 75% for the three months ended June 30, 2025. The gross margin increase during the three months ended June 30, 2026 was primarily attributable to our increase in revenue case volume. We also benefited from the continued commercialization of Heartflow Plaque Analysis cases and from ongoing improvements in production team productivity driven by AI efficiency initiatives, partially offset by our continued investment in the hiring and training of additional personnel in our production team to support our increasing revenue case volume. Although we expect to continue to invest in the hiring and training of additional personnel in our production team, we expect our gross margin will continue to increase over the long term.
Previous wording
Selling, general and administrative expenses increased $11.1 million, or 35%, to $42.6 million during the three months ended March 31, 2026, compared to $31.5 million during the three months ended March 31, 2025. The increase in selling, general and administrative expenses was primarily attributable to an increase of $8.4 million in personnel and related expenses directly associated with an increase in headcount, $0.7 million in professional fees, including legal, audit and consulting fees, $0.7 million in computer hardware and software-related costs, $0.7 million in travel expenses and $0.4 million in advertising and other promotional expenses, partially offset by a decrease of $0.4 million in allocated overhead. Personnel and related expenses included $4.3 million and $1.9 million of stock-based compensation costs for the three months ended March 31, 2026 and 2025, respectively.
Current wording
Selling, general and administrative expenses increased $13.3 million, or 42%, to $44.8 million during the three months ended June 30, 2026, compared to $31.5 million during the three months ended June 30, 2025. The increase in selling, general and administrative expenses was primarily attributable to an increase of $8.8 million in personnel and related expenses directly associated with an increase in headcount, $3.1 million in professional fees, including legal, audit and consulting fees, $0.9 million in computer hardware and software-related costs, $0.5 million in advertising and other promotional expenses, $0.5 million in net amortization of capitalized acquisition and commissions costs, and $0.2 million in travel expenses, partially offset by a decrease of $0.8 million in direct and allocated facility and IT overhead costs. Personnel and related expenses included $5.0 million and $1.8 million of stock-based compensation costs for the three months ended June 30, 2026 and 2025, respectively.
Previous wording
Interest income (expense), net increased to income of $2.5 million during the three months ended March 31, 2026, compared to an expense of $4.6 million during the three months ended March 31, 2025. This change was mainly attributable to the repayment in full of our 2024 Term Loan in August 2025 and the conversion of our 2025 Convertible Notes to common stock upon our IPO in August 2025.
Current wording
Interest income (expense), net increased to income of $2.3 million during the three months ended June 30, 2026, compared to an expense of $6.0 million during the three months ended June 30, 2025. This change was mainly attributable to the repayment in full of our 2024 Term Loan in August 2025 and the conversion of our 2025 Convertible Notes to common stock upon our IPO in August 2025.
Previous wording
Other expense, net decreased to an expense of $0.3 million during the three months ended March 31, 2026, compared to an expense of $10.3 million during the three months ended March 31, 2025. The three months ended March 31, 2025 included a $1.6 million charge from the remeasurement and recognition of the change in fair value related to our common stock warrant liability and a $9.0 million charge from the remeasurement and recognition of the change in fair value related to our derivative liability.
Current wording
Other expense, net increased to an expense of $0.1 million during the three months ended June 30, 2026, compared to income of $10.6 million during the three months ended June 30, 2025. The three months ended June 30, 2025 included a $0.9 million charge from the remeasurement and recognition of the change in fair value related to our common stock warrant liability offset by an $11.5 million benefit from the remeasurement and recognition of the change in fair value related to our derivative liability.
Previous wording
Provision for income taxes was $23,000 for the three months ended March 31, 2026, compared to $0 for the three months ended March 31, 2025, which was related to our foreign taxes.
Current wording
Provision for income taxes was $22,000 for the three months ended June 30, 2026, compared to $59,000 for the three months ended June 30, 2025, which was related to our foreign taxes.
Previous wording
Research and development expenses increased $7.7 million, or 55%, to $21.6 million during the three months ended March 31, 2026, compared to $13.9 million during the three months ended March 31, 2025. The increase in research and development expenses was primarily attributable to an increase of $6.1 million in personnel and related expenses directly associated with an increase in headcount, $0.8 million in consulting and professional fees, $0.3 million in allocated overhead, $0.2 million in allocated production team costs to support clinical trials and research and development efforts, $0.2 million in software-related costs and $0.2 million in third-party hosting fees, partially offset by a decrease of $0.2 million in clinical trial expenses and a net increase of$0.2 million of capitalized internal-use software costs. Personnel and related expenses included $2.1 million and $0.5 million of stock-based compensation costs during the three months ended March 31, 2026 and 2025, respectively.
Current wording
Research and development expenses increased $18.9 million, or 65%, to $47.9 million during the six months ended June 30, 2026, compared to $29.0 million during the six months ended June 30, 2025. The increase in research and development expenses was primarily attributable to an increase of $14.7 million in personnel and related expenses directly associated with an increase in headcount, $1.5 million in consulting and professional fees, $1.1 million in allocated overhead, $0.6 million in third-party hosting fees, $0.4 million in software-related costs, $0.2 million in allocated production team costs to support clinical trials and research and development efforts, and $0.1 million in clinical trial expenses. Personnel and related expenses included $4.9 million and $0.9 million of stock-based compensation costs during the six months ended June 30, 2026 and 2025, respectively.
Previous wording
Asset impairment charge consists of a non-cash impairment charge related to the right-of-use asset and leasehold improvements for our Mountain View, California facility. In March 2026, we entered into a sublease agreement with a third-party subtenant to sublease this facility. We evaluated the associated right-of-use asset and leasehold improvements for impairment as the substantially lower sublease income indicated that the carrying amount of such assets may not be recoverable. We compared the carrying value of the impacted assets to the fair value to determine the impairment amount and recognized an asset impairment charge of $7.5 million during the three months ended March 31, 2026.
Current wording
Asset impairment charge consists of a non-cash impairment charge related to the right-of-use asset and leasehold improvements for our Mountain View, California facility. In March 2026, we entered into a sublease agreement with a third-party subtenant to sublease this facility. We evaluated the associated right-of-use asset and leasehold improvements for impairment as the substantially lower sublease income indicated that the carrying amount of such assets may not be recoverable. We compared the carrying value of the impacted assets to the fair value to determine the impairment amount and recognized an asset impairment charge of $7.5 million in March 2026.
Previous wording
As of March 31, 2026, we had $254.9 million in cash, cash equivalents and investments and an accumulated deficit of $1.1 billion. Prior to our IPO, we primarily funded our operations with proceeds from sales of shares of our redeemable convertible preferred stock, common stock and convertible promissory notes, borrowings under our term loans and revenue received from our customers, which we expect to continue to be our primary source of future liquidity.
Current wording
As of June 30, 2026, we had $246.8 million in cash, cash equivalents and investments and an accumulated deficit of $1.1 billion. Prior to our IPO, we primarily funded our operations with proceeds from sales of shares of our redeemable convertible preferred stock, common stock and convertible promissory notes, borrowings under our term loans and revenue received from our customers, which we expect to continue to be our primary source of future liquidity.
Previous wording
Net cash used in operating activities during the three months ended March 31, 2026 was $30.1 million, attributable to a net loss of $27.4 million and a net change in operating assets and liabilities of $18.3 million, partially offset by non-cash charges of $15.6 million. The non-cash charges primarily consisted of an asset impairment charge of $7.5 million, $6.6 million in stock-based compensation expense, $1.4 million of depreciation and amortization, $1.0 million of amortization of right-of-use asset and $0.8 million amortization of discounts on investments. The increase in net operating assets was primarily due to an increase of $6.2 million in accounts receivable, a $3.9 million increase in prepaid expenses and other current assets, a $1.6 million increase in other non-current assets, and an increase of $1.7 million in accounts payable, partially offset by a $7.4 million decrease in accrued expenses and other current liabilities and a $1.0 million decrease in operating lease liabilities.
Current wording
Net cash used in operating activities during the six months ended June 30, 2026 was $38.7 million, attributable to a net loss of $43.1 million and a net change in operating assets and liabilities of $20.8 million, partially offset by non-cash charges of $25.2 million. The non-cash charges primarily consisted of an asset impairment charge of $7.5 million, $14.5 million in stock-based compensation expense, $2.6 million of depreciation and amortization, $2.1 million of amortization of right-of-use asset and $1.4 million accretion of discounts on investments. The increase in net operating assets was primarily due to an increase of $13.4 million in accounts receivable, a $4.6 million increase in prepaid expenses and other current assets, a $1.5 million increase in other non-current assets, an increase of $1.7 million in accounts payable, a $0.9 million decrease in accrued expenses and other current liabilities, and a $2.1 million decrease in operating lease liabilities.
Previous wording
Net cash used in operating activities during the three months ended March 31, 2025 was $13.2 million, attributable to a net loss of $32.3 million and a net change in operating assets and liabilities of $2.5 million, partially offset by non-cash charges of $16.7 million. The non-cash charges primarily consisted of $2.5 million in stock-based compensation expense, $9.0 million of change in fair value of derivative liability, $1.6 million of change in fair value of common stock warrant, $1.4 million of depreciation and amortization, $0.7 million of amortization of right-of-use asset, $0.5 million of non-cash interest charges and $1.0 million of amortization of debt discount and debt issuance costs. The increase in net operating assets was primarily due to an increase of $3.6 million in accounts receivable, a $0.4 million increase in prepaid expenses and other current assets, a $0.3 million increase in other non-current assets, a $9.3 million increase in accrued expenses and other current liabilities, a $1.6 million decrease in accounts payable and a $0.9 million decrease in operating lease liabilities.
Current wording
Net cash used in operating activities during the six months ended June 30, 2025 was $40.5 million, attributable to a net loss of $41.5 million and a net change in operating assets and liabilities of $12.6 million, partially offset by non-cash charges of $13.7 million. The non-cash charges primarily consisted of $4.7 million in stock-based compensation expense, $2.5 million of change in fair value of derivative liability, $2.5 million of change in fair value of common stock warrant liability, $2.8 million of depreciation and amortization, $1.5 million of amortization of right-of-use asset, $1.1 million of non-cash interest charges, $3.8 million of amortization of debt discount and debt issuance costs and $0.2 million change in allowance for credit losses. The increase in net operating assets was primarily due to an increase of $4.9 million in accounts receivable, a $2.4 million increase in prepaid expenses and other current assets, a $1.9 million increase in other non-current assets, a $1.4 million decrease in accounts payable, a $0.3 million decrease in accrued expenses and other current liabilities, and a $1.8 million decrease in operating lease liabilities.
Previous wording
Net cash used in investing activities for the three months ended March 31, 2026 was $1.4 million, which consisted of $29.5 million in purchases of investments and $1.9 million in purchases of property and equipment, offset by $30.0 million in maturities of investments.
Current wording
Net cash provided by investing activities for the six months ended June 30, 2026 was $19.8 million, which consisted of $45.3 million in purchases of investments and $3.8 million in purchases of property and equipment, offset by $68.9 million in maturities of investments.
Previous wording
Net cash used in investing activities for the three months ended March 31, 2025 was $1.1 million consisting of purchases of property and equipment.
Current wording
Net cash used in investing activities for the six months ended June 30, 2025 was $1.9 million consisting of purchases of property and equipment.
Previous wording
Net cash provided by financing activities during the three months ended March 31, 2026 was $6.2 million, which consisted primarily of proceeds from the exercise of stock options and purchases under our employee stock purchase plan.
Current wording
Net cash provided by financing activities during the six months ended June 30, 2026 was $8.2 million, which consisted primarily of proceeds from the exercise of stock options and purchases under our employee stock purchase plan.
Previous wording
Net cash provided by financing activities during the three months ended March 31, 2025 consisted primarily of $73.9 million in net proceeds from the issuance of our 2025 Convertible Notes, $0.6 million in proceeds from the exercise of stock options, offset by $0.5 million in exit and prepayment penalty fees related to our 2024 Term Loan and $1.0 million in payments of deferred IPO offering costs.
Current wording
Net cash provided by financing activities during the six months ended June 30, 2025 was $71.1 million, consisting primarily of $72.8 million in net proceeds from the issuance of our 2025 Convertible Notes and $1.4 million in proceeds from the exercise of stock options, offset by $1.1 million in exit and prepayment penalty fees related to our 2024 Term Loan and $2.0 million in payments of deferred IPO offering costs.
Previous wording
Our contractual commitments will have an impact on our future liquidity. Our material commitments include future payments on non-cancellable facility leases and the sublease of our Mountain View, California facility lease as disclosed in Note 2 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q, and our royalty obligations for exclusive technology licensing agreements. There have been no other material changes to our contractual obligations from those described in our Annual Report on Form 10-K filed with the SEC on March 18, 2026.
Current wording
Our contractual commitments will have an impact on our future liquidity. Our material commitments include future payments on non-cancellable facility leases and the sublease of our Mountain View, California facility lease and our royalty obligations for exclusive technology licensing agreements as disclosed in Notes 6 and 7 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q. There have been no other material changes to our contractual obligations from those described in our Annual Report on Form 10-K filed with the SEC on March 18, 2026.
Previous wording
See Note 2 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for information about our significant accounting policies and estimates used in the preparation of our condensed consolidated financial statements. There have been no significant and material changes in our critical accounting policies during the three months ended March 31, 2026, as compared to those disclosed in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” for the year ended December 31, 2025 included in our Annual Report on Form 10-K filed with the SEC on March 18, 2026.
Current wording
See Note 2 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for information about our significant accounting policies and estimates used in the preparation of our condensed consolidated financial statements. There have been no significant and material changes in our critical accounting policies during the three and six months ended June 30, 2026, as compared to those disclosed in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” for the year ended December 31, 2025 included in our Annual Report on Form 10-K filed with the SEC on March 18, 2026.
Previous wording
We will remain an emerging growth company until the earliest of: (i) December 31, 2030; (ii) the last day of the fiscal year in which we have total annual gross revenue of at least $1.235 billion; (iii) the last day of the fiscal year in which we are deemed to be a “large accelerated filer” as defined in Rule 12b-2 under the Exchange Act, which would occur if the market value of our common stock held by non-affiliates exceeded $700.0 million as of the last business day of the second fiscal quarter of such year; or (iv) the date on which we have issued more than $1.0 billion in non-convertible debt securities during the prior three-year period.
Current wording
Emerging growth company status continues until the earliest of: (i) December 31, 2030; (ii) the last day of the fiscal year in which the company has total annual gross revenue of at least $1.235 billion; (iii) the last day of the fiscal year in which the company is deemed to be a “large accelerated filer” as defined in Rule 12b-2 under the Exchange Act, which would occur if the market value of its common stock held by non-affiliates exceeded $700.0 million as of the last business day of the second fiscal quarter of such year; or (iv) the date on which the company issued more than $1.0 billion in non-convertible debt securities during the prior three-year period. As of June 30, 2026, the end of our second fiscal quarter, the market value of our common stock held by non-affiliates exceeded $700.0 million and, as a result, we expect to qualify as a “large accelerated filer” as of the end of our fiscal year ended December 31, 2026 and will no longer be an “emerging growth company” at such time.
Rearranged current paragraphs (6)
Current report — wording carried from elsewhere
The percentage of our U.S. revenue cases attributable to office and clinic-based accounts was 36% and 31% for the three months ended June 30, 2026 and 2025, respectively, and 36% and 31% for the six months ended June 30, 2026 and 2025, respectively.
Current report — wording carried from elsewhere
Research and development expenses increased $11.3 million, or 75%, to $26.3 million during the three months ended June 30, 2026, compared to $15.0 million during the three months ended June 30, 2025. The increase in research and development expenses was primarily attributable to an increase of $8.6 million in personnel and related expenses directly associated with an increase in headcount, $0.8 million in allocated overhead, $0.7 million in consulting and professional fees, $0.4 million in third-party hosting fees, $0.4 million in clinical trial expenses, and
Current report — wording carried from elsewhere
Cost of revenue and gross margin
Current report — wording carried from elsewhere
Cost of revenue increased $1.4 million, or 7%, to $21.3 million during the six months ended June 30, 2026, compared to $19.9 million during the six months ended June 30, 2025. This increase was primarily attributable to an increase of $2.1 million in personnel and related expenses, $0.7 million in third-party hosting fees, and $0.4 million in royalties, partially offset by a decrease of$0.1 million in computer hardware expenses and a net increase of $1.7 million in capitalized and amortized contract fulfillment costs. Personnel and related expenses included $0.3 million and $0.1 million of stock-based compensation costs during the six months ended June 30, 2026 and 2025, respectively. Gross margin for the six months ended June 30, 2026 increased to 82% as compared to 75% for the six months ended June 30, 2025. The gross margin increase during the six months ended June 30, 2026 was primarily attributable to our increase in revenue case volume. We also benefited from the continued commercialization of Heartflow Plaque Analysis and from ongoing improvements in production team productivity driven by AI efficiency initiatives, partially offset by our continued investment in the hiring and training of additional personnel in our production team to support our increasing revenue case volume. Although we expect to continue to invest in the hiring and training of additional personnel in our production team, we expect our gross margin will continue to increase over the long term.
Current report — wording carried from elsewhere
Interest income (expense), net increased to income of $4.8 million during the six months ended June 30, 2026, compared to an expense of $10.5 million during the six months ended June 30, 2025. This change was mainly attributable to the repayment in full of our 2024 Term Loan in August 2025 and the conversion of our 2025 Convertible Notes to common stock upon our IPO in August 2025.
Current report — wording carried from elsewhere
Other expense, net increased to an expense of $0.4 million during the six months ended June 30, 2026, compared to income of $0.3 million during the six months ended June 30, 2025. The six months ended June 30, 2025 included a $2.5 million charge from the remeasurement and recognition of the change in fair value related to our common stock warrant liability offset by a $2.5 million benefit from the remeasurement and recognition of the change in fair value related to our derivative liability.
Rearranged previous paragraphs (1)
Previous report — wording carried elsewhere
Net cash used in investing activities