EXACT SCIENCES CORP, 10-K filed on 2/13/2026
Annual Report
v3.25.4
Cover Page - USD ($)
 12 Months Ended
Dec. 31, 2025
Feb. 12, 2026
Jun. 30, 2025
Cover [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2025    
Current Fiscal Year End Date --12-31    
Document Transition Report false    
Entity File Number 001-35092    
Entity Registrant Name EXACT SCIENCES CORPORATION    
Entity Incorporation, State or Country Code DE    
Entity Address, Address Line One 5505 Endeavor Lane    
Entity Address, City or Town Madison    
Entity Address, State or Province WI    
Entity Tax Identification Number 02-0478229    
Entity Address, Postal Zip Code 53719    
City Area Code 608    
Local Phone Number 284‑5700    
Title of 12(b) Security Common Stock, $0.01 Par Value    
Trading Symbol EXAS    
Security Exchange Name NASDAQ    
Entity Well-known Seasoned Issuer Yes    
Entity Voluntary Filers No    
Entity Current Reporting Status Yes    
Entity Interactive Data Current Yes    
Entity Filer Category Large Accelerated Filer    
Entity Small Business false    
Entity Emerging Growth Company false    
ICFR Auditor Attestation Flag true    
Entity Shell Company false    
Entity Public Float     $ 9,970,230,370
Entity Common Stock, Shares Outstanding   190,888,211  
Documents Incorporated by Reference None.    
Entity Central Index Key 0001124140    
Amendment Flag false    
Document Fiscal Year Focus 2025    
Document Fiscal Period Focus FY    
Document Financial Statement Error Correction [Flag] false    
v3.25.4
Audit Information
 12 Months Ended
Dec. 31, 2025
Audit Information [Abstract]  
Auditor Firm ID 238
Auditor Name PricewaterhouseCoopers LLP
Auditor Location Chicago, Illinois
v3.25.4
Consolidated Balance Sheets - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Current assets:    
Cash and cash equivalents $ 955,996 $ 600,889
Marketable securities 8,715 437,137
Accounts receivable, net 298,653 248,968
Inventory 166,201 162,383
Prepaid expenses and other current assets 126,284 122,046
Total current assets 1,555,849 1,571,423
Long-term assets:    
Property, plant and equipment, net 708,664 693,673
Operating lease right-of-use assets 122,332 116,952
Goodwill 2,368,048 2,366,676
Intangible assets, net 919,925 1,009,693
Other long-term assets, net 185,811 169,722
Total assets 5,860,629 5,928,139
Current liabilities:    
Accounts payable 175,868 89,572
Accrued liabilities 416,473 328,292
Operating lease liabilities, current portion 33,591 27,405
Other current liabilities 15,220 37,765
Convertible Notes Payable, Current 0 249,153
Total current liabilities 641,152 732,187
Convertible notes, net, less current portion 2,327,177 2,321,067
Other long-term liabilities 329,317 315,503
Operating lease liabilities, less current portion 161,931 157,133
Total liabilities 3,459,577 3,525,890
3459577000
Stockholders’ equity:    
Preferred stock, $0.01 par value Authorized—5,000,000 shares issued and outstanding—no shares at December 31, 2025 and December 31, 2024 0 0
Common stock, $0.01 par value Authorized—400,000,000 shares issued and outstanding—190,802,322 and 185,616,438 shares at December 31, 2025 and December 31, 2024 1,909 1,857
Additional paid-in capital 7,102,766 6,899,368
Accumulated other comprehensive income (loss) 2,358 (944)
Accumulated deficit (4,705,981) (4,498,032)
Total stockholders’ equity 2,401,052 2,402,249
Total liabilities and stockholders’ equity $ 5,860,629 $ 5,928,139
v3.25.4
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2025
Dec. 31, 2024
Statement of Financial Position [Abstract]    
Preferred stock, par value (in dollars per share) $ 0.01 $ 0.01
Preferred stock, authorized shares (in shares) 5,000,000 5,000,000
Preferred stock, issued shares (in shares) 0 0
Preferred stock, outstanding shares (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, authorized shares (in shares) 400,000,000 400,000,000
Common stock, issued shares (in shares) 190,802,322 185,616,438
Common stock, outstanding shares (in shares) 190,802,322 185,616,438
v3.25.4
Consolidated Statements of Operations - USD ($)
shares in Thousands, $ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Statement [Abstract]      
Net loss $ (207,949) $ (1,028,857) $ (204,149)
Net loss before tax (203,888) (1,036,161) (201,746)
Loss from operations (206,298) (1,048,703) (215,012)
Gross profit 2,262,755 1,918,717 1,762,202
Revenue 3,246,990 2,758,867 2,499,766
Cost of sales 984,235 840,150 737,564
Total operating expenses 2,469,053 2,976,620 2,055,641
Research and development 522,996 431,210 426,927
Sales and marketing 1,050,183 894,125 827,805
General and administrative 888,674 781,825 800,288
Impairment of long-lived and indefinite-lived assets 7,200 869,460 621
Other operating income 0 9,200 78,427
Total other income (expense) 2,410 12,542 13,266
Investment income, net 41,771 39,558 32,713
Interest Expense, Nonoperating (39,361) (27,016) (19,447)
Income Tax Expense (Benefit) $ (4,061) $ 7,304 $ (2,403)
Increase (decrease) in net loss per share (in usd per share) $ (1.10) $ (5.59) $ (1.13)
Increase (decrease) in net loss per share (in usd per share) $ (1.10) $ (5.59) $ (1.13)
Weighted average number of shares outstanding, basic (in shares) 188,688 184,197 180,144
Weighted average number of shares outstanding, diluted (in shares) 188,688 184,197 180,144
v3.25.4
Consolidated Statements of Comprehensive Loss - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Other comprehensive loss, before tax:      
Comprehensive Income (Loss), Net of Tax, Attributable to Parent, Total $ (204,647) $ (1,031,229) $ (197,485)
Net Income (Loss) (207,949) (1,028,857) (204,149)
Unrealized gain (loss) on available-for-sale investments (976) 922 5,343
Foreign currency adjustment $ 4,278 $ (3,294) $ 1,321
v3.25.4
Consolidated Statements of Stockholders’ Equity - USD ($)
$ in Thousands
Total
Common Stock
Additional Paid In Capital
AOCI
Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2022   177,925,631      
Beginning balance at Dec. 31, 2022 $ 3,043,162 $ 1,780 $ 6,311,644 $ (5,236) $ (3,265,026)
Increase (Decrease) in Stockholders' Equity          
Exercise of common stock options (in shares)   194,597      
Stock Issued During Period, Value, Stock Options Exercised 3,197 $ 2 3,195    
Issuance of common stock to fund the Company's 401(k) match (in shares)   517,550      
Stock Issued During Period, Value, Employee Benefit Plan 35,100 $ 5 35,095    
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures 0 $ 18 (18)    
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   1,801,954      
Employee Benefits and Share-Based Compensation     231,312    
Stock-based compensation expense 231,312        
Proceeds from stock issued under the Company's stock purchase plan 28,344 $ 10 28,334    
Stock issued under the Company's stock purchase plan (in shares)   924,448      
Issuance of common stock to fund business combinations (in shares)   0      
Stock Issued During Period, Value, Acquisitions 1,675 $ 0 1,675    
Net Income (Loss) (204,149)       (204,149)
Other Comprehensive Income (Loss), Net of Tax, Portion Attributable to Parent 6,664     6,664  
Ending balance (in shares) at Dec. 31, 2023   181,364,180      
Ending balance at Dec. 31, 2023 3,145,305 $ 1,815 6,611,237 1,428 (3,469,175)
Increase (Decrease) in Stockholders' Equity          
Exercise of common stock options (in shares)   204,034      
Stock Issued During Period, Value, Stock Options Exercised 1,651 $ 2 1,649    
Issuance of common stock to fund the Company's 401(k) match (in shares)   617,384      
Stock Issued During Period, Value, Employee Benefit Plan 40,550 $ 6 40,544    
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (140) $ 25 (165)    
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   2,475,448      
Employee Benefits and Share-Based Compensation     214,885    
Stock-based compensation expense 214,885        
Proceeds from stock issued under the Company's stock purchase plan 31,227 $ 9 31,218    
Stock issued under the Company's stock purchase plan (in shares)   955,392      
Net Income (Loss) (1,028,857)       (1,028,857)
Other Comprehensive Income (Loss), Net of Tax, Portion Attributable to Parent $ (2,372)     (2,372)  
Ending balance (in shares) at Dec. 31, 2024 185,616,438 185,616,438      
Ending balance at Dec. 31, 2024 $ 2,402,249 $ 1,857 6,899,368 (944) (4,498,032)
Increase (Decrease) in Stockholders' Equity          
Exercise of common stock options (in shares) 161,596 110,289      
Stock Issued During Period, Value, Stock Options Exercised $ 1,902 $ 1 1,901    
Issuance of common stock to fund the Company's 401(k) match (in shares)   793,057      
Stock Issued During Period, Value, Employee Benefit Plan 43,943 $ 8 43,935    
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (86,605) $ 36 (86,641)    
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   3,596,845      
Employee Benefits and Share-Based Compensation     217,666    
Stock-based compensation expense 217,666        
Proceeds from stock issued under the Company's stock purchase plan 26,544 $ 7 26,537    
Stock issued under the Company's stock purchase plan (in shares)   685,693      
Net Income (Loss) (207,949)       (207,949)
Other Comprehensive Income (Loss), Net of Tax, Portion Attributable to Parent $ 3,302     3,302  
Ending balance (in shares) at Dec. 31, 2025 190,802,322 190,802,322      
Ending balance at Dec. 31, 2025 $ 2,401,052 $ 1,909 $ 7,102,766 $ 2,358 $ (4,705,981)
v3.25.4
Consolidated Statements of Stockholders Equity (Parenthetical) - $ / shares
Dec. 31, 2025
Dec. 31, 2024
Statement of Financial Position [Abstract]    
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
v3.25.4
Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash flows from operating activities:      
Net loss $ (207,949) $ (1,028,857) $ (204,149)
Adjustments to reconcile net loss to net cash provided by operating activities:      
Depreciation 124,879 119,701 114,448
Equity Securities, FV-NI, Gain (Loss) 3,081 (2,713) 4,098
Deferred tax benefit (1,544) (10,119) (955)
Share-Based Payment Arrangement, Noncash Expense 217,666 214,885 231,312
Gain on settlements of convertible notes, net 0 (10,254) (10,324)
Amortization of Intangible Assets 96,700 95,158 92,160
Impairment of long-lived and indefinite-lived assets 7,200 869,460 621
Research and Development Asset Acquired in Transaction Other than Business Combination or Joint Venture Formation, Writeoff 75,000 0 500
Gain (Loss) On Contingent Consideration From Disposition Of Asset 0 (9,200) (73,300)
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability 26,806 (3,346) (18,044)
Non-cash lease expense 27,040 26,926 27,891
Other Noncash Income (Expense) 6,896 (519) 399
Changes in assets and liabilities, net of effects of acquisition:      
Accounts receivable, net (48,891) (46,259) (43,416)
Inventory, net (3,772) (34,911) (7,690)
Operating lease liabilities (28,541) (25,783) (26,701)
Accounts payable and accrued liabilities 214,042 43,538 82,750
Increase (Decrease) in Other Operating Assets (5,794) (2,323) (11,618)
Increase (Decrease) in Other Operating Liabilities (5,219) 9,726 6,333
Net cash provided by operating activities 491,438 210,536 156,119
Cash flows from investing activities:      
Purchases of marketable securities (140,269) (465,031) (139,854)
Maturities and sales of marketable securities 572,277 205,821 363,156
Purchases of property, plant and equipment (134,656) (135,989) (124,190)
Proceeds From Contingent Consideration Receivable 27,971 0 0
Proceeds From Sale Of Investments In Privately-Held Companies 0 0 19,794
Payments to Acquire Other Investments (55,499) (1,731) (16,564)
Business combination, net of cash acquired and issuance costs 0 0 (52,413)
Asset acquisitions, net of cash acquired (75,000) (45,000) (500)
Other investing activities 297 (225) 250
Net cash provided by (used in) investing activities 195,121 (442,155) 49,679
Cash flows from financing activities:      
Proceeds, Issuance of Shares, Share-Based Payment Arrangement, Including Option Exercised 1,902 1,651 3,197
Proceeds in connection with the Company's employee stock purchase plan 26,544 31,227 28,344
Proceeds from issuance of convertible notes 0 266,750 137,976
Repayments of Accounts Receivable Securitization 0 50,000 0
Repayments of convertible debt 249,172 0 0
Payment, Tax Withholding, Share-Based Payment Arrangement 86,477 0 0
Payment for Contingent Consideration Liability, Financing Activities 19,000 0 0
Other financing activities (11,887) (17,754) (9,751)
Net cash provided by (used in) financing activities (338,090) 231,874 159,766
Effects of exchange rate changes on cash and cash equivalents 891 (3,294) 1,321
Net increase (decrease) in cash, cash equivalents, and restricted cash 349,360 (3,039) 366,885
Cash, cash equivalents, and restricted cash, beginning of period 606,636 609,675 242,790
Cash, cash equivalents, and restricted cash, end of period 955,996 606,636 609,675
Non-cash investing and financing activities:      
Property, plant and equipment acquired but not paid 16,282 13,721 18,505
Stock Issued During Period, Value, Employee Benefit Plan 43,943 40,550 35,100
Supplemental disclosure of cash flow information:      
Interest paid 30,444 27,839 18,776
Reconciliation of cash, cash equivalents, and restricted cash:      
Cash and cash equivalents 955,996 600,889 605,378
Restricted cash — included in other long-term assets, net 0 5,747 4,297
Total cash, cash equivalents, and restricted cash $ 955,996 $ 606,636 $ 609,675
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Business
Exact Sciences Corporation (together with its subsidiaries, “Exact” or the “Company”) was incorporated in February 1995. A leading provider of cancer screening and diagnostic tests, Exact Sciences gives patients and health care professionals the clarity needed to take life-changing action earlier. Building on the success of Cologuard® and Oncotype DX® tests, Exact Sciences is investing in its pipeline to develop innovative solutions for use before, during, and after a cancer diagnosis.
Merger Agreement
On November 19, 2025, the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with Abbott Laboratories (“Abbott”) and Badger Merger Sub I, Inc., a direct, wholly owned subsidiary of Abbott (“Merger Sub”), providing for, among other things, the merger of Merger Sub with and into Exact (the “Merger”) on the terms and subject to the conditions set forth in the Merger Agreement. Upon the terms and subject to the conditions set forth in the Merger Agreement, at the effective time of the Merger (the “Effective Time”), the separate existence of Merger Sub will cease, and the Company will continue as the surviving corporation in the Merger and as a direct, wholly owned subsidiary of Abbott. At the Effective Time, on the terms and subject to the conditions set forth in the Merger Agreement, each share of Exact common stock (other than certain excluding shares) issued and outstanding immediately prior to the Effective Time will be converted into and will thereafter represent the right to receive $105.00 in cash, without interest, less any applicable withholding taxes. Following the Merger, Exact common stock will no longer be publicly traded or listed on The Nasdaq Stock Market LLC.
Under the terms of the Merger Agreement, the Company is subject to various customary covenants and obligations, including, among others, until the earlier of the Effective Time and the termination of the Merger Agreement, the obligation to use commercially reasonable efforts to conduct the Company's business in the ordinary course of business in all material respects and to refrain from taking certain actions without Abbott’s consent, subject to specified exceptions. The Company does not believe these restrictions will prevent the Company from meeting its debt service obligations, ongoing costs of operations, working capital needs or capital expenditure requirements.
Consummation of the Merger is subject to the satisfaction or waiver of certain conditions, including the adoption of the Merger Agreement by the affirmative vote of holders of a majority of the outstanding shares of Exact common stock entitled to vote thereon (the “Stockholder Approval”), receipt of specified regulatory approvals and the satisfaction of other customary closing conditions.
The Merger Agreement contains specified termination rights for Exact and Abbott, including, among others, the right of each party to terminate if (i) the Merger is not consummated by November 19, 2026, subject to extension in certain cases, (ii) any law or order restraining, enjoining, making illegal or otherwise prohibiting the consummation of the Merger is in effect and has become final and non-appealable, (iii) the Stockholder Approval is not obtained upon a vote taken on the adoption of the Merger Agreement at the meeting of the Company's stockholders held for the purpose of obtaining stockholder approval or any adjournment or postponement thereof, or (iv) the other party breaches or fails to perform its representations, warranties, agreements or covenants in the Merger Agreement in a manner that would cause the conditions to the consummation of the Merger to not be satisfied and does not cure such breach or failure within the applicable cure period, subject to certain exceptions. If the Merger Agreement is terminated under specified circumstances, the Company may be required to pay to Abbott a termination fee of approximately $628.7 million.
The foregoing description of the Merger Agreement and the transactions contemplated thereby does not purport to be complete and is qualified in its entirety by reference to the copy of the Merger Agreement that was attached as Exhibit 2.1 to the Company’s Current Report on Form 8-K filed on November 20, 2025 and that is incorporated by reference as an exhibit to this Annual Report on Form 10-K.
Basis of Presentation and Principles of Consolidation
The accompanying consolidated financial statements include the accounts of Exact Sciences Corporation and those of its wholly owned subsidiaries. All intercompany transactions and balances have been eliminated upon consolidation.
Use of Estimates
The preparation of the consolidated financial statements in conformity with accounting principles generally accepted in the United States (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Critical accounting policies are those that affect the Company's financial statements materially and involve difficult, subjective or complex judgments by management, and actual results could differ from those estimates. These estimates include revenue recognition, valuation of intangible assets and goodwill, contingent consideration, and accounting for income taxes.
Cash and Cash Equivalents
The Company considers cash on hand, demand deposits in a bank, money market funds, and all highly liquid investments with an original maturity of 90 days or less to be cash and cash equivalents.
Marketable Securities
Management determines the appropriate classification of debt securities at the time of purchase and re-evaluates such designation as of each balance sheet date. Debt securities carried at amortized cost are classified as held-to-maturity when the Company has the positive intent and ability to hold the securities to maturity. Debt securities not classified as held-to-maturity are classified as available-for-sale. Available-for-sale securities are carried at fair value. The unrealized gains and losses, net of tax, on the Company's debt securities are reported in other comprehensive income. Marketable equity securities are measured at fair value and the unrealized gains and losses, net of tax, are recognized in other income (expense) in the consolidated statements of operations. The amortized cost of debt securities in this category is adjusted for amortization of premiums and accretion of discounts to maturity computed under the effective interest rate method. Such amortization is included in investment income, net. Realized gains and losses and declines in value as a result of credit losses on available-for-sale securities are included in the consolidated statements of operations as investment income, net. The cost of securities sold is based on the specific identification method. Interest and dividends on securities classified as available-for-sale are included in the consolidated statements of operations as investment income, net.
The Company’s investment policy limits investments to certain types of instruments issued by institutions with investment grade credit ratings and places restrictions on maturities and concentration by type and issuer. Investments in which the Company has the ability and intent, if necessary, to liquidate in order to support its current operations (including those with a contractual term greater than one year from the date of purchase) are classified as current.
The Company periodically evaluates its available-for-sale debt securities in unrealized loss positions to determine whether any impairment is a result of a credit loss or other factors. This evaluation includes, but is not limited to, significant quantitative and qualitative assessments and estimates regarding credit ratings, significance of a security’s loss position, adverse conditions specifically related to the security, and the payment structure of the security.
Allowance for Doubtful Accounts
The Company estimates an allowance for doubtful accounts against accounts receivable using historical collection trends, aging of accounts, current and future implications surrounding the ability to collect such as economic conditions, and regulatory changes. The allowance for doubtful accounts is evaluated on a regular basis and adjusted when trends, significant events, or other substantive evidence such as an adverse change in a payer's ability to pay indicate that expected collections will be less than previously estimated. At December 31, 2025 and 2024, the allowance for doubtful accounts recorded was not significant to the Company’s consolidated balance sheets. For the years ended December 31, 2025, 2024 and 2023, there was an insignificant amount of bad debt expense written off against the allowance and charged to operating expense.
Inventory
Inventory is stated at the lower of cost or net realizable value. The Company determines the cost of inventory using the first-in, first out method (“FIFO”). The Company estimates the recoverability of inventory by reference to internal estimates of future demands and product life cycles, including expiration. The Company periodically analyzes its inventory levels to identify inventory that may expire prior to expected sale, no longer meets quality specifications, or has a cost basis in excess of its estimated realizable value and records a charge to cost of sales for such inventory as appropriate.
Direct and indirect manufacturing costs incurred during process validation with probable future economic benefit are capitalized. Validation costs incurred for other research and development activities, which are not permitted to be sold, are expensed to research and development in the Company’s consolidated statements of operations.
Materials that may be used for either research and development or commercial purposes are classified as inventory until the material is consumed or otherwise allocated for research and development. Materials that have alternative uses outside of commercial purposes are classified within prepaid expenses and other current assets on the consolidated balance sheet. If the material is used for research and development, it is expensed as research and development once that determination is made.
When future commercialization of new products is considered probable and the future economic benefit is expected to be realized, based on management’s judgment, pre-launch inventory costs are capitalized prior to regulatory approval. Prior to the capitalization of inventory costs, the Company records such material costs within either prepaid expenses and other current assets or research and development expenses on the Company’s consolidated balance sheets and consolidated statements of operations, respectively.
Property, Plant and Equipment
Property, plant and equipment are stated at cost and depreciated using the straight-line method over the assets’ estimated useful lives. Land is stated at cost and does not depreciate. Additions and improvements are capitalized, including direct and indirect costs incurred to validate equipment and bring to working conditions. Revalidation costs, including maintenance and repairs, are expensed when incurred.
Software Development Costs
Costs related to internal use software, including hosted arrangements, are incurred in three stages: the preliminary project stage, the application development stage, and the post-implementation stage. Costs incurred during the preliminary project and post-implementation stages are expensed as incurred. Costs incurred during the application development stage that meet the criteria for capitalization are capitalized and amortized, when the software is ready for its intended use, using the straight‑line method over the estimated useful life of the software, or the duration of the hosting agreement.
Investments in Non-Marketable Securities
The Company determines whether its investments in non-marketable securities are debt or equity based on their characteristics. The Company also evaluates the investee to determine if the entity is a variable interest entity (“VIE”) and, if so, whether the Company is the primary beneficiary of the VIE, in order to determine whether consolidation of the VIE is required. If consolidation is not required and the Company does not have voting control of the entity, the investment is evaluated to determine if the equity method of accounting should be applied. The equity method applies to investments in common stock or in substance common stock where the Company exercises significant influence over the investee.
Investments in non-marketable securities determined to be equity securities without readily determinable fair values are accounted for under the measurement alternative method as permitted in Accounting Standards Codification (“ASC”) 321, Investments - Equity Securities. The Company adjusts the carrying value of its non-marketable equity securities for changes from observable transactions for identical or similar investments of the same issuer, less impairment. All gains and losses on non-marketable equity securities, realized and unrealized, are recognized in investment income, net in the consolidated statements of operations.
Investments in non-marketable securities determined to be debt securities are accounted for as available-for-sale or held-to-maturity securities unless the fair value option is elected.
Derivative Financial Instruments
The Company hedges a portion of its foreign currency exposures related to outstanding monetary assets and liabilities using foreign currency forward contracts. The foreign currency forward contracts are included in prepaid expenses and other current assets or in accrued liabilities in the consolidated balance sheets, depending on the contracts’ net position. These contracts are not designated as hedges, and as a result, changes in their fair value are recorded in other income (expense) in the consolidated statements of operations.
Business Combinations and Asset Acquisitions
Business Combinations are accounted for under the acquisition method in accordance with Accounting Standards Codification (“ASC”) 805, Business Combinations. The acquisition method requires identifiable assets acquired and liabilities assumed and any non-controlling interest in the business acquired be recognized and measured at fair value on the acquisition date, which is the date that the acquirer obtains control of the acquired business. The amount by which the fair value of consideration transferred as the purchase price exceeds the net fair value of assets acquired and liabilities assumed is recorded as goodwill. Acquisitions that do not meet the definition of a business combination under ASC 805 are accounted for as asset acquisitions. Asset acquisitions are accounted for by allocating the cost of the acquisition to the individual assets acquired and liabilities assumed on a relative fair value basis. Goodwill is not recognized in an asset acquisition with any consideration in excess of net assets acquired allocated to acquired assets on a relative fair value basis. Transaction costs are expensed in a business combination and are considered a component of the cost of the acquisition in an asset acquisition.
Intangible Assets
Purchased intangible assets are recorded at fair value. The Company uses a discounted cash flow model to value intangible assets. The discounted cash flow model requires assumptions about the timing and amount of future net cash flows, risk, the cost of capital, terminal values and market participants. The Company’s finite-lived intangible assets are being amortized on a straight-line basis over their estimated useful lives.
Patent costs are capitalized as incurred, only if the Company determines that there is some probable future economic benefit derived from the transaction. A capitalized patent is amortized over its estimated useful life, beginning when such patent is approved. Capitalized patent costs are expensed upon disapproval, upon a decision by the Company to no longer pursue the patent or when the related intellectual property is either sold or deemed to be no longer of value to the Company. The Company determined that all patent costs incurred during the years ended December 31, 2025, 2024, and 2023 should be expensed and not capitalized as the future economic benefit derived from the patent costs incurred cannot be determined.
Acquired In-process Research and Development (“IPR&D”)
Acquired IPR&D represents the fair value assigned to research and development assets that have not reached technological feasibility. The primary basis for determining technological feasibility of these projects is obtaining regulatory approval to market the underlying product. The amounts capitalized are accounted for as indefinite-lived intangible assets and are subject to impairment testing until completion or abandonment of the research and development efforts associated with the projects. Upon successful completion of the project, the capitalized amount is amortized over its estimated useful life. If a project is abandoned, all remaining capitalized amounts are written off immediately. The value assigned to acquired IPR&D is determined using the multi-period excess earnings method approach, which utilizes significant unobservable inputs (Level 3 inputs) including projected revenues, projected gross margin, projected operating expenses, discount rate, tax rate, obsolescence factor, and probability of commercial success. There are often major risks and uncertainties associated with IPR&D projects as the Company is required to obtain regulatory approvals in order to market the resulting products. Such approvals require completing clinical trials that demonstrate the product's effectiveness. Consequently, the eventual realized value of the IPR&D project may vary from its fair value at the date of acquisition, and IPR&D impairment charges may occur in future periods.
Capitalized IPR&D projects are tested for impairment annually in the fourth quarter, whenever events or changes in circumstances indicate that the carrying amount may not be recoverable, and upon successful completion of the project. The Company considers various factors for potential impairment, including the current legal and regulatory environment, current and future strategic initiatives, and the competitive landscape. Adverse clinical trial results, significant delays in obtaining marketing approval, the inability to bring a product to market and the introduction or advancement of competitors' products could result in partial or full impairment of the related intangible assets.
Contingent Consideration Liabilities
Certain of the Company’s business combinations involve potential payment of future consideration that is contingent upon the achievement of certain regulatory and product development milestones being achieved. The Company records contingent consideration at fair value at the date of acquisition based on the consideration expected to be transferred, estimated as the probability-weighted future cash flows, discounted back to present value. The fair value of contingent consideration is measured using projected probabilities of success, projected payment dates, present value-factors, and projected revenues (for revenue-based considerations). Changes in probabilities of success, present-value factors, and projected payment dates may result in adjustments to the fair value measurements. Contingent consideration is remeasured each reporting period using Level 3 inputs, and the change in fair value, including accretion for the passage of time, is recognized as income or expense within general and administrative expenses on the Company’s consolidated statements of operations. Cash contingent consideration payments up to the acquisition date fair value of the contingent consideration liability are classified as financing activities in the consolidated statements of cash flows, and amounts paid in excess of the original acquisition date fair value are classified as operating activities in the consolidated statements of cash flows.
Contingent Consideration Asset
The sale of the Company’s intellectual property and know-how related to the Company’s Oncotype DX Genomic Prostate Score test (“GPS test”) resulted in the recognition of variable consideration in accordance with ASC 606. The Company estimates the amount of variable consideration that it is entitled to each quarter using the most likely amount method and considers whether there are any constraints on the consideration. If it is probable that a significant reversal of a gain would not occur, the Company will record a gain. To determine the classification of the consideration, the Company determines if the consideration is conditional on something other than the passage of time. Revenue-based contingent consideration that is conditional on something other than the passage of time, including future revenues from sales related to the GPS test, result in the variable consideration being classified as a contract asset. At the time the amount earned is determined, and passage of time is the only condition remaining, the contract asset is reclassified to a receivable.
Collateralized Debt Instruments
Debt instruments that are collateralized by security interests in financial assets held by the Company are accounted for as a secured borrowing and therefore: (i) the asset balances pledged as collateral are included within the applicable balance sheet line item and the borrowings are included within long-term debt in the consolidated balance sheet; (ii) interest expense is included within the consolidated statements of operations; and (iii) in the case of collateralized accounts receivable, receipts from customers related to the underlying accounts receivable are reflected as operating cash flows, and (iv) borrowings and repayments under the collateralized loans are reflected as financing cash flows within the consolidated statements of cash flows.
Goodwill
The Company evaluates goodwill for possible impairment at the reporting unit level on an annual basis during the fourth quarter, or more frequently if events or changes in circumstances indicate that the carrying amount of such assets may not be recoverable. Qualitative factors considered in this assessment include industry and market conditions, overall financial performance, and other relevant events and factors affecting the Company's business. Based on the qualitative assessment, if it is determined that the fair value of goodwill is more likely than not to be less than its carrying amount, the fair value of a reporting unit will be calculated and compared with its carrying amount and an impairment charge will be recognized for the amount that the carrying value exceeds the fair value.
Impairment of Long-Lived Assets
The Company evaluates the fair value of long-lived assets, which include property, plant and equipment, leases, and finite-lived intangible assets for impairment whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be fully recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future undiscounted net cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell.
Net Loss Per Share
Basic net loss per common share was determined by dividing net loss applicable to common stockholders by the weighted average common shares outstanding during the period. Basic and diluted net loss per share is the same because all outstanding common stock equivalents have been excluded, as they are anti-dilutive as a result of the Company’s losses.
The following potentially issuable common shares were not included in the computation of diluted net loss per share because they would have an anti-dilutive effect due to net losses for each period:
December 31,
(In thousands)202520242023
Shares issuable upon conversion of convertible notes23,223 26,526 23,231 
Shares issuable upon the release of restricted stock awards6,896 7,245 6,273 
Shares issuable upon the release of performance share units1,048 2,021 1,598 
Shares issuable upon exercise of stock options781 983 1,286 
31,948 36,775 32,388 
Accounting for Stock-Based Compensation
The Company requires all share-based payments to employees, including grants of employee stock options, restricted stock, restricted stock units, shares purchased under an employee stock purchase plan (if certain parameters are not met), and performance share units to be recognized in the financial statements based on their grant date fair values. The estimated fair value of these awards is recognized to expense using the straight-line method over the requisite service period, which is generally the vesting period. The Company will recognize expense on an accelerated basis for restricted stock units upon an employee's death, disability, or upon retirement eligibility, provided certain criteria are met. Forfeitures of any share-based awards are recognized as they occur.
The fair values and recognition of the Company’s share-based payment awards are determined as follows:
The fair value of each service-based option award is estimated on the date of grant using the Black-Scholes option-pricing model. The Black-Scholes pricing model utilizes the following assumptions:
Expected Term—Expected life of an option award is the average length of time over which the Company expects employees will exercise their options, which is based on historical experience with similar grants.
Expected Volatility—Expected volatility is based on the Company’s historical stock volatility data over the expected term of the awards.
Risk-Free Interest Rate—The Company bases the risk-free interest rate on the implied yield currently available on U.S. Treasury zero-coupon issues with an equivalent expected term.
The fair value of service-based awards for each restricted stock unit award is determined on the date of grant using the closing stock price on that day.
The fair value of performance-based equity awards that do not include a market condition is determined on the date of grant using the closing stock price on that day. The fair value of performance-based equity awards that include a market condition is determined on the date of grant using a Monte Carlo valuation technique. The expense recognized each period is also dependent on the probability of what performance conditions will be met which is determined by management's evaluation of internal and external factors. Determining the appropriate amount to expense based on the anticipated achievement of the stated goals requires judgment, including forecasting future financial results. The estimate of the timing of the expense recognition is revised periodically based on the probability of achieving the goals and adjustments are made as appropriate. The cumulative impact of any revision is reflected in the period of the change. If the financial performance targets and operational milestones are not achieved, the award would not vest resulting in no stock-based compensation being recognized and any previously recognized stock-based compensation expense being reversed.
Research and Development Costs
Research and development costs are expensed as incurred. These expenses include the costs of the Company's proprietary research and development efforts, as well as costs of IPR&D projects acquired as part of an asset acquisition that have no alternative future use. Acquired IPR&D assets that are acquired in an asset acquisition and which have no alternative future use are classified as an investing cash outflow in the consolidated statements of cash flows. Upfront and milestone payments due to third parties in connection with research and development collaborations prior to regulatory approval are expensed as incurred. Milestone payments due to third parties upon, or subsequent to, regulatory approval are capitalized and amortized into research and development costs over the shorter of the remaining license or product patent life, when there are no corresponding revenues related to the license or product. Nonrefundable advance payments for goods and services that will be used in future research and development activities are expensed when the activity has been performed or when the goods have been received, rather than when the payment is made.
Advertising Costs
Advertising costs are expensed as incurred. The Company expensed approximately $199.2 million, $180.3 million, and $137.9 million of media advertising during the years ended December 31, 2025, 2024, and 2023, respectively, which is recorded in sales and marketing expenses on the Company’s consolidated statements of operations.
Fair Value Measurements
The Financial Accounting Standards Board (“FASB”) has issued authoritative guidance that requires fair value to be based on the assumptions market participants would use when pricing an asset or liability and establishes a fair value hierarchy that prioritizes the information used to develop those assumptions. Under that standard, fair value measurements are separately disclosed by level within the fair value hierarchy. The fair value hierarchy establishes and prioritizes the inputs used to measure fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs. Observable inputs are inputs that reflect the assumptions that market participants would use in pricing the asset or liability developed based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the assumptions market participants would use in pricing the asset or liability developed based on the best information available in the circumstances.
Leases
The Company acts as lessee in its lease agreements, which include operating leases for corporate offices, laboratory space, warehouse space, vehicles, and certain laboratory and office equipment, and finance leases for certain equipment and vehicles.
The Company determines whether an arrangement is, or contains, a lease at inception. The Company records the present value of lease payments as right-of-use (“ROU”) assets and lease liabilities on the consolidated balance sheets. ROU assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent an obligation to make lease payments based on the present value of lease payments over the lease term. Classification of lease liabilities as either current or non-current is based on the expected timing of payments due under the Company’s obligations.
As the implicit interest rate is not readily determinable in most of the Company’s leases, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. The incremental borrowing rate is the rate of interest that a lessee would have to pay to borrow on a collateralized basis over a similar term and at an amount equal to the lease payments in a similar economic environment and credit profile.
The ROU asset also consists of any lease incentives received. The lease terms used to calculate the ROU asset and related lease liability include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. “Reasonably certain” is assessed internally based on economic, industry, company, strategic and contractual factors. The leases have remaining lease terms of 1 year to 15 years, some of which include options to extend the lease for up to 10 years, and some of which include options to terminate the lease within 1 year. Operating lease expense and amortization of finance lease ROU assets are recognized on a straight-line basis over the lease term as an operating expense. Finance lease interest expense is recorded as interest expense on the Company’s consolidated statements of operations.
The Company accounts for leases acquired in business combinations by measuring the lease liability at the present value of the remaining lease payments as if the acquired lease were a new lease for the Company. This measurement includes recognition of a lease intangible for any below-market terms present in the leases acquired. The below-market lease intangible is included in the ROU asset on the consolidated balance sheets and are amortized over the remaining lease term. The Company has not acquired any leases with above-market terms.
The Company has taken advantage of certain practical expedients offered to registrants at adoption of ASC 842. The Company does not apply the recognition requirements of ASC 842 to short-term leases. Instead, those lease payments are recognized in profit or loss on a straight-line basis over the lease term. Further, as a practical expedient, all lease contracts are accounted for as one single lease component, as opposed to separating lease and non-lease components to allocate the consideration within a single lease contract.
Revenue Recognition
Revenues are recognized when the satisfaction of the performance obligation occurs, in an amount that reflects the consideration the Company expects to collect in exchange for those services. The Company’s revenue is primarily generated by its laboratory testing services utilizing its Cologuard, Oncotype DX, and PreventionGenetics LLC (“PreventionGenetics”) tests. The services are considered completed when the performance obligation is fulfilled, which is upon release of an approved patient test result to the healthcare provider. The Company follows ASC 606, Revenue from Contracts with Customers, to account for its laboratory service revenues.
Laboratory testing services
The Company’s customer is primarily the patient, but the Company does not enter into a formal reimbursement contract with a patient. The Company establishes a contract with a patient in accordance with other customary business practices, which is the point in time an order is received from a provider and a patient specimen has been returned to the laboratory for testing. Payment terms are a function of a patient’s existing insurance benefits, including the impact of coverage decisions with Center for Medicare & Medicaid Services (“CMS”) and applicable reimbursement contracts established between the Company and payers. However, when a patient is considered self-pay, or in the context of certain lab service or reference agreements, the Company requires payment prior to the commencement of the Company's performance obligations.
Additionally, the Company periodically engages with third party international distributor partners to provide patients access to the Company’s laboratory testing services and is considered the principal in these arrangements as control over the intellectual property, lab processing activities, and result delivery remain with the Company. Revenues from these contracts are recorded at gross in an amount that reflects the amount ultimately paid to the distributor for the testing services if known or, if this is unknown or unable to be estimated, is recorded at an effective net fixed transaction price equal to the amount billed to and received from the distributor.
The Company’s contracts have a single performance obligation, which is satisfied upon rendering of services, which culminates in the release of a patient’s test result to the ordering healthcare provider.
The Company’s transaction price is comprised of variable consideration and is allocated entirely to a single performance obligation defined as the point in time an approved patient test result is released to the ordering healthcare provider. Variable consideration is primarily derived from payer and patient billing and can be impacted by several factors such as the amount of contractual adjustments, any patient co-payments, deductibles or patient adherence incentives, the existence of secondary payers, and claim denials. Estimates of variable consideration are calculated using the expected value method and is the sum of probability-weighted amounts in a range of possible consideration amounts. Several factors are evaluated during this process, such as historical collections experience, current contractual and statutory requirements, customer mix, patient insurance eligibility and payer reimbursement contracts, and known or anticipated reimbursement trends not yet reflected in the data. The Company limits the amount of variable consideration included in the transaction price to the unconstrained portion of such consideration. In other words, the Company recognizes revenue up to the amount of variable consideration that is not subject to a significant reversal until additional information is obtained or the uncertainty associated with the additional payments or refunds is subsequently resolved. Differences between original estimates and subsequent revisions, including final settlements, represent changes in the estimate of variable consideration and are included in the period in which such revisions are made.
The Company monitors its estimates of transaction price to depict conditions that exist at each reporting date. If the Company subsequently determines that it will collect more or less consideration than it originally estimated for a contract with a patient, it will account for the change as an increase or decrease in the estimate of the transaction price (i.e., an upward or downward revenue adjustment) in the period identified.
When the Company does not have significant historical experience or that experience has limited predictive value, the constraint over estimates of variable consideration may result in no revenue being recognized upon completion of the performance obligations associated with the Company's tests, with recognition, generally occurring at the date of cash receipt.
Contract Balances
The timing of revenue recognition, billings, and cash collections results in billed accounts receivable and deferred revenue on the consolidated balance sheets. Generally, billing occurs after the release of an approved patient test result to the healthcare provider, resulting in an account receivable. However, the Company sometimes receives advance payment from a patient or a direct bill payer before services are performed, resulting in deferred revenue. The deferred revenue recorded is recognized as revenue at the point in time an approved patient test result is released to the patient's healthcare provider.
Practical Expedients
The Company does not adjust the transaction price for the effects of a significant financing component, as at contract inception, the Company expects the collection cycle to be one year or less.
The Company expenses sales commissions when incurred because the amortization period would have been one year or less. These costs are recorded within sales and marketing expenses in the Company’s consolidated statements of operations.
The Company incurs certain other costs that are incurred regardless of whether a contract is obtained. Such costs are primarily related to legal services and patient communications (e.g. adherence reminder letters). These costs are expensed as incurred and recorded within general and administrative expenses in the Company’s consolidated statements of operations.
Cost of Sales
Cost of sales reflects the aggregate costs incurred in delivering the Company's products and services and includes material and service costs, personnel costs, including stock-based compensation expense, equipment, and infrastructure expenses associated with laboratory testing services, shipping charges, allocated overhead such as rent, information technology costs, equipment depreciation, and utilities, and amortization of acquired developed technology or license intangible assets related to products commercialized by the Company. Costs associated with the shipment of Cologuard test collection kits are recognized upon shipment, and costs associated with performing the Company’s tests are recorded as the tests are performed regardless of whether revenue was recognized with respect to that test.
Foreign Currency Transactions
The functional currency for most of the Company’s international subsidiaries is the United States (“U.S.”) dollar. When the functional currency differs from the local currency, monetary assets and liabilities are remeasured at the current period-end exchange rate, while non-monetary assets and liabilities are remeasured at the historical rate. The gains and losses as a result of exchange rate adjustments of these subsidiaries are recognized in the consolidated statements of operations. Net foreign currency transaction gains or losses were not significant to the consolidated statements of operations for the periods presented.
For the Company’s international subsidiaries where the functional currency is other than the U.S. dollar, the financial statements are translated into the U.S. dollar, and the cumulative adjustments resulting from the translation into the U.S. dollar are included in the Company's consolidated balance sheet as a component of accumulated other comprehensive income (loss) (“AOCI”).
Concentration of Credit Risk
Financial instruments that subject the Company to credit risk consist of cash, cash equivalents, and marketable securities. As of December 31, 2025, the Company had cash and cash equivalents deposited in financial institutions in which the balances exceed the federal government agency insured limit of $250,000 by approximately $892.6 million. The Company has not experienced any losses in such accounts and management believes it is not exposed to any significant credit risk.
Through December 31, 2025, the Company’s revenues have been primarily derived from the sale of Cologuard and Oncotype tests. The following is a breakdown of revenue and accounts receivable from major payers:
% Revenue for the years ended December 31,% Accounts Receivable at December 31,
Major Payer202520242023202520242023
Centers for Medicare and Medicaid Services15%16%17%8%10%10%
UnitedHealthcare13%12%12%8%9%10%
Tax Positions
A valuation allowance to reduce the deferred tax assets is reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The Company has incurred significant losses since its inception and due to the uncertainty of the amount and timing of future taxable income, the Company has determined that a valuation allowance at December 31, 2025 and 2024 is necessary to reduce the tax assets to the amount that is more likely than not to be realized. Due to the existence of the valuation allowance, future changes in the Company's unrecognized tax benefits will not impact the Company's effective tax rate.
Guarantees and Indemnifications
The Company, as permitted under Delaware law and in accordance with its bylaws, indemnifies its officers and directors for certain events or occurrences, subject to certain limits, while the officer or director is or was serving at the Company’s request in such capacity. The term of the indemnification period is for the officer’s or director’s lifetime. The maximum amount of potential future indemnification is unlimited; however, the Company has a directors and officers insurance policy that limits its exposure and may enable it to recover a portion of any future amounts paid. The Company believes the fair value of these indemnification agreements is minimal. Accordingly, the Company has not recorded any liabilities for these agreements as of December 31, 2025 and 2024.
Recent Accounting Pronouncements
Recently Adopted Accounting Pronouncements
In December 2023, the FASB issued Accounting Standards Update (“ASU”) No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This update improves income tax disclosure requirements, primarily through enhanced transparency and decision usefulness of disclosures. The amendments in this update should be applied prospectively with the option to apply retrospectively and are effective for fiscal years beginning after December 15, 2024. The Company adopted and prospectively applied the amendments in this update during the fourth quarter of fiscal year 2025.
Recently Issued Accounting Pronouncements Not Yet Adopted
In October 2023, the FASB issued ASU No. 2023-06, Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure Update and Simplification Initiative. This update modifies the disclosure or presentation requirements of a variety of topics in the ASC to conform with certain Securities and Exchange Commission (“SEC”) amendments in Release No. 33-10532, Disclosure Update and Simplification. The amendments in this update should be applied prospectively, and the effective date for each amendment will be the date on which the SEC’s removal of that related disclosure from Regulation S-X or S-K becomes effective. However, if the SEC has not removed the related disclosure from its regulations by June 30, 2027, the amendments will be removed from the Codification and not become effective. Early adoption is prohibited. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In November 2024, the FASB issued ASU No. 2024-03, Income Statement – Reporting Comprehensive Income – Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses. This update enhances financial statement disclosures by requiring public business entities to disclose specified information about certain costs and expenses including the amounts of (a) purchases of inventory, (b) employee compensation, (c) depreciation, and (d) intangible asset amortization included in each relevant expense caption. The update also requires disclosure of certain amounts that are already required to be disclosed under current GAAP, disclosure of a qualitative description of the amounts remaining in relevant expense captions that are not separately disaggregated quantitatively, and disclosure of the total amount of selling expenses and, in annual reporting periods, an entity’s definition of selling expenses. The amendments in this update may be applied either prospectively or retrospectively and are effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In May 2025, the FASB issued ASU No. 2025-03, Business Combinations (Topic 805) and Consolidation (Topic 810): Determining the Accounting Acquirer in the Acquisition of a Variable Interest Entity. This guidance clarifies the framework for identifying the accounting acquirer in transactions involving variable interest entities that meet the definition of a business. The amendments should be applied prospectively and are effective for fiscal years beginning after December 15, 2026, including interim periods within those fiscal years. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In July 2025, the FASB issued ASU No. 2025-05, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses for Account Receivable and Contract Assets. This update introduces a practical expedient for all entities when estimating expected credit losses on current accounts receivable and current contract assets arising from revenue transactions accounted for under Topic 606. The expedient allows entities to assume current conditions as of the balance sheet date remain unchanged over the remaining life of the asset. The amendments are required to be applied prospectively and are effective for annual and interim periods beginning after December 15, 2025. Early adoption is permitted. The Company is currently evaluating adoption of the practical expedient.
In September 2025, the FASB issued ASU No. 2025-06, Intangibles—Goodwill and Other— Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. This update provides amendments to clarify and modernize the accounting for costs incurred to develop or acquire internal-use software. The amendments address the capitalization of implementation costs by utilizing a principles-based approach and consolidates website development guidance under Subtopic 350-40. The amendments can be applied prospectively, modified prospectively, or retrospectively and are effective for annual and interim periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
In September 2025, the FASB issued ASU No. 2025-07, Derivatives and Hedging (Topic 815) and Revenue from Contracts with Customers (Topic 606): Derivatives Scope Refinements and Scope Clarification for Share-Based Noncash Consideration from a Customer in a Revenue Contract. This update introduces a scope exception to derivative accounting for certain contracts with underlyings tied to operations or activities specific to one of the parties. Additionally, the update clarifies that share-based noncash consideration received from a customer should be accounted for under Topic 606 until the right to receive or retain the consideration becomes unconditional. The amendments can be applied prospectively or modified retrospectively and are effective for annual and interim periods beginning after December 15, 2026. The Company is currently evaluating the potential impact of this guidance and the timing of adoption. The provisions related to Topic 606 are not applicable.
In December 2025, the FASB issued ASU No. 2025-10, Government Grants (Topic 832): Accounting for Government Grants Received by Business Entities. This update establishes authoritative guidance for entities receiving government grants, replacing previous guidance that relied on analogies to IAS 20 or ASC 450. Under the new guidance, entities must first determine whether the grant is related to an asset or income. Grants related to assets can either adopt the deferred income approach or the cost accumulation approach while grants related to income should be recognized in earnings on a systematic and rational basis over the periods in which the costs are incurred. The amendments can be applied modified prospectively, modified retrospectively, or retrospectively and are effective for annual and interim periods beginning after December 15, 2028. Early adoption is permitted. The Company is currently evaluating the potential impact of the guidance and the timing of adoption.
In December 2025, the FASB issued ASU No. 2025-11, Interim Reporting (Topic 270): Narrow-Scope Improvements. This update clarifies that all entities issuing interim financial statements under U.S. GAAP fall within the scope of ASC 270. SEC registrants must follow the requirements of Regulation S-X, Rule 10-01, while non-SEC registrants may present interim financial statements, and related notes, under GAAP at the same level of detail as annual reporting. Additionally, entities issuing condensed interim financial statements must disclose material events occurring since the end of the prior fiscal year. The amendments can be applied prospectively or retrospectively, and are effective for annual and interim periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
In December 2025, the FASB issues ASU No. 2025-12, Codification Improvements. This update results from the Board's ongoing project to address suggestions received from stakeholders and to make technical corrections, clarifications, and other incremental improvements to GAAP. This evergreen project facilitates Codification updates for a broad range of ASC topics. The amendments are not expected to have a significant effect on current accounting practice. This ASU can be applied using a prospective or retrospective approach and are effective for annual and interim periods beginning after December 15, 2026. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
v3.25.4
REVENUE
 12 Months Ended
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]  
REVENUE REVENUE
 The following table presents the Company’s revenues disaggregated by revenue source:
Year Ended December 31,
(In thousands)202520242023
Screening
Medicare Parts B & C$955,075 $776,155 $701,400 
Commercial1,323,216 1,118,338 992,244 
Other251,575 209,375 171,057 
Total Screening2,529,866 2,103,868 1,864,701 
Precision Oncology
Medicare Parts B & C$196,468 $187,948 $188,689 
Commercial196,170 190,595 181,318 
International223,844 189,092 153,277 
Other100,642 87,364 105,826 
Total Precision Oncology717,124 654,999 629,110 
COVID-19 Testing$— $— $5,955 
Total$3,246,990 $2,758,867 $2,499,766 
Screening revenue primarily includes laboratory service revenue from Cologuard and PreventionGenetics, LLC tests while Precision Oncology revenue primarily includes laboratory service revenue from global Oncotype DX and therapy selection tests. The Company discontinued its COVID-19 testing operations in the second quarter of 2023.
At each reporting period end, the Company conducts an analysis of the estimates used to calculate the transaction price to determine whether any new information available impacts those estimates made in prior reporting periods. Adjustments to revenue recognized during the period relating to prior period estimates were less than 1%, 1%, and 2% of revenue recorded in the Company’s consolidated statement of operations for the years ended December 31, 2025, 2024, and 2023, respectively.
The Company’s deferred revenue, which is reported in other current liabilities in the Company’s consolidated balance sheets, was not significant as of December 31, 2025 and 2024.
Revenue recognized for the years ended December 31, 2025 and 2024, which was included in the deferred revenue balance at the beginning of the year was not significant.
v3.25.4
MARKETABLE SECURITIES
 12 Months Ended
Dec. 31, 2025
Cash and Cash Equivalents [Abstract]  
MARKETABLE SECURITIES MARKETABLE SECURITIES
The following table sets forth the Company’s cash, cash equivalents, and marketable securities at December 31, 2025 and 2024:
December 31,
(In thousands)20252024
Cash and cash equivalents
Cash and money market$955,996 $595,548 
Cash equivalents— 5,341 
Total cash and cash equivalents955,996 600,889 
Marketable securities
Available-for-sale debt securities$— $431,165 
Equity securities8,715 5,972 
Total marketable securities8,715 437,137 
Total cash, cash equivalents, and marketable securities$964,711 $1,038,026 
Available-for-sale debt securities, including the classification within the consolidated balance sheet at December 31, 2024, consisted of the following:
(In thousands)Amortized Cost
Gains in AOCI (1)
Losses in AOCI (1)
Estimated Fair Value
Cash equivalents
Commercial paper$5,341 $— $— $5,341 
Total cash equivalents5,341 — — 5,341 
Marketable securities
Corporate bonds$206,063 $932 $(121)$206,874 
U.S. government agency securities140,992 160 (200)140,952 
Asset backed securities83,134 256 (51)83,339 
Total marketable securities430,189 1,348 (372)431,165 
Total available-for-sale debt securities$435,530 $1,348 $(372)$436,506 
_________________________________
(1)     There was no tax impact from the gains and losses in AOCI.
The following table summarizes the gross unrealized losses and fair values of available-for-sale debt securities in an unrealized loss position as of December 31, 2024, aggregated by investment category and length of time those individual securities have been in a continuous unrealized loss position:
Less than one year
One year or greater
Total
(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss
Marketable securities
U.S. government agency securities$39,542 $(199)$1,990 $(1)$41,532 $(200)
Corporate bonds25,979 (121)— — 25,979 (121)
Asset backed securities5,567 (28)2,666 (23)8,233 (51)
Total available-for-sale securities$71,088 $(348)$4,656 $(24)$75,744 $(372)
The Company evaluates investments that are in an unrealized loss position for impairment as a result of credit loss. It was determined that no credit losses exist as of December 31, 2025 and 2024 because the change in market value for those securities in an unrealized loss position has resulted from fluctuating interest rates rather than a deterioration of the credit worthiness of the issuers.
The gains and losses recorded on available-for-sale debt securities and equity securities are included in investment income, net in the Company’s consolidated statements of operations. The gains and losses recorded were not significant for the years ended December 31, 2025, 2024, and 2023.
v3.25.4
INVENTORY
 12 Months Ended
Dec. 31, 2025
Inventory Disclosure [Abstract]  
INVENTORY INVENTORY
Inventory consisted of the following:
December 31,
(In thousands)20252024
Raw materials$75,716 $69,730 
Semi-finished and finished goods90,485 92,653 
Total inventory$166,201 $162,383 
v3.25.4
PROPERTY, PLANT AND EQUIPMENT
 12 Months Ended
Dec. 31, 2025
Property, Plant and Equipment [Abstract]  
PROPERTY, PLANT AND EQUIPMENT PROPERTY, PLANT AND EQUIPMENT
The carrying value and estimated useful lives of property, plant and equipment are as follows:
December 31,
(In thousands)Estimated Useful Life20252024
Property, plant and equipment
Landn/a$4,716 $4,716 
Leasehold and building improvements(1)257,503 227,885 
Land improvements15 years6,740 6,747 
Buildings
30 - 40 years
290,777 290,777 
Computer equipment and computer software3 years243,624 206,460 
Machinery and equipment
3 - 10 years
387,943 339,421 
Furniture and fixtures
3 - 10 years
37,347 37,176 
Assets under constructionn/a84,142 89,065 
Property, plant and equipment, at cost1,312,792 1,202,247 
Accumulated depreciation(604,128)(508,574)
Property, plant and equipment, net$708,664 $693,673 
_________________________________
(1)     Lesser of remaining lease term, building life, or estimated useful life.
At December 31, 2025, the Company had $84.1 million of assets under construction, which consisted of $42.0 million in machinery and equipment, $15.3 million in leasehold and building improvements, and $26.8 million of capitalized costs related to software projects. Depreciation will begin on these assets once they are placed into service upon completion.
v3.25.4
INTANGIBLE ASSETS AND GOODWILL
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
INTANGIBLE ASSETS AND GOODWILL INTANGIBLE ASSETS AND GOODWILL
Intangible Assets
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2025:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at December 31, 2025
Finite-lived intangible assets
Acquired developed technology
5.6$887,518 $(495,986)$391,532 
Trade name9.9104,000 (42,403)61,597 
Patents and licenses8.662,442 (17,868)44,574 
Customer relationships5.04,000 (1,778)2,222 
Total finite-lived intangible assets1,057,960 (558,035)499,925 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,477,960 $(558,035)$919,925 
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2024:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at December 31, 2024
Finite-lived intangible assets
Acquired developed technology
6.4$887,104 $(412,504)$474,600 
Trade name10.8104,000 (35,153)68,847 
Patents and licenses9.556,542 (12,963)43,579 
Customer relationships6.04,000 (1,333)2,667 
Total finite-lived intangible assets1,051,646 (461,953)589,693 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,471,646 $(461,953)$1,009,693 
As of December 31, 2025, the estimated future amortization expense associated with the Company’s finite-lived intangible assets for each of the five succeeding fiscal years is as follows:
(In thousands)
2026$95,955 
202795,955 
202895,955 
202989,832 
203022,473 
Thereafter99,755 
Total$499,925 
The Company recorded an IPR&D asset of $1.25 billion related to a project associated with the development of a blood-based, multi-cancer screening test (“MCED”) as part of the acquisition of Thrive Earlier Detection Corporation (“Thrive”) in January 2021.
During the fourth quarter of 2024, the Company performed a quantitative impairment assessment for the IPR&D asset, which required a fair value measurement as of the Company's annual test date, November 15, 2024. The Company determined that the fair value of the IPR&D was $420.0 million and recorded a non-cash, pre-tax impairment charge of $830.0 million. The impairment charge recorded was the result of a decrease in projected cash flows for the asset due to external factors since the acquisition, primarily an expected decline in reimbursement rates. The ongoing legislation discussion around the proposed MCED Act legislation gave the Company new information on how reimbursement may develop. The fair value of the IPR&D asset was measured using the multi-period excess earnings method approach, which utilizes significant unobservable inputs (Level 3 inputs) including projected revenues, projected gross margin, projected operating expenses, discount rate, tax rate, obsolescence factor, and probability of commercial success. The discount rate utilized in the fair value measurement was 18.0%. The impairment loss recorded is included in impairment of long-lived and indefinite-lived assets in the Company’s consolidated statement of operations.

The Company performed a quantitative assessment as part of its annual IPR&D impairment analysis in the fourth quarter of 2025 under which it determined that the fair value exceeded the carrying value and no impairment loss was recorded.
There were no impairment losses recorded on finite-lived intangible assets during the years ended December 31, 2025, 2024, and 2023.
Goodwill
The change in the carrying amount of goodwill for the years ended December 31, 2025 and 2024 is as follows:
(In thousands)
Balance, January 1, 2024$2,367,120 
Resolution Bioscience acquisition adjustments (1)
225 
Effects of changes in foreign currency exchange rates
(669)
Balance, December 31, 20242,366,676 
Effects of changes in foreign currency exchange rates1,372 
Balance, December 31, 2025$2,368,048 
_________________________________
(1)    Refer to Note 17 for further discussion on the Company’s acquisition of Resolution Bioscience, Inc. (“Resolution Bioscience”)
There were no impairment losses recorded on goodwill for the years ended December 31, 2025, 2024, and 2023.
v3.25.4
FAIR VALUE MEASUREMENTS
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
FAIR VALUE MEASUREMENTS FAIR VALUE MEASUREMENTS
The three levels of the fair value hierarchy established are as follows:
Level 1    Quoted prices (unadjusted) in active markets for identical assets or liabilities that the Company has the ability to access as of the reporting date. Active markets are those in which transactions for the asset or liability occur in sufficient frequency and volume to provide pricing information on an ongoing basis.
Level 2    Pricing inputs other than quoted prices in active markets included in Level 1, which are either directly or indirectly observable as of the reporting date. These include quoted prices for similar assets or liabilities in active markets and quoted prices for identical or similar assets or liabilities in markets that are not active.
Level 3    Unobservable inputs that reflect the Company’s assumptions about the assumptions that market participants would use in pricing the asset or liability. Unobservable inputs shall be used to measure fair value to the extent that observable inputs are not available.
The following table presents the Company’s fair value measurements as of December 31, 2025 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair value at December 31, 2025Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash and cash equivalents
Cash and money market$955,996 $955,996 $— $— 
Marketable securities
Equity securities
$8,715 $8,715 $— $— 
Non-marketable securities$52,538 $— $— $52,538 
Liabilities
Contingent consideration$(289,018)$— $— $(289,018)
Total$728,231 $964,711 $— $(236,480)
The following table presents the Company’s fair value measurements as of December 31, 2024 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at December 31, 2024Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash, cash equivalents, and restricted cash
Cash and money market$595,548 $595,548 $— $— 
Restricted cash (1)
5,747 5,747 — — 
U.S. government agency securities5,341 — 5,341 — 
Marketable securities
Corporate bonds$206,874 $— $206,874 $— 
U.S. government agency securities140,952 — 140,952 — 
Asset backed securities83,339 — 83,339 — 
Equity securities
5,972 5,972 — — 
Non-marketable securities$796 $— $— $796 
Liabilities
Contingent consideration$(282,212)$— $— $(282,212)
Total$762,357 $607,267 $436,506 $(281,416)
_________________________________
(1)Restricted cash primarily represented cash held by a third-party financial institution as part of a cash collateral agreement related to the Company’s credit card program. The restrictions lapsed in 2025 upon the removal of the cash collateral requirement by the third-parties.
There have been no material changes in valuation techniques or transfers between fair value measurement levels during the year ended December 31, 2025. The fair value of Level 2 instruments classified as cash equivalents and marketable debt securities are valued using a third-party pricing agency where the valuation is based on observable inputs including pricing for similar assets and other observable market factors.
Non-Marketable Securities
The following table summarizes the Company’s non-marketable securities, which are primarily included in other long-term assets on the consolidated balance sheet as of December 31, 2025 and December 31, 2024:
December 31,
(In thousands)20252024
Investments for which the fair value option has been elected$52,538 $796 
Investments without readily determinable fair values54,941 50,448 
Equity method investments7,843 7,488 
Total$115,322 $58,732 
Fair Value Option Securities
The Company has elected the fair value option to measure certain non-marketable securities at fair value to simplify the accounting. The fair value measurement of non-marketable securities is categorized as Level 3 as the measurement amount is primarily based on significant, unobservable inputs.
In August 2025, the Company executed a note purchase agreement with Freenome Holdings, Inc. (“Freenome”) under which the Company purchased a $50.0 million senior convertible note, which bears interest at a rate of 5.0% per year and matures on August 12, 2030. The convertible note and accrued interest will be paid back in cash upon maturity, if not previously repaid or converted into equity at the applicable conversion price pursuant to optional or automatic mechanisms per the note purchase agreement. The Company utilizes a probability-weighted scenario-based discounted cash flow model under the income approach to measure the fair value of the note. Probabilities are applied to each potential scenario and the resulting values are discounted using a present-value factor. The passage of time, in addition to changes in probabilities and the present-value factor, may result in adjustments to the fair value measurement. Interest income is accrued based on the contractual annual interest rate, which is included in interest expense, net in the consolidated statement of operations. The fair value of the convertible note was $50.1 million as of December 31, 2025.
Gains and losses recorded on non-marketable securities for which the fair value option has been elected are recognized in investment income, net in the consolidated statement of operations. The following table provides a reconciliation of the beginning and ending balances of non-marketable securities valued using the fair value option:
(In thousands)Non-Marketable Securities
Beginning balance, January 1, 2024
$7,650 
Changes in fair value
(604)
Settlement of non-marketable securities
(6,250)
Balance, December 31, 2024
796 
Purchases of non-marketable securities
51,250 
Changes in fair value492 
Ending balance, December 31, 2025
$52,538 
Investments without Readily Determinable Fair Values
Investments without readily determinable fair values had the following cumulative upward and downward adjustments and aggregate carrying amounts as of December 31, 2025 and 2024:
December 31,
(In thousands)
20252024
Cumulative upward adjustments (1)
$5,595 $5,102 
Cumulative downward adjustments and impairments (2)
(16,850)(16,850)
Aggregate carrying value54,941 50,448 
_________________________________
(1)    There were no material upward adjustments recorded for the years ended December 31, 2025, 2024, and 2023.
(2)    There were no material downward adjustments or impairments for the years ended December 31, 2025, 2024, and 2023.
There were no material realized gains or losses recorded during the years ended December 31, 2025, 2024, and 2023.
Equity Method Investments
The Company has committed capital to venture capital investment funds of $18.0 million, of which $9.4 million remains callable through 2033 as of December 31, 2025. The aggregate carrying amount of these funds was $7.8 million and $7.5 million as of December 31, 2025 and 2024, respectively. Gains and losses recorded on the Company's investments in these funds were not significant for the years ended December 31, 2025, 2024, and 2023.
Contingent Consideration Liabilities
The fair value of the contingent consideration liabilities was $289.0 million and $282.2 million as of December 31, 2025 and 2024, respectively. As of December 31, 2025, the contingent consideration liability was included in other long-term liabilities in the consolidated balance sheet. As of December 31, 2024, $19.7 million was included in other current liabilities and $262.5 million was included in other long-term liabilities in the consolidated balance sheet.
The following table provides a reconciliation of the beginning and ending balances of contingent consideration:
Year Ended December 31,
(In thousands)202520242023
Beginning balance
$282,212 $288,657 $306,927 
Changes in fair value (1)
26,806 (3,345)(18,044)
Payments (2)
(20,000)(3,100)(226)
Ending balance
$289,018 $282,212 $288,657 
_________________________________
(1)    The change in fair value of the contingent consideration liability is included in general and administrative expenses in the consolidated statement of operations for the years ended December 31, 2025, 2024, and 2023.
(2)    Payments were made to settle the product development milestone contingent consideration liabilities previously recorded related to the Company's acquisitions of Ashion Analytics, LLC (“Ashion”) and OmicEra Diagnostics GmbH in the years ended December 31, 2025 and 2024, respectively.
This fair value measurement of contingent consideration is categorized as a Level 3 liability, as the measurement amount is based primarily on significant inputs not observable in the market.
The fair value of the contingent consideration liability recorded from the Company's acquisition of Thrive related to regulatory milestones was $289.0 million as of December 31, 2025. The fair value of the contingent consideration liabilities recorded from the Company's acquisitions of Thrive and Ashion related to regulatory and product development milestones was $282.2 million as of December 31, 2024. The Company estimates the fair value of the contingent consideration liabilities related to the regulatory and product development milestones using the probability-weighted scenario based discounted cash flow model, which is consistent with the initial measurement of the contingent consideration liabilities. Probabilities of success are applied to each potential scenario and the resulting values are discounted using a present-value factor. The passage of time in addition to changes in projected milestone achievement timing, present-value factor, the degree of achievement if applicable, and probabilities of success may result in adjustments to the fair value measurement. The fair value of the contingent consideration liability recorded related to regulatory and product development milestones was determined using a weighted average probability of success of 90% as of December 31, 2025 and 2024, and a weighted average present-value factor of 5.5% and 6.2% as of December 31, 2025 and 2024, respectively. The projected fiscal year of payment range is from 2030 to 2031. Unobservable inputs were weighted by the relative fair value of the contingent consideration liabilities.
The revenue milestone associated with the Ashion acquisition is not expected to be achieved and therefore no liability has been recorded for this milestone as of December 31, 2025 or December 31, 2024.
Derivative Financial Instruments
The Company enters into foreign currency forward contracts on the last day of each month to mitigate the impact of adverse movements in foreign exchange rates related to the remeasurement of monetary assets and liabilities and hedge the Company’s foreign currency exchange rate exposure. As of December 31, 2025 and 2024, the Company had open foreign currency forward contracts with notional amounts of $31.8 million and $44.2 million, respectively. The Company’s foreign exchange derivative instruments are classified as Level 2 within the fair value hierarchy as they are valued using inputs that are observable in the market or can be derived principally from or corroborated by observable market data. The fair value of the open foreign currency forward contracts was zero at December 31, 2025 and 2024, and there were no gains or losses recorded to adjust the fair value of the open foreign currency contract held as of December 31, 2025. The contracts are closed subsequent to each month-end, and the gains and losses recorded from the contracts were not significant for the years ended December 31, 2025 and 2024.
v3.25.4
ACCRUED LIABILITIES
 12 Months Ended
Dec. 31, 2025
Payables and Accruals [Abstract]  
ACCRUED LIABILITIES ACCRUED LIABILITIES
Accrued liabilities at December 31, 2025 and 2024 consisted of the following:
December 31,
(In thousands)20252024
Compensation$276,660 $185,934 
Professional fees59,528 80,452 
Other27,445 23,529 
Research and trial related expenses25,161 16,043 
Licenses20,262 15,107 
Assets under construction7,417 7,227 
Total $416,473 $328,292 
v3.25.4
LONG-TERM DEBT
 12 Months Ended
Dec. 31, 2025
Debt Disclosure [Abstract]  
LONG-TERM DEBT
Accounts Receivable Securitization Facility
On June 29, 2022, the Company, through a wholly owned special purpose entity, Exact Receivables LLC (“Exact Receivables”) entered into an accounts receivable securitization program (the “Securitization Facility”) with PNC Bank, National Association (“PNC”), with a scheduled maturity date of June 29, 2024. The Securitization Facility required the Company to maintain minimum borrowings under the facility of $50.0 million. Upon the maturity of the Securitization Facility in June 2024, the Company repaid the previously outstanding balance of $50.0 million in full. The Securitization Facility provided Exact Receivables with a revolving line-of-credit of up to $150.0 million of borrowing capacity, subject to certain borrowing base requirements, by collateralizing a security interest in the domestic customer accounts receivable of certain wholly owned subsidiaries of the Company. The debt issuance costs incurred related to the Securitization Facility were not significant and were amortized over the life of the Securitization Facility through interest expense, net within the consolidated statements of operations. Prior to the repayment, the outstanding balance accrued interest at a rate equal to a daily secured overnight financing rate (“SOFR”) plus a SOFR adjustment and an applicable margin. The interest rate was 6.89% as of the maturity date.
Revolving Credit Agreement
On January 13, 2025, the Company entered into a senior secured revolving credit agreement (the “Revolving Credit Agreement”) with a syndicate of lenders.
Borrowings under the Revolving Credit Agreement are permitted up to a maximum amount of $500.0 million on a revolving basis. In addition, the Company may request, in lieu of cash advances, letters of credit with an aggregate stated amount outstanding not to exceed $20.0 million. Up to $50.0 million of borrowings may be made, at the Company’s election, in additional currencies. Borrowings under the Revolving Credit Agreement will be used for working capital and other general corporate purposes. The Revolving Credit Facility matures on the earlier to occur of January 13, 2028 and the date that is 91 days prior to the maturity date of indebtedness of the Company and any restricted subsidiary in the event that the aggregate outstanding principal amount of such maturing indebtedness equals or exceeds $300.0 million. The Revolving Credit Agreement also provides for uncommitted incremental facilities in an amount up to $200.0 million plus an unlimited additional amount so long as the Company is in compliance with certain financial covenants.
Outstanding revolving loans denominated in U.S. dollars under the Revolving Credit Agreement will bear interest at a floating rate of either (A) Term SOFR plus 0.10% (subject to a 0.00% floor) plus the Applicable Rate (as defined below) or (B) a base rate (subject to a 1.00% per annum floor) plus the Applicable Rate, as elected by the Company. Revolving loans denominated in foreign currencies will bear interest at floating reference rates described in the Revolving Credit Agreement plus the Applicable Rate. The Applicable Rate means (A) in the case of U.S. dollar base rate loans, a margin ranging from 1.50% to 2.00% per annum, depending on the Company's consolidated secured gross leverage ratio, and (B) in the case of U.S. dollar Term SOFR loans and all foreign currency loans, a margin ranging from 2.50% to 3.00% per annum, depending on the Company's consolidated secured gross leverage ratio.
The Company is required to pay customary fees for a credit facility of this size and type, including a commitment fee on the unused portion of the Revolving Credit Facility.
Certain of the Company's present and future subsidiaries (the “Subsidiary Guarantors”) guarantee the obligations under the Revolving Credit Agreement. The obligations under the Revolving Credit Agreement are secured by a first priority security interest in substantially all of the Company's and the Subsidiary Guarantors’ assets, subject to certain exceptions and exclusions. The Revolving Credit Agreement contains customary representations and warranties, affirmative covenants and negative covenants for credit facilities of this nature, including financial covenants. The Company must maintain a consolidated secured gross leverage ratio not to exceed 2.50 to 1.00 (subject to certain exceptions) and a consolidated interest charge coverage ratio not less than 3.00 to 1.00, in each case, of as of the last day of each fiscal quarter.
The Company has agreed to various financial covenants under the Revolving Credit Agreement, and as of December 31, 2025, the Company was in compliance with all covenants.
As of December 31, 2025, the Company had $5.9 million of issued and outstanding letters of credit under the Revolving Credit Agreement, which reduced the amount available for cash advances under the facility to $494.1 million. As of December 31, 2025, the Company has not drawn funds from, nor are any amounts outstanding under, the Revolving Credit Agreement.
v3.25.4
CONVERTIBLE NOTES
 12 Months Ended
Dec. 31, 2025
CONVERTIBLE DEBT  
CONVERTIBLE NOTES CONVERTIBLE NOTES
Convertible note obligations included in the consolidated balance sheet consisted of the following as of December 31, 2025:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(11,364)$609,345 $759,636 2
2030 Convertible Notes - 2.000%
572,993 (2,937)570,056 795,045 2
2028 Convertible Notes - 0.375%
589,380 (3,389)585,991 605,570 2
2027 Convertible Notes - 0.375%
563,822 (2,037)561,785 587,672 2
Convertible note obligations included in the consolidated balance sheet consisted of the following as of December 31, 2024:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(13,511)$607,198 $581,648 2
2030 Convertible Notes - 2.000%
572,993 (3,642)569,351 592,756 2
2028 Convertible Notes - 0.375%
589,380 (4,952)584,428 512,761 2
2027 Convertible Notes - 0.375%
563,822 (3,732)560,090 523,932 2
2025 Convertible Notes - 1.000% (2)
249,172 (19)249,153 246,705 2
____________________________
(1)     The fair values are based on observable market prices for this debt, which is traded in less active markets and therefore is classified as a Level 2 fair value measurement.
(2)    The Company’s convertible notes due in 2025 (the “2025 Notes”) matured on January 15, 2025 and were included in convertible notes, net, current portion on the consolidated balance sheet as of December 31, 2024. Upon maturity of the 2025 Notes on January 15, 2025, the Company made a cash payment of $250.4 million in settlement of the total principal of the 2025 Notes and accrued interest that was previously outstanding as of December 31, 2024.
Issuances and Settlements
In January 2018, the Company issued and sold $690.0 million in aggregate principal amount of 1.0% Convertible Notes (the “January 2025 Notes”) with a maturity date of January 15, 2025. The January 2025 Notes accrued interest at a fixed rate of 1.0% per year, payable semi-annually in arrears on January 15 and July 15 of each year, beginning on July 15, 2018. The net proceeds from the issuance of the January 2025 Notes were approximately $671.1 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
In June 2018, the Company issued and sold an additional $218.5 million in aggregate principal amount of 1.0% Convertible Notes (the “June 2025 Notes”). The June 2025 Notes were issued under the same indenture pursuant to which the Company previously issued the January 2025 Notes (the “Indenture”). The January 2025 Notes and the June 2025 Notes had identical terms (including the same January 15, 2025 maturity date) and were treated as a single series of securities. The net proceeds from the issuance of the June 2025 Notes were approximately $225.3 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
In March 2019, the Company issued and sold $747.5 million in aggregate principal amount of 0.375% Convertible Notes (the “2027 Notes”) with a maturity date of March 15, 2027. The 2027 Notes accrue interest at a fixed rate of 0.375% per year, payable semi-annually in arrears on March 15 and September 15 of each year, beginning on September 15, 2019. The net proceeds from the issuance of the 2027 Notes were approximately $729.5 million, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
The Company utilized a portion of the proceeds from the issuance of the 2027 Notes to settle a portion of the 2025 Notes in privately negotiated transactions. In March 2019, the Company used cash of $494.1 million and an aggregate of 2.2 million shares of the Company’s common stock valued at $182.4 million for total consideration of $676.5 million to settle $493.4 million of the 2025 Notes, of which $0.7 million was used to pay off interest accrued on the 2025 Notes. The transaction resulted in a loss on settlement of convertible notes of $187.7 million.
In February 2020, the Company issued and sold $1.15 billion in aggregate principal amount of 0.375% Convertible Notes (the “2028 Notes”) with a maturity date of March 1, 2028. The 2028 Notes accrue interest at a fixed rate of 0.375% per year, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2020. The net proceeds from the issuance of the 2028 Notes were approximately $1.13 billion, after deducting underwriting discounts and commissions and the offering expenses payable by the Company.
In February 2020, the Company used $150.1 million of the proceeds from the issuance of the 2028 Notes to settle $100.0 million of the 2025 Notes, of which $0.1 million was used to pay off interest accrued on the 2025 Notes. The transaction resulted in a loss on settlement of convertible notes of $50.8 million.
In February 2023, the Company entered into a privately negotiated exchange and purchase agreement with a single holder of certain of the Company’s 2027 Notes and 2028 Notes. The Company issued the holder $500.0 million aggregate principal amount of 2.0% Convertible Notes due in 2030 (the “2030 Notes”) in exchange for $183.7 million of aggregate principal of 2027 Notes, $201.0 million of aggregate principal of 2028 Notes, and $138.0 million of cash. The extinguishment resulted in a gain on settlement of convertible notes of $17.7 million, which is included in interest expense, net in the consolidated statement of operations for the year ended December 31, 2023.
In March 2023, the Company entered into a privately negotiated exchange agreement with two holders of certain of the 2025 Notes. The Company issued the holder $73.0 million aggregate principal amount of 2030 Notes in exchange for $65.8 million of aggregate principal of 2025 Notes. The extinguishment resulted in a loss on settlement of convertible notes of $7.4 million, which is included in interest expense, net in the consolidated statement of operations for the year ended December 31, 2023.
The net proceeds from the issuance of the 2030 Notes were approximately $133.0 million, after deducting commissions and offering expenses payable by the Company. The 2030 Notes will mature on March 1, 2030 and bear interest at a rate of 2.0% per year, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on September 1, 2023.
In April 2024, the Company entered into a privately negotiated exchange and purchase agreement with certain holders of the Company’s 2028 Notes. The Company issued $620.7 million aggregate principal amount of 1.75% Convertible Notes due in 2031 (the “2031 Notes”) in exchange for $359.7 million of aggregate principal of 2028 Notes, and $266.8 million of cash after deducting underwriting discounts. The extinguishment resulted in a gain on settlement of convertible notes of $10.3 million, which is included in interest expense, net in the consolidated statement of operations for the year ended December 31, 2024.
The net proceeds from the issuance of the 2031 Notes were approximately $259.8 million, after deducting commissions and offering expenses payable by the Company.
The 2031 Notes will mature on April 15, 2031 and bear interest at a rate of 1.75% per year, payable semi-annually in arrears on October 15 and April 15 of each year, beginning on October 15, 2024. The Company has the ability to repurchase the 2031 Notes after April 17, 2029 upon the occurrence of certain events and during certain periods, as set forth in the Indenture filed at the time of the offering.
The extinguishment gains and losses recorded on the settlement of convertible notes discussed above represent the difference between (i) the fair value of the consideration transferred and (ii) the carrying value of the debt at the time of the exchange, and is included in interest expense, net in the consolidated statement of operations for the respective period.
Summary of Conversion Features
Until the six months immediately preceding the maturity date of the applicable series of the Company’s convertible notes (the “Notes”), each series of Notes is convertible only upon the occurrence of certain events and during certain periods, as set forth in the Indentures filed at the time of the original offerings. On or after the date that is six months immediately preceding the maturity date of the applicable series of Notes until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may elect to convert such Notes at any time, and if elected, the conversion would occur on the maturity date. The Notes will be convertible into cash, shares of the Company’s common stock (plus, if applicable, cash in lieu of any fractional share), or a combination of cash and shares of the Company’s common stock, at the Company’s election. If the Notes are not converted prior to the maturity date, the principal amount will be settled in cash upon maturity.
It is the Company’s intent to settle all conversions through combination settlement. The initial conversion rate is 8.96, 8.21, 12.37, and 10.06 shares of common stock per $1,000 principal amount for the 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes, respectively, which is equivalent to an initial conversion price of approximately $111.66, $121.84, $80.83, and $99.36 per share of the Company’s common stock for the 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes, respectively. The 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes are potentially convertible into up to 5.0 million, 4.8 million, 7.1 million, and 6.2 million shares, respectively. The conversion rate is subject to adjustment upon the occurrence of certain specified events as set forth in the Indentures filed at the time of the original offerings but will not be adjusted for accrued and unpaid interest. In addition, holders of the Notes who convert their Notes in connection with a “make-whole fundamental change” (as defined in the Indentures), will, under certain circumstances, be entitled to an increase in the conversion rate.
If the Company undergoes a “fundamental change” (as defined in the Indentures), holders of the Notes may require the Company to repurchase for cash all or part of their Notes at a repurchase price equal to 100% of the principal amount of the Notes to be repurchased, plus accrued and unpaid interest.
Based on the closing price of the Company’s common stock of $101.56 on December 31, 2025, the if-converted values on the 2027 Notes and 2028 Notes do not exceed the principal amount. The if-converted values on the Company's 2030 Notes and 2031 Notes exceed the principal amount by $147.0 million and $13.7 million, respectively.
The Notes do not contain any financial or operating covenants or any restrictions on the payment of dividends, the issuance of other indebtedness or the issuance or repurchase of securities by the Company.
Ranking of Convertible Notes
The Notes are the Company’s senior unsecured obligations and (i) rank senior in right of payment to all of its future indebtedness that is expressly subordinated in right of payment to the Notes; (ii) rank equal in right of payment to each outstanding series thereof and to all of the Company’s future liabilities that are not so subordinated, unsecured indebtedness; (iii) are effectively junior to all of the Company’s existing and future secured indebtedness and other secured obligations, to the extent of the value of the assets securing that indebtedness and other secured obligations; and (iv) are structurally subordinated to all indebtedness and other liabilities of the Company’s subsidiaries.
Issuance Costs
Issuance costs are amortized to interest expense, net over the term of the Notes. The following table summarizes the original issuance costs at the time of issuance for each set of Notes:
(In thousands)
2031 Convertible Notes$6,780 
2030 Convertible Notes
4,938 
2028 Convertible Notes
24,453 
2027 Convertible Notes
14,285 
2025 Convertible Notes
17,646 
Interest Expense
Interest expense on the Notes includes the following:
Year Ended December 31,
(In thousands)202520242023
Debt issuance costs amortization$4,609 $5,296 $5,350 
Debt discount amortization1,520 933 106 
Gain on settlement of convertible notes— (10,254)(10,324)
Coupon interest expense26,737 26,339 18,072 
Total interest expense on convertible notes$32,866 $22,314 $13,204 
The following table summarizes the effective interest rates of the Notes:
Year Ended December 31,
202520242023
2031 Convertible Notes2.14 %2.06 %— %
2030 Convertible Notes2.14 %2.09 %2.09 %
2028 Convertible Notes0.65 %0.63 %0.63 %
2027 Convertible Notes0.68 %0.67 %0.67 %
2025 Convertible Notes1.05 %1.16 %1.17 %
The remaining period over which the unamortized debt discount will be recognized as non-cash interest expense is 1.20 years, 2.17 years, 4.17 years, and 5.29 years for the 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes, respectively.
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS
 12 Months Ended
Dec. 31, 2025
LICENSE AGREEMENTS [Abstract]  
LICENSE AND COLLABORATION AGREEMENTS LICENSE AND COLLABORATION AGREEMENTS 
The Company licenses certain technologies that are, or may be, incorporated into its technology under several license agreements, as well as the rights to commercialize certain diagnostic tests through collaboration agreements. Generally, the license agreements require the Company to pay single-digit royalties based on net revenues received using the technologies and may require minimum royalty amounts, milestone payments, or maintenance fees.
Mayo Foundation for Medical Education and Research
In June 2009, the Company entered into an exclusive, worldwide license agreement with the Mayo Foundation for Medical Education and Research (“Mayo”), under which Mayo granted the Company an exclusive, worldwide license to certain Mayo patents and patent applications, as well as a non-exclusive, worldwide license with regard to certain Mayo know-how. The scope of the license covers any screening, surveillance or diagnostic test or tool for use in connection with any type of cancer, pre-cancer, disease or condition. The Company’s license agreement with Mayo was most recently amended and restated in September 2020.
The licensed Mayo patents and patent applications contain both method and composition claims that relate to sample processing, analytical testing and data analysis associated with nucleic acid screening for cancers and other diseases. The jurisdictions covered by these patents and patent applications include the U.S., Australia, Canada, the European Union, China, Japan and Korea. Under the license agreement, the Company assumed the obligation and expense of prosecuting and maintaining the licensed Mayo patents and is obligated to make commercially reasonable efforts to bring to market products using the licensed Mayo intellectual property.
Pursuant to the Company’s agreement with Mayo, the Company is required to pay Mayo a low-single-digit royalty on the Company’s net sales of current and future products using the licensed Mayo intellectual property each year during the term of the Mayo agreement.
The Company is also required to pay Mayo up to $3.0 million in sales-based milestone payments upon cumulative net sales of each product using the licensed Mayo intellectual property reaching specified levels.
The license agreement will remain in effect, unless earlier terminated by the parties in accordance with the agreement, until the last of the licensed patents expires in 2039 (or later, if certain licensed patent applications are issued). However, if the Company is still using the licensed Mayo know-how or certain Mayo-provided biological specimens or their derivatives on such expiration date, the term shall continue until the earlier of the date the Company stops using such know-how and materials and the date that is five years after the last licensed patent expires. The license agreement contains customary termination provisions and permits Mayo to terminate the license agreement if the Company sues Mayo or its affiliates, other than any such suit claiming an uncured material breach by Mayo of the license agreement.
In addition to granting the Company a license to the covered Mayo intellectual property, Mayo provides the Company with product development and research and development assistance pursuant to the license agreement and other collaborative arrangements. In connection with this collaboration, the Company has incurred insignificant charges for the years ended December 31, 2025, 2024, and 2023, respectively. The charges incurred in connection with this collaboration are recorded in research and development expenses in the Company’s consolidated statements of operations.
Johns Hopkins University
Through the acquisition of Thrive, the Company acquired a worldwide exclusive license agreement with Johns Hopkins University (“JHU”) for use of several JHU patents and licensed know-how. The license is designed to enable the Company to leverage JHU intellectual property in the development and commercialization of certain of its products. The agreement terms would require the Company to pay single-digit sales-based royalties and up to $45.0 million in sales-based milestone payments on JHU licensed products that reach specified net sales levels. The Company will record the sales-based royalties once sales of licensed products have occurred and sales-based milestones once achievement is deemed probable. The Company recorded insignificant charges related to sales-based royalties during the year ended December 31, 2025, and the Company has not incurred charges related to the achievement of any sales-based milestones as of December 31, 2025.
Targeted Digital Sequencing (“TARDIS”) License Agreement
In January 2021, the Company entered into an exclusive, worldwide license to the proprietary TARDIS technology from The Translational Genomics Research Institute (“TGen”). Under the agreement, the Company acquired a royalty-free, worldwide exclusive license to proprietary TARDIS patents and know-how. Under the agreement, the Company was obligated to make milestone payments to TGen of up to $45.0 million in sales-based milestone payments upon cumulative net sales related to molecular residual disease (“MRD”) detection and/or treatment reaching specified levels. These payments were contingent upon achievement of these cumulative revenues on or before December 31, 2030, which was not achieved prior to the termination.
Effective May 1, 2024, the Company entered into termination agreements (the “Termination Agreements”) with TGen for the purpose of terminating the license and sponsored research agreement relating to the TARDIS technology and an additional sponsored research agreement with a broader scope (collectively, the “Original Agreements”). As part of the Termination Agreements, the Company will pay TGen $27.6 million in compensation for the termination of the Original Agreements, which will be allocated into three annual installments of $9.2 million per year beginning in the second quarter of 2024. The fair value of the termination payments as of the date of the Termination Agreements was $25.8 million, which was recorded as research and development expense in the consolidated statement of operations for the year ended December 31, 2024. The remaining $1.8 million in expense is being recognized ratably through the date of the final payment in the second quarter of 2026. The Company has recorded a liability of $9.0 million representing the fair value of the remaining payments, which is included in accrued liabilities on the consolidated balance sheet as of December 31, 2025. The termination payments eliminate the Company’s obligation to pay TGen any further payments, equities, fees, costs, or other amounts that would have been due under the Original Agreements, including the milestone payments. The Company’s ongoing development efforts for its pipeline tests are not impacted by the Termination Agreements.
Broad Institute, Inc.
In June 2023, the Company entered into an exclusive license agreement with Broad Institute, Inc. (“Broad Institute”) to utilize the Minor Allele Enriched Sequencing Through Recognition Oligonucleotides (“MAESTRO”) technology in the Company’s MRD testing. Under the license agreement, the Company is obligated to make development milestone payments to Broad Institute of up to $6.5 million upon achievement of certain development milestones related to prospective MRD tests that use the MAESTRO technology. In addition, the Company is obligated to make sales-based milestone payments to Broad Institute that equate up to a mid-single-digit royalty upon the achievement of certain cumulative net sales targets of licensed products using the MAESTRO technology beginning at $500.0 million. The Company will record the development milestones once achieved and the sales milestones once achievement is deemed probable. The Company has not incurred charges related to the achievement of development milestones or sales milestones as of December 31, 2025.
Watchmaker Genomics, Inc.
In July 2023, the Company entered into a co-exclusive development and license agreement with Watchmaker Genomics, Inc. (“Watchmaker”) under which the Company granted Watchmaker a co-exclusive license to the non-bisulfite technology for the detection of methylated DNA and other epigenetic modifications (“TAPS”). TAPS is based on patents obtained by the Company through an exclusive license agreement with the Ludwig Institute for Cancer Research. Under the agreement, both parties have the right to use and develop TAPS for commercial purposes. The Company has the potential to receive up to $82.0 million in sales-based milestone payments and mid-single-digit royalties based on future Watchmaker net sales of licensed products including TAPS. Additionally, Watchmaker has the right to sublicense TAPS, and the Company has the potential to receive royalties based on future Watchmaker sublicense receipts. The Company has not received any sales-based milestone payments, royalties on Watchmaker net sales of licensed products, or royalties on Watchmaker sublicense receipts as of December 31, 2025.
TwinStrand Biosciences, Inc.
In July, 2024, the Company entered into an agreement with TwinStrand Biosciences, Inc. (“TwinStrand”), under which TwinStrand licensed to the Company intellectual property related to the error correction technology in next-generation sequencing. The Company’s rights are broadly exclusive with respect to cell-free nucleic acid sequencing, subject to certain non-exclusive relationships in the field. The Company also holds exclusive rights to sublicense the licensed intellectual property. Under the license agreement, the Company made upfront payments to TwinStrand totaling $45.0 million in July 2024. The upfront payments were capitalized as a patent and license intangible asset in the consolidated balance sheet, which is amortized over its estimated useful life of 10 years. In addition, the Company agreed to pay TwinStrand a low-single-digit royalty on the Company’s and any sublicensee's net sales of certain licensed products and services. The Company will record the sales-based royalties once sales using relevant licensed products and services have occurred. Sublicense revenue and sales-based royalty charges were not significant for the year ended December 31, 2025.
Freenome Holdings, Inc.
In August 2025, the Company entered into a Collaboration and License Agreement (the “Agreement”) with Freenome Holdings, Inc., under which the Company and Freenome will collaborate to develop and commercialize certain blood-based screening and diagnostic products (“Collaboration Products”) for colorectal cancer (“CRC”). Upon execution of the Agreement, the Company has co-exclusive rights to commercialize Freenome’s existing CRC screening test as a laboratory developed test in the United States. Upon the later of (1) certain requirements related to antitrust clearance being satisfied (the “Antitrust Clearance Date”) and (2) receipt of first-line U.S. Food and Drug Administration (“FDA”) approval for a Collaboration Product, the Company will obtain exclusive rights to commercialize such Collaboration Products in the United States.
Under the terms of the Agreement, the Company made a payment to Freenome of $75.0 million in cash in November 2025. The Company received antitrust clearance in November 2025, and the upfront payment was recognized as research and development expense in the consolidated statement of operations in the fourth quarter of 2025.
Up to an additional $700.0 million would be payable based upon the achievement of certain development and regulatory milestones, which include a $100.0 million payment upon first-line FDA approval of a Collaboration Product, $100.0 million upon first-line FDA approval for the next-generation test contingent on meeting pre-defined performance benchmarks, and $500.0 million upon a Collaboration Product being rated as a first-line A or B test in the United States Preventive Services Taskforce (“USPSTF”) guidelines or meeting certain payer contracted coverage requirements. If the pre-defined performance benchmarks are not achieved, or if the Collaboration Product is rated as a second-line A or B test in the USPSTF guidelines, then each respective milestone payment may be reduced as provided in the Agreement. The Company will record the development milestones once achieved, and there have no charges incurred as of December 31, 2025.
The Company will pay Freenome a laboratory service fee for each CRC blood test processed by Freenome on behalf of the Company prior to laboratory testing being transferred to the Company’s facilities, which will be recognized as cost of sales as incurred. In addition, the Company will pay sales royalties on all net sales of Collaboration Products ranging from 0% to 10% depending on the test’s profitability and subject to customary royalty stacking provisions.
The Company also committed to $20.0 million in joint development costs annually over three years, which began on the Antitrust Clearance Date, and the costs incurred are recognized as research and development expenses as incurred.
Additionally, the Company purchased a $50.0 million senior convertible note as discussed in further detail in Note 7.
v3.25.4
STOCKHOLDERS' EQUITY
 12 Months Ended
Dec. 31, 2025
Equity [Abstract]  
STOCKHOLDERS' EQUITY STOCKHOLDERS' EQUITY
Changes in Accumulated Other Comprehensive Income (Loss)
The amount recognized in AOCI for the years ended December 31, 2025, 2024 and 2023 were as follows:
(In thousands)Cumulative Translation Adjustment
Unrealized Gain (Loss) on Securities (1)
AOCI
Balance at January 1, 2023
$53 $(5,289)$(5,236)
Other comprehensive income before reclassifications
1,321 1,416 2,737 
Amounts reclassified from accumulated other comprehensive income (loss)
— 3,927 3,927 
Net current period change in accumulated other comprehensive income (loss)
1,321 5,343 6,664 
Balance at December 31, 2023$1,374 $54 $1,428 
Other comprehensive income (loss) before reclassifications(3,294)873 (2,421)
Amounts reclassified from accumulated other comprehensive income (loss)
— 49 49 
Net current period change in accumulated other comprehensive income (loss)
(3,294)922 (2,372)
Balance at December 31, 2024$(1,920)$976 $(944)
Other comprehensive income before reclassifications
4,278 — 4,278 
Amounts reclassified from accumulated other comprehensive income (loss)
— (976)(976)
Net current period change in accumulated other comprehensive income (loss)
4,278 (976)3,302 
Balance at December 31, 2025$2,358 $— $2,358 
_________________________________
(1)There was no tax impact from the amounts recognized in AOCI for the years ended December 31, 2025, 2024, and 2023. The unrealized gain (loss) recorded on available-for-sale securities is a non-cash investing activity.
Amounts reclassified from AOCI for the years ended December 31, 2025, 2024, and 2023 were as follows:
Year Ended December 31,
Details about AOCI Components (In thousands)Affected Line Item in the
Statements of Operations		202520242023
Change in value of available-for-sale investments
Sales and maturities of available-for-sale investments
Investment income, net
$(976)$49 $3,927 
Total reclassifications$(976)$49 $3,927 
v3.25.4
STOCK-BASED COMPENSATION
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
STOCK-BASED COMPENSATION STOCK-BASED COMPENSATION
Stock-Based Compensation Plans
The Company maintains the following plans for which awards were granted from or had awards outstanding in 2025: the 2010 Omnibus Long-Term Incentive Plan (As Amended and Restated Effective July 27, 2017), the 2019 Omnibus Long-Term Incentive Plan, the 2025 Omnibus Long-Term Incentive Plan, and the 2010 Employee Stock Purchase Plan. These plans are collectively referred to as the “Stock Plans.”
The Stock Plans are administered by the Human Capital Committee of the Company’s Board of Directors (“Human Capital Committee”). The 2019 Omnibus Long-Term Incentive Plan provides that upon an acquisition of the Company, all equity will accelerate by a period of one year. In addition, upon the termination of an employee without cause or for good reason prior to the first anniversary of the completion of the acquisition, all equity awards then outstanding under the respective plan held by that employee will immediately vest.
2025 Omnibus Long-Term Incentive Plan. The Company adopted the 2025 Omnibus Long-Term Incentive Plan (the “2025 Stock Plan”) on June 12, 2025 to grant share-based awards to employees, officers, directors, consultants, and advisors. Awards granted under the 2025 Stock Plan may include incentive stock options, as defined under the Internal Revenue Code, non-qualified options, restricted stock awards and other stock awards in amounts and with terms and conditions determined by the Human Capital Committee, subject to the provisions of the 2025 Stock Plan. The 2025 Stock Plan will expire on April 15, 2035 and after such date no further awards may be granted under the plan. Options granted under the 2025 Stock Plan expire ten years from the date of grant. Grants made from the 2025 Stock Plan generally vest over a period of three to four years. At December 31, 2025, there were no options to purchase shares outstanding under the 2025 Stock Plan and 66,320 shares of restricted stock and restricted stock units were outstanding. At December 31, 2025, there were 12,357,179 shares available for future grant under the 2025 Stock Plan.
2019 Omnibus Long-Term Incentive Plan. The Company adopted the 2019 Omnibus Long-Term Incentive Plan (the “2019 Stock Plan”) on July 25, 2019 to grant share-based awards to employees, officers, directors, consultants, and advisors. Awards granted under the 2019 Stock Plan may include incentive stock options, as defined under the Internal Revenue Code, non-qualified options, restricted stock awards and other stock awards in amounts and with terms and conditions determined by the Human Capital Committee, subject to the provisions of the 2019 Stock Plan. The 2019 Stock Plan will expire on July 25, 2029 and after such date no further awards may be granted under the plan. Options granted under the 2019 Stock Plan expire ten years from the date of grant. Grants made from the 2019 Stock Plan generally vest over a period of three to four years. At December 31, 2025, options to purchase 270,749 shares were outstanding under the 2019 Stock Plan and 7,874,434 shares of restricted stock and restricted stock units were outstanding. The Company's stockholders approved amendments to the 2019 Stock Plan to increase the number of shares available for future grant thereunder by 14,000,000 and 4,340,000 shares on June 9, 2022 and June 8, 2023, respectively. At December 31, 2025, there were no shares available for future grant under the 2019 Stock Plan.
2010 Omnibus Long-Term Incentive Plan. The Company adopted the 2010 Omnibus Long-Term Incentive Plan (the “2010 Stock Plan”) on July 16, 2010 to grant share-based awards to employees, officers, directors, consultants, and advisors. Awards granted under the 2010 Stock Plan may include incentive stock options, as defined under the Internal Revenue Code, non-qualified options, restricted stock awards and other stock awards in amounts and with terms and conditions determined by the Human Capital Committee, subject to the provisions of the 2010 Stock Plan. The 2010 Stock Plan expired on July 16, 2020 and after such date no further awards may be granted under the plan. Options granted under the 2010 Stock Plan expire ten years from the date of grant. Grants made from the 2010 Stock Plan generally vest over a period of three to four years. At December 31, 2025, there were 510,540 share options and 3,340 shares of restricted stock and restricted stock units outstanding under the 2010 Stock Plan. At December 31, 2025, there were no shares available for future grant under the 2010 Stock Plan.
2010 Employee Stock Purchase Plan. The 2010 Employee Stock Purchase Plan (the “2010 Purchase Plan”) was adopted by the Company on July 16, 2010 to provide participating employees the right to purchase shares of common stock at a discount through a series of offering periods. The 2010 Purchase Plan will expire on October 31, 2030. The Company’s stockholders approved amendments to the 2010 Employee Stock Purchase Plan to increase the number of shares available for purchase thereunder by 500,000 shares, 2,000,000 shares, 3,000,000 shares, and 4,000,000 shares on July 24, 2014, July 28, 2016, June 9, 2022, and June 12, 2025, respectively. At December 31, 2025, there were 4,193,108 shares of common stock available for purchase by participating employees under the 2010 Purchase Plan.
Generally, all employees whose customary employment is more than 20 hours per week and more than five months in any calendar year are eligible to participate in the 2010 Purchase Plan. Participating employees authorize an amount, between 1% and 15% of the employee’s compensation, to be deducted from the employee’s pay during the offering period. On the last day of the offering period, the employee is deemed to have exercised the employee’s option to purchase shares of Company common stock, at the option exercise price, to the extent of accumulated payroll deductions. Under the terms of the 2010 Purchase Plan, the option exercise price is an amount equal to 85% of the fair market value, as defined under the 2010 Purchase Plan, and no employee can purchase more than $25,000 of Company common stock under the 2010 Purchase Plan in any calendar year. Rights granted under the 2010 Purchase Plan terminate upon an employee’s voluntary withdrawal from the 2010 Purchase Plan at any time or upon termination of employment. At December 31, 2025, there were 5,606,892 cumulative shares issued under the 2010 Purchase Plan.
Stock-Based Compensation Expense
The Company records stock-based compensation expense in connection with the amortization of restricted stock and restricted stock unit awards (“RSUs”), performance share units (“PSUs”), stock purchase rights granted under the Company’s employee stock purchase plan (“ESPP”) and stock options granted to employees, non-employee consultants, and non-employee directors. A summary of non-cash stock-based compensation expense by expense category included in the Company’s consolidated statements of operations for the years ended December 31, 2025, 2024, and 2023 is as follows:
Year Ended December 31,
(In thousands)202520242023
Cost of sales$17,244 $20,518 $20,761 
Research and development37,379 39,684 41,242 
Sales and marketing66,762 68,236 73,016 
General and administrative96,281 86,447 96,293 
Total stock-based compensation$217,666 $214,885 $231,312 
In connection with the Merger Agreement and to mitigate the potential impact of Sections 280G and 4999 of the Internal Revenue code of 1986, as amended, on the Company and certain of its employees, the Human Capital Committee approved the acceleration of 454,811 shares of previously unvested RSUs held by 12 employees and 1,227,496 shares of previously unvested PSUs held by 14 employees. Accelerated PSUs were accelerated based on the number of PSUs that would have otherwise been deemed achieved under the terms of the Merger Agreement. These modifications resulted in incremental stock-based compensation expense that will be recognized over the in substance service period of the respective award, which was not significant for the year ended December 31, 2025.
As of December 31, 2025, there was approximately $314.9 million of expected total unrecognized compensation cost related to non-vested stock-based compensation arrangements granted under all equity compensation plans. The Company expects to recognize that cost over a weighted average period of 2.33 years.
Stock Options
The Company determined the fair value of each service-based option award on the date of grant using the Black-Scholes option-pricing model, which utilized several key assumptions including risk-free interest rate, expected term, expected volatility, and dividend yield. There were no option awards granted during the years ended December 31, 2025, 2024 and 2023.
A summary of stock option activity under the Stock Plans is as follows:
OptionsSharesWeighted Average Exercise PriceWeighted Average Remaining Contractual Term (Years)Aggregate Intrinsic Value (1)
(Aggregate intrinsic value in thousands)
Outstanding, January 1, 2025
982,742 $53.60 3.1
Exercised(161,596)27.48 
Forfeited(39,857)85.58 
Outstanding, December 31, 2025
781,289 $57.37 2.4$34,528 
Vested and expected to vest, December 31, 2025
781,289 $57.37 2.4$34,528 
Exercisable, December 31, 2025
781,289 $57.37 2.4$34,528 
_________________________________
(1)     The total intrinsic value of options exercised, net of shares withheld for taxes, during the years ended December 31, 2025, 2024, and 2023 was $6.0 million, $7.8 million, and $11.7 million, respectively, determined as of the date of exercise.
Restricted Stock and Restricted Stock Units
The fair value of restricted stock and RSUs is determined on the date of grant using the closing stock price on that day.
A summary of restricted stock and RSU activity is as follows:
Restricted SharesWeighted Average Grant Date Fair Value (1)
Outstanding, January 1, 2025
7,244,796 $63.18 
Granted3,661,929 51.61 
Released (2)(3,102,685)66.18 
Forfeited(907,813)55.98 
Outstanding, December 31, 2025
6,896,227 $56.12 
_________________________________
(1)     The weighted average grant date fair value of the RSUs granted during the years ended December 31, 2024 and 2023 was $56.94 and $62.36, respectively.
(2)     The fair value of RSUs vested and converted to shares of the Company’s common stock was $205.3 million, $184.2 million, and $158.2 million for the years ended December 31, 2025, 2024, and 2023, respectively. The stock-based compensation expense associated with the RSUs that were accelerated and vested in 2025 related to the modification of awards to mitigate the potential impact of Sections 280G and 4999 of the Internal Revenue Code of 1986, as amended, as discussed in further detail above, will continue to be recognized over the substantive service period of the respective award.
Performance Share Units
The Company has issued performance-based equity awards to certain employees which vest upon the achievement of certain performance goals, including financial performance targets and operational milestones.
A summary of PSU activity is as follows:
Performance Share Units (1)Weighted Average Grant Date Fair Value (2)
Outstanding, January 1, 20252,021,208 $75.86 
Granted1,283,717 59.49 
Released (3)(1,380,061)79.03 
Forfeited(876,997)81.24 
Outstanding, December 31, 20251,047,867 $62.20 
_________________________________
(1)     The PSUs listed above assumes attainment of maximum payout rates as set forth in the performance criteria. Applying actual or expected payout rates, the number of outstanding PSUs as of December 31, 2025 was 631,833.
(2)     The weighted average grant date fair value of the PSUs granted during the years ended December 31, 2024 and 2023 was $63.68 and $80.50, respectively.
(3)     The fair value of PSUs vested and converted to shares of the Company’s common stock was $77.2 million, $9.9 million, and $1.0 million for the years ended December 31, 2025, 2024, and 2023, respectively. The stock-based compensation expense associated with the PSUs that were accelerated and vested in 2025 related to the modification of awards to mitigate the potential impact of Sections 280G and 4999 of the Internal Revenue Code of 1986, as amended, as discussed in further detail above, will continue to be recognized over the substantive service period of the respective award.
Employee Stock Purchase Plan
A summary of ESPP activity is as follows:
Year Ended December 31,
(in thousands, except share and per share amounts)202520242023
Shares issued under the 2010 Purchase Plan685,693 955,392924,448
Cash received under the 2010 Purchase Plan$26,544 $31,227 $28,344 
Weighted average fair value per share of stock purchase rights granted during the period$19.17 $16.26 $16.32 
The 685,693 shares issued during the year ended December 31, 2025 were as follows:
Offering period endedNumber of SharesWeighted Average price per Share
April 30, 2025419,070 $38.26 
October 31, 2025266,623 $39.42 
The fair value of shares purchased under the ESPP is based on the assumptions in the following table:
Year Ended December 31,
202520242023
Risk-free interest rates
4.22% - 5.15%
4.71% - 5.30%
4.68% - 4.71%
Expected term (in years)
0.50 - 1.25
1.17 - 1.25
1.25
Expected volatility
44.40% - 60.67%
44.40% - 63.13%
63.13% - 67.30%
Dividend yield0%0%0%
Shares Reserved for Issuance
The Company has reserved shares of its authorized common stock for issuance pursuant to its employee stock purchase and equity plans, including all outstanding stock option grants noted above at December 31, 2025, as follows:
Shares reserved for issuance
2025 Stock Plan
12,357,179 
2010 Purchase Plan4,193,108 
16,550,287 
v3.25.4
COMMITMENTS AND CONTINGENCIES
 12 Months Ended
Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]  
COMMITMENTS AND CONTINGENCIES COMMITMENTS AND CONTINGENCIES
Leases
The components of lease expense were as follows:
Year Ended December 31,
(In thousands)202520242023
Finance lease cost
Amortization of right-of-use assets$6,554 $7,311 $3,845 
Interest on lease liabilities1,047 1,406 800 
Operating lease cost32,870 31,797 36,576 
Short-term lease cost946 1,036 750 
Variable lease cost8,218 9,055 8,449 
Total lease Cost$49,635 $50,605 $50,420 
Supplemental disclosure of cash flow information related to the Company’s cash and non-cash activities with its leases are as follows:
Year Ended December 31,
(In thousands)202520242023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$41,253$38,135$39,301
Operating cash flows from finance leases1,0831,359783
Finance cash flows from finance leases6,4216,8273,569
Non-cash investing and financing activities:
Right-of-use assets obtained in exchange for new operating lease liabilities29,27319,6744,986
Right-of-use assets obtained in exchange for new finance lease liabilities—16,4255,443
Weighted-average remaining lease term - operating leases (in years)6.887.376.87
Weighted-average remaining lease term - finance leases (in years)2.222.902.80
Weighted-average discount rate - operating leases6.50 %6.54 %6.59 %
Weighted-average discount rate - finance leases6.65 %6.69 %7.43 %
As of December 31, 2025 and 2024, the Company’s right-of-use assets from operating leases are $122.3 million and $117.0 million, respectively, which are reported in operating lease right-of-use assets in the Company’s consolidated balance sheets. As of December 31, 2025, the Company has outstanding operating lease obligations of $195.5 million, of which $33.6 million is reported in operating lease liabilities, current portion and $161.9 million is reported in operating lease liabilities, less current portion in the Company’s consolidated balance sheet. As of December 31, 2024, the Company had outstanding operating lease obligations of $184.5 million, of which $27.4 million is reported in operating lease liabilities, current portion and $157.1 million is reported in operating lease liabilities, less current portion in the Company’s consolidated balance sheet.
In the third quarter of 2024, the Company recorded an impairment charge of $18.7 million, which consisted of a right-of-use asset of $11.8 million and associated leasehold improvements of $6.9 million relating to one of its domestic facilities that was vacated in the fourth quarter of 2024 as a result of a change in strategic priorities. The Company used the income approach, under which the recoverability of the assets was measured by comparing the carrying amount of the asset to future undiscounted, pre-tax cash flows generated by the assets held. The fair value of the assets was determined using discounted cash flows, and the impairment charge recorded represents the difference between the carrying value and fair value of the impaired assets. The impairment charge recorded is included in impairment of long-lived and indefinite-lived assets in the Company’s consolidated statement of operations for the year ended December 31, 2024.
As of December 31, 2025 and 2024, the Company’s right-of-use assets from finance leases are $11.1 million and $19.8 million, respectively, which are reported in other long-term assets, net in the Company’s consolidated balance sheets. As of December 31, 2025, the Company has outstanding finance lease obligations of $12.1 million, of which $5.7 million is reported in other current liabilities and $6.4 million is reported in other long-term liabilities in the Company’s consolidated balance sheet. As of December 31, 2024, the Company had outstanding finance lease obligations of $21.0 million, of which $7.8 million is reported in other current liabilities and $13.2 million is reported in other long-term liabilities in the Company’s consolidated balance sheet.
Maturities of operating lease liabilities on an annual basis as of December 31, 2025 were as follows:
(In thousands)
2026$43,164 
202745,208 
202835,876 
202925,806 
203017,451 
Thereafter78,654 
Total minimum lease payments246,159 
Imputed interest(50,637)
Total$195,522 
Maturities of finance lease liabilities on an annual basis as of December 31, 2025 were as follows:
(In thousands)
2026$6,284
20275,201
20281,282
202993
203093
Thereafter36
Total minimum lease payments12,989
Imputed interest(861)
Total$12,128
Legal Matters
The Company accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such accrued costs reflect the Company’s best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, that they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices.
As of the date of this Annual Report on Form 10-K, amounts accrued for legal proceedings and regulatory matters were not significant except for the amounts accrued related to the matters discussed below. However, it is possible that in a particular quarter or annual period the Company’s financial condition, results of operations, cash flow and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of, or development in, legal and/or regulatory proceedings, including as described below. Except for the proceedings discussed below, the Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow or liquidity.
Intellectual Property Litigation Matters
In November 2023, the Company filed suit against Geneoscopy, Inc. (“Geneoscopy”) in the United States District Court for the District of Delaware, alleging that certain of Geneoscopy’s products infringe the ‘781 Patent and seeking unspecified monetary damages and injunctive relief (the “’781 Action”) and in January 2024, the Company amended the complaint, alleging that Geneoscopy has made false and misleading statements in the marketing and promotion of its product, in violation of the Lanham Act. In May 2024, the Company filed a second complaint against Geneoscopy alleging infringement of the Company’s U.S. Patent No. 11,970,746 (the “’746 Patent”), which has been consolidated with the ’781 Action. Geneoscopy filed counterclaims against the Company challenging the validity of the patents at issue and alleging breach of contract, misappropriation of trade secrets, unfair competition, and other violations of state and federal law seeking unspecified monetary damages and injunctive relief. On July 16, 2024, the Company filed a motion for preliminary injunction seeking an order prohibiting Geneoscopy from selling its infringing Colosense test in the United States. On May 27, 2025, Geneoscopy filed amended counterclaims against the Company, alleging false advertising under the Lanham Act, as well as other related violations under state law. On August 21, 2025, the Company voluntarily withdrew its motion for preliminary injunction, without prejudice, to preserve the ability to refile after the U.S. Patent and Trademark Office concludes its review of additional asserted patents.
Geneoscopy petitioned the United States Patent and Trademark Office to institute an inter partes review (“IPR”) challenging the validity of the ‘781 Patent and the ‘746 Patent before the Patent Trial and Appeals Board (“PTAB”) and the PTAB instituted review for both patents. On July 9, 2025, the PTAB issued its decision finding all claims of the ‘781 Patent unpatentable. The Company filed a notice of appeal with the United States Court of Appeals for the Federal Circuit on September 10, 2025. On February 5, 2026, the PTAB issued its decision finding all claims of the '746 patent unpatentable. A notice of appeal may be filed on or before April 9, 2026. On February 20, 2025, Geneoscopy filed a motion to stay the district court litigation pending IPR of the ‘781 and ‘746 Patents, which the Court denied on August 21, 2025.
DOS Rule Matter
In September 2023, the Company’s wholly owned subsidiary Genomic Health, Inc., which was acquired in November 2019, entered into a settlement agreement with the United States of America, acting through the Department of Justice (“DOJ”) and on behalf of the Office of Inspector General of the Department of Health and Human Services, and two qui tam relators to resolve the previously disclosed civil investigation concerning Genomic Health’s compliance with the Medicare Date of Service billing regulations (the “DOS Rule Matter”). Genomic Health entered into the settlement agreement to avoid the delay, uncertainty and expense of protracted litigation. The settlement agreement contains no admission of liability by Genomic Health.
Under the terms of the settlement agreement, the Company made a payment of $32.5 million in September 2023, of which $22.4 million is included in general and administrative expenses in the Company’s consolidated statements of operations for the year ended December 31, 2023. Following the United States’ receipt of the settlement payment, the Company was released from any civil or administrative monetary claims under the civil False Claims Act and other specified civil statutes and common law theories of liability concerning the conduct identified in the settlement agreement.
On September 29, 2023, the United States District Court for the Eastern District of New York unsealed two qui tam actions filed under the False Claims Act involving the DOS Rule Matter, and on October 2, 2023, those two actions were dismissed with prejudice pursuant to the terms of the settlement agreement.
Gift Card Matter
In September 2023, the Company entered into a settlement agreement to resolve the previously disclosed False Claims Act qui tam suit that alleged a violation of the Federal Anti-Kickback Statute and False Claims Act for offering gift cards to patients in exchange for returning the Cologuard screening test (the “Qui Tam Suit”). In accordance with the settlement agreement, the Company made payment of $13.8 million plus legal fees in October 2023, which is included in general and administrative expenses in the Company's consolidated statement of operations for the year ended December 31, 2023. Following payment of the settlement amount, the Company was released from any civil or administrative monetary claims under the civil False Claims Act and other specified civil statutes and common law theories of liability concerning the conduct identified in the settlement agreement. On November 1, 2023, the court dismissed the qui tam suit with prejudice pursuant to the terms of the settlement agreement.
v3.25.4
Restructuring and Related Activities
 12 Months Ended
Dec. 31, 2025
Restructuring and Related Activities [Abstract]  
Restructuring and Related Activities Disclosure RESTRUCTURING AND BUSINESS TRANSFORMATION
In August 2025, the Company announced a multi-year productivity plan (the “Plan”). The Plan includes several initiatives that are intended to drive sustainable growth, improve operating leverage, and amplify the Company’s ability to invest in innovation and serve more patients. These savings are expected to primarily come from general and administrative efficiencies, that in addition to restructuring certain support functions globally, include external spend optimization, and building more automation in core operations. The Company currently expects to incur additional business transformation costs of approximately $5 million through the completion of certain initiatives already underway, which are expected to be completed by the fourth quarter of 2026. The Company continues to pursue cost savings initiatives, and to the extent further cost saving initiatives are identified, the Company could incur additional charges to implement those business transformation initiatives in future periods.
The Company recorded the following charges related to the Plan for the year ended December 31, 2025.
(In thousands)
Restructuring charges
$22,169 
Business transformation costs (1)
51,044 
Total restructuring and business transformation
$73,213 
_________________________________
(1)Business transformation costs represent non-recurring expenses for strategic projects with anticipated long-term benefits to the Company focused on cost reduction and productivity improvement that do not meet the definition of restructuring charges. For the year ended December 31, 2025, these costs primarily include consulting services, and employee termination benefits.
The restructuring charges were recorded as follows within the consolidated statement of operations for the year ended December 31, 2025:
(In thousands)
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$84 $554 $2,868 $10,884 $14,390 
Other costs
— — — 7,779 7,779 
Total restructuring charges$84 $554 $2,868 $18,663 $22,169 
The following table summarizes activity in the liability related to the Company’s restructuring initiatives:
(In thousands)Employee Termination Costs
Other Costs
Total
Balance, December 31, 2024
$— $— $— 
Charges (1)
14,390 7,779 22,169 
Payments(11,348)(7,470)(18,818)
Adjustments (2)
496 — 496 
Balance, December 31, 2025
$3,538 $309 $3,847 
_________________________________
(1)Inclusive of the reversal of employee termination related charges originally recorded in the third quarter of 2025 primarily due to certain employees identified for termination finding other positions within the Company or voluntarily separating prior to their scheduled termination date.
(2)Adjustments relate to the effects of foreign currency exchange rates.
The Company does not expect to incur additional significant costs related to this restructuring. Substantially all of the cash payments for the liability are expected to be disbursed by the middle of 2026.
v3.25.4
EMPLOYEE BENEFIT PLAN
 12 Months Ended
Dec. 31, 2025
Retirement Benefits [Abstract]  
EMPLOYEE BENEFIT PLAN EMPLOYEE BENEFIT PLAN
The Company maintains a qualified 401(k) retirement savings plan for Exact Sciences employees (the “401(k) Plan”). The Company also maintains additional retirement savings plans that are acquired as a result of business combinations. These plans are maintained for a period of time before being merged into the 401(k) Plan. Under the terms of the 401(k) Plan, participants may elect to defer a portion of their compensation into the 401(k) Plan, subject to certain limitations. Company matching contributions may be made at the discretion of the Company's Human Capital Committee.
The Human Capital Committee approved 401(k) Plan matching contributions for the years ended December 31, 2025, 2024, and 2023 in the form of Company common stock equal to 100% of a participant's elective deferrals up to 6% of the participant’s eligible compensation for that year. The Company recorded compensation expense of approximately $47.9 million, $44.1 million, and $40.6 million, respectively, in the statements of operations for the years ended December 31, 2025, 2024, and 2023.
v3.25.4
BUSINESS COMBINATIONS AND ASSET ACQUISITIONS
 12 Months Ended
Dec. 31, 2025
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]  
Business Combination, Divestiture, And Asset Acquisition ACQUISITIONS AND DIVESTITURES
Business Combinations
Resolution Bioscience, Inc.
On September 12, 2023, the Company completed the acquisition of all of the outstanding capital stock of Resolution Bioscience, Inc. from Agilent Technologies, Inc. Resolution Bioscience develops and commercializes next-generation sequencing-based precision oncology solutions through its Clinical Laboratory Improvement Amendments (“CLIA”) certified lab based in Kirkland, Washington. The acquisition provides the Company with a high-quality blood-based therapy selection platform, complementing its comprehensive, tissue-based OncoExTra® test. The Company has included the financial results of Resolution Bioscience in the consolidated financial statements from the date of the acquisition.
The acquisition date fair value of the consideration transferred for Resolution Bioscience was approximately $54.2 million, which consisted of the following:
(In thousands)
Cash$52,527 
Fair value of replaced equity awards1,675 
Total purchase price$54,202 
The Company replaced unvested RSUs with a combination-date fair value of $4.6 million. Of the total consideration for replaced equity awards, $1.7 million was allocated to the consideration transferred, and $2.9 million was deemed compensatory as it was attributable to post acquisition vesting. The compensatory replaced equity awards will be expensed over the remaining service periods on a straight-line basis.
The following unaudited pro forma financial information summarizes the combined results of operations for the Company and Resolution Bioscience, as though the companies were combined as of the beginning of January 1, 2022.
Twelve Months Ended December 31,
(In thousands)20232022
Total revenues$2,507,111 $2,097,680 
Net loss before tax(237,854)(675,091)
The unaudited pro forma financial information is presented for informational purposes only and is not indicative of the results that would have been achieved if the acquisition had taken place at such time. Expected cost savings and other synergistic benefits resulting from the acquisition were not reflected in the unaudited pro forma financial information. The Company did not have any significant, nonrecurring pro forma adjustments directly attributable to the acquisition included in the reported unaudited pro forma financial information. Revenue and net loss before tax from Resolution Bioscience included in the Company's consolidated statements of operations for the year ended December 31, 2023 was not significant.
Acquisition-related costs were not significant and were recorded within general and administrative expenses in the consolidated statement of operations. These costs include fees associated with financial, legal, accounting, and other advisors incurred to complete the acquisition.
Divestitures
Oncotype DX Genomic Prostate Score Test
On August 2, 2022, pursuant to an asset purchase agreement (the “Asset Purchase Agreement”) with MDxHealth SA (“MDxHealth”), the Company completed the sale of the intellectual property and know-how related to the Company’s Oncotype DX Genomic Prostate Score test (“GPS test”).
The Asset Purchase Agreement required MDxHealth to pay the Company up to an additional $70.0 million of contingent consideration that would be earned and receivable in cash and/or equity based on the achievement of certain revenue milestones by MDxHealth between 2023 and 2025. Under the Asset Purchase Agreement, contingent consideration would have been recognized in the consolidated statement of operations when it was probable a significant reversal of a gain would not occur. As of December 31, 2022, no contingent consideration was probable of not resulting in a significant gain reversal due to minimum revenue thresholds in place and therefore it was fully constrained.
On August 23, 2023, the Company and MDxHealth executed the Second Amendment to the Asset Purchase Agreement (the “Second Amendment”). Under the Second Amendment, the Company agreed to allow MDxHealth to defer the 2023 contingent consideration payment by three years in exchange for additional consideration and more favorable contingent consideration terms, including elimination of the minimum revenue thresholds previously required to be met under the Asset Purchase Agreement. The Company received additional consideration with a fair value of $3.1 million, which was recorded as a gain for the year ended December 31, 2023, and is included in other operating income in the consolidated statement of operations.
Under the Second Amendment, the maximum contingent consideration increased from $70.0 million to $82.5 million and the minimum revenue thresholds previously required to be met under the Asset Purchase Agreement were eliminated. As a result of the elimination of the minimum revenue thresholds, the Company determined that a significant reversal of a gain is not probable and therefore the contingent consideration is no longer constrained. The Company recorded a contingent consideration gain of $9.2 million, and $73.3 million during the years ended December 31, 2024 and 2023, respectively, which totaled the maximum contingent consideration under the Second Amendment. The gains recorded are included in other operating income in the consolidated statement of operations. The gains recorded were estimated using historical GPS test revenues by MDxHealth under the most likely amount method.
As of December 31, 2025, the remaining contingent consideration balance, which includes the amount earned during the 2023 and 2025 earnout years classified as a receivable, was $54.5 million, of which $29.8 million is included in prepaid expenses and other current assets and $24.8 million is included in other long-term assets, net on the consolidated balance sheet. As of December 31, 2024, the contingent consideration balance, which includes the amounts earned during the 2023 and 2024 earnout years classified as a receivable, was $56.6 million, of which $27.9 million is included in prepaid expenses and other current assets and $28.7 million is included in other long-term assets, net on the consolidated balance sheet. As of December 31, 2024, the remaining portion of the contingent consideration of $25.9 million was classified as a contract asset, which was included in other long-term assets, net on the consolidated balance sheet.
In April 2025, the Company received the cash payment of $28.0 million related to the 2024 earnout year, which was included in prepaid expenses and other current assets on the consolidated balance sheet as of December 31, 2024. The cash receipt is presented as a cash inflow from investing activities for the year ended December 31, 2025 on the consolidated statement of cash flows.
On January 9, 2026, the Company and MDxHealth executed the Fourth Amendment to the Asset Purchase Agreement (“Fourth Amendment”) related to the sale of the GPS test. Under the Fourth Amendment, the Company agreed to restructure the timing of the remaining contingent consideration payments in exchange for additional consideration with a fair value of $4.7 million, which will be recorded as a gain within other operating income on the consolidated statement of operations during the first quarter of 2026. The remaining contingent consideration payments will be structured with $15.0 million due on or before April 15, 2026, $18.0 million due on or before April 15, 2027, and $21.5 million due on or before April 15, 2028.
Transaction-related costs were not significant and were recorded within general and administrative expenses in the consolidated statement of operations. These costs include fees associated with financial, legal, accounting, and other advisors incurred to complete the divestiture.
v3.25.4
SEGMENT INFORMATION
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
SEGMENT INFORMATION SEGMENT INFORMATION
The Company is managed as one operating segment, and thus reports as a single reportable segment. This operating segment is focused on the development and global commercialization of clinical laboratory services allowing healthcare providers and patients to make individualized treatment decisions. The accounting policies of the segment are the same as those described in Note 1 - Summary of Significant Accounting Policies. The Company's Chief Operating Decision Maker (“CODM”), its President and Chief Executive Officer, monitors the Company's operating performance and makes decisions regarding allocation of resources to its operations at the consolidated level. The measure of segment profit or loss used by the CODM in assessing performance and deciding how to allocate resources is based on net loss. The CODM is regularly provided consolidated net loss to monitor budget versus actual results on a monthly basis to timely identify deviations from expected results, which is used in assessing performance and deciding where to reinvest profits and allocate resources predominantly in the annual budget and forecasting process. Significant segment expenses regularly provided to the CODM are those presented on the consolidated statement of operations. These significant segment expenses include cost of sales, research and development, sales and marketing, and general and administrative. Additional significant segment expenses that are not separately presented in the consolidated statement of operations include stock-based compensation, depreciation expense, and amortization of acquired intangible assets, which are presented in the consolidated statement of cash flows, and restructuring and business transformation costs, which are presented in Note 15. For the year ended December 31, 2024, impairment of long-lived and indefinite-lived assets was identified as a significant segment expense as a result of a significant impairment charge discussed in Note 6. All other items presented on the consolidated statements of operations are characterized as other segment items.
The measure of segment assets provided to and reviewed by the CODM is reported on the consolidated balance sheet as total assets. Long-lived assets located in countries outside the U.S. are not significant.
The following table summarizes total revenue from customers by geographic region. Product revenues are attributed to countries based on ship-to location.
Year Ended December 31,
(In thousands)202520242023
United States$3,023,146 $2,569,775 $2,346,489 
Outside of United States223,844 189,092 153,277 
Total revenues$3,246,990 $2,758,867 $2,499,766 
v3.25.4
INCOME TAXES
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
INCOME TAXES INCOME TAXES
Under financial accounting standards, deferred tax assets or liabilities are computed based on the differences between the financial statement and income tax bases of assets and liabilities using the enacted tax rates. Deferred income tax expense or benefit represents the change in the deferred tax assets or liabilities from period to period. At December 31, 2025, the Company had federal net operating loss, state net operating loss, and foreign net operating loss carryforwards of approximately $418.6 million, $66.9 million, and $10.9 million, respectively, for financial reporting purposes, which may be used to offset future taxable income. The Tax Cuts and Jobs Act (H.R. 1) of 2017 limits the deduction for net operating losses to 80% of current year taxable income and provides for an indefinite carryover period for federal net operating losses. Both provisions are applicable for losses arising in tax years beginning after December 31, 2017. As of December 31, 2025 the Company has $310.4 million of federal net operating loss carryovers incurred after December 31, 2017 with an unlimited carryover period and $108.2 million of federal net operating loss carryovers expiring at various dates through 2037. State and foreign net operating loss carryovers expire at various dates through 2045. All net operating loss carryforwards are subject to review and possible adjustment by federal, state, and foreign taxing jurisdictions. The Company also had federal and state research tax credit carryforwards of $93.4 million and $43.2 million, respectively, which may be used to offset future income tax liability. The federal credit carryforwards expire at various dates through 2045 and are subject to review and possible adjustment by the Internal Revenue Service. The state credit carryforwards expire at various dates through 2040 with the exception of $25.9 million of California research and development tax credits that have an indefinite carryforward period. All state tax credits are subject to review and possible adjustment by local tax jurisdictions. In the event of a change of ownership, the federal and state net operating loss and research and development tax credit carryforwards may be subject to annual limitations provided by the Internal Revenue Code and similar state provisions.
Loss before provision for taxes consisted of the following:
Year Ended December 31,
(In thousands)202520242023
Income (loss) before income taxes:
Domestic$(220,010)$(1,036,306)$(204,128)
Foreign16,122 145 2,382 
Total loss before income taxes$(203,888)$(1,036,161)$(201,746)
The expense (benefit) for income taxes consists of:
Year Ended December 31,
(In thousands)202520242023
Current expense (benefit):
Federal$— $— $— 
State1,516 933 2,266 
Foreign3,909 1,882 2,561 
Deferred tax expense (benefit):
Federal498 (4,775)2,395 
State(334)(5,145)(1,829)
Foreign(1,528)(199)(2,990)
Total income tax expense (benefit)$4,061 $(7,304)$2,403 
The Company recorded an income tax expense for the year ended December 31, 2025 of $4.1 million primarily related to current foreign and state tax expense.
The components of the net deferred tax asset with the approximate income tax effect of each type of carryforward, credit and temporary differences are as follows:
December 31,
(In thousands)20252024
Deferred tax assets:
Operating loss carryforwards$496,415 $452,410 
Tax credit carryforwards137,617 121,635 
Compensation related differences82,350 72,349 
Lease liabilities46,764 47,199 
Capitalized research and development186,957 251,760 
Other temporary differences9,497 7,271 
Tax assets before valuation allowance959,600 952,624 
Less - Valuation allowance(735,979)(708,788)
Total deferred tax assets223,621 243,836 
Deferred tax liabilities
Amortization$(174,182)$(205,764)
Property, plant and equipment(15,430)(7,160)
Lease assets(30,216)(31,266)
Other temporary differences(9,599)(6,816)
Total deferred tax liabilities(229,427)(251,006)
Net deferred tax liabilities$(5,806)$(7,170)
A valuation allowance to reduce the deferred tax assets is reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The Company has incurred significant losses since its inception and due to the uncertainty of the amount and timing of future taxable income and the realization of deferred tax liabilities, management has determined that a valuation allowance of $736.0 million and $708.8 million at December 31, 2025 and 2024, respectively, is necessary to reduce the tax assets to the amount that is more likely than not to be realized. Given the future limitations on and expiration of certain federal and state deferred tax assets, the recording of a valuation allowance resulted in a deferred tax liability of approximately $5.8 million remaining as of December 31, 2025, which is included in other long-term liabilities on the Company's consolidated balance sheet. The overall change in valuation allowance for December 31, 2025 and 2024 was an increase of $27.2 million and an increase of $243.0 million, respectively.
Activity associated with the Company's valuation allowance is as follows:
December 31,
(In thousands)202520242023
Balance as of January 1, $(708,788)$(465,832)$(419,356)
Valuation allowances established(32,224)(241,849)(44,759)
Changes to existing valuation allowances5,033 (1,107)(1,242)
Acquisition and purchase accounting— — (475)
Balance as of December 31,$(735,979)$(708,788)$(465,832)
The effective tax rate differs from the statutory tax rate due to the following:
December 31, 2025
AmountPercent
U.S. Federal statutory rate$(42,817)21.0 %
State and local taxes, net of federal income tax effect (1)
768 (0.4)
Foreign tax effects(376)0.2 
Effect of cross border laws
Subpart F38 0.0 
Tax credits
Research and development(10,861)5.3 
Other(107)0.1 
Changes in valuation allowance29,385 (14.4)
Nontaxable or nondeductible items
Stock-based compensation expense(6,906)3.4 
Non-deductible executive compensation22,552 (11.1)
Transaction costs2,987 (1.5)
Meals and entertainment3,326 (1.6)
Contingent consideration5,568 (2.7)
Other non-deductible items574 (0.3)
Other adjustments(70)— 
Effective tax rate$4,061 (2.0)%
_________________________________
(1)The majority of taxes in the state and local income tax category are reported in Wisconsin and California.
December 31,
20242023
U.S. Federal statutory rate21.0 %21.0 %
State taxes3.0 3.9 
Federal and state tax rate changes— 1.1 
Foreign tax rate differential0.1 — 
Research and development tax credits1.6 7.6 
Stock-based compensation expense(1.0)(4.4)
Non-deductible executive compensation(0.5)(3.5)
Loss on extinguishment - convertible debt— (0.7)
Other adjustments(0.1)(2.5)
Valuation allowance(23.5)(23.7)
Effective tax rate0.6 %(1.2)%
For the year ended December 31, 2025, the Company recognized an income tax benefit, representing an effective tax rate of (2.0)%. The difference between the expected statutory federal tax rate of 21.0% and the effective tax rate of (2.0)% for the year ended December 31, 2025, was primarily attributable to the valuation allowance established against the Company's current period losses.
For the year ended December 31, 2024, the Company recognized an income tax benefit, representing an effective tax rate of 0.6%. The difference between the expected statutory federal tax rate of 21.0% and the effective tax rate of 0.6% for the year ended December 31, 2024, was primarily attributable to the valuation allowance established against the Company's current period losses.
For the year ended December 31, 2023, the Company recognized an income tax expense, representing an effective tax rate of (1.2)%. The difference between the expected statutory federal tax rate of 21.0% and the effective tax rate of (1.2)% for the year ended December 31, 2023, was primarily attributable to the valuation allowance established against the Company's current period losses.
The Company had unrecognized tax benefits related to federal and state research and development tax credits of $47.5 million, $43.3 million, and $36.4 million as of December 31, 2025, 2024, and 2023, respectively. These amounts have been recorded as a reduction to the Company's deferred tax asset, if recognized they would not have an impact on the effective tax rate due to the existing valuation allowance. Certain of the Company's unrecognized tax benefits could change due to activities of various tax authorities, including possible settlement of audits, or through normal expiration of various statutes of limitations. The Company does not expect a material change in unrecognized tax benefits in the next twelve months.
The following is a tabular reconciliation of the amounts of unrecognized tax benefits:
December 31,
(In thousands)202520242023
January 1,$43,344 $36,399 $28,270 
Increase due to current year tax positions5,166 7,322 7,447 
Increase due to prior year tax positions— — 1,108 
Decrease due to prior year tax positions(1,051)(377)(426)
December 31,$47,459 $43,344 $36,399 
As of December 31, 2025, due to the carryforward of unutilized net operating losses and research and development credits, the Company is subject to U.S. federal income tax examinations for the tax years 2005 through 2025, and to state income tax examinations for the tax years 2005 through 2025. There were no interest or penalties related to income taxes that have been accrued or recognized as of and for the years ended December 31, 2025, 2024, and 2023.
The Organization for Economic Co-operation and Development has endorsed a framework (“Pillar Two”) with model rules introducing a global minimum corporate tax rate via a system where multinational groups with consolidated revenue over €750.0 million are subject to a minimum effective tax rate of 15% on income arising in low-tax jurisdictions on a country-by-country basis. Many countries have implemented laws based on these model rules, with effective dates beginning January 1, 2024. These rules do not have a material impact on the Company for the current period and, as currently designed, are not expected to materially increase the Company’s global tax costs. The Company will continue to monitor U.S. and global legislative action related to Pillar Two for potential impacts.
v3.25.4
Restructuring and Related Activities
 12 Months Ended
Dec. 31, 2025
Restructuring and Related Activities [Abstract]  
Restructuring and Related Activities Disclosure RESTRUCTURING AND BUSINESS TRANSFORMATION
In August 2025, the Company announced a multi-year productivity plan (the “Plan”). The Plan includes several initiatives that are intended to drive sustainable growth, improve operating leverage, and amplify the Company’s ability to invest in innovation and serve more patients. These savings are expected to primarily come from general and administrative efficiencies, that in addition to restructuring certain support functions globally, include external spend optimization, and building more automation in core operations. The Company currently expects to incur additional business transformation costs of approximately $5 million through the completion of certain initiatives already underway, which are expected to be completed by the fourth quarter of 2026. The Company continues to pursue cost savings initiatives, and to the extent further cost saving initiatives are identified, the Company could incur additional charges to implement those business transformation initiatives in future periods.
The Company recorded the following charges related to the Plan for the year ended December 31, 2025.
(In thousands)
Restructuring charges
$22,169 
Business transformation costs (1)
51,044 
Total restructuring and business transformation
$73,213 
_________________________________
(1)Business transformation costs represent non-recurring expenses for strategic projects with anticipated long-term benefits to the Company focused on cost reduction and productivity improvement that do not meet the definition of restructuring charges. For the year ended December 31, 2025, these costs primarily include consulting services, and employee termination benefits.
The restructuring charges were recorded as follows within the consolidated statement of operations for the year ended December 31, 2025:
(In thousands)
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$84 $554 $2,868 $10,884 $14,390 
Other costs
— — — 7,779 7,779 
Total restructuring charges$84 $554 $2,868 $18,663 $22,169 
The following table summarizes activity in the liability related to the Company’s restructuring initiatives:
(In thousands)Employee Termination Costs
Other Costs
Total
Balance, December 31, 2024
$— $— $— 
Charges (1)
14,390 7,779 22,169 
Payments(11,348)(7,470)(18,818)
Adjustments (2)
496 — 496 
Balance, December 31, 2025
$3,538 $309 $3,847 
_________________________________
(1)Inclusive of the reversal of employee termination related charges originally recorded in the third quarter of 2025 primarily due to certain employees identified for termination finding other positions within the Company or voluntarily separating prior to their scheduled termination date.
(2)Adjustments relate to the effects of foreign currency exchange rates.
The Company does not expect to incur additional significant costs related to this restructuring. Substantially all of the cash payments for the liability are expected to be disbursed by the middle of 2026.
v3.25.4
Pay vs Performance Disclosure - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Pay vs Performance Disclosure      
Net Income (Loss) $ (207,949) $ (1,028,857) $ (204,149)
v3.25.4
Insider Trading Arrangements
 3 Months Ended
Dec. 31, 2025
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement
Rule 10b5-1 Trading Plans
During the three months ended December 31, 2025, none of our directors or officers (as defined in Rule 16a-1 under the Exchange Act) adopted or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement” (as those terms are defined in Item 408 of Regulation S-K).
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
v3.25.4
Insider Trading Policies and Procedures
 12 Months Ended
Dec. 31, 2025
Insider Trading Policies and Procedures [Line Items]  
Insider Trading Policies and Procedures Adopted true
v3.25.4
Cybersecurity Risk Management and Strategy Disclosure
 12 Months Ended
Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]  
Cybersecurity Risk Management Processes Integrated [Flag] true
Cybersecurity Risk Management Processes Integrated [Text Block] The CISO, with the support of the cybersecurity team and the owners of information technology across the business, monitors current events and trends related to cybersecurity and assesses impact on current systems and operations. There are several processes in place to monitor and review our systems, including third-party solutions, to identify potential risks. Third-party service providers are required to notify us in the event of a cybersecurity incident within their systems, and annual reviews are conducted on the Company’s critical third-party vendors. Cybersecurity risks, threats, and incidents, including those from third-party service providers, are tracked and regularly provided to the CISO. The Cybersecurity Leadership Team, which includes the CISO and executives from all business functions across the organization, meets at least quarterly to review and discuss cybersecurity risks facing the Company.
Cybersecurity Risk Management Third Party Engaged [Flag] true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]
Our Board of Directors administers its cybersecurity risk oversight function directly through our Audit and Finance Committee (“AFC”). Our AFC has primary responsibility for overseeing our risk management practices, programs, and policies related to data privacy, data protection, and cybersecurity. The AFC reviews and evaluates the processes utilized by management to identify and assess the material internal and external risks that may affect our business. Our AFC regularly discusses our major risk exposures with management, legal counsel, and the internal audit department. This includes potential financial impact on the Company and the steps taken to monitor and control those risks. Annual reviews with management include summaries of legal and regulatory compliance matters, risk management activities, and cybersecurity assessments. Additionally, our AFC oversees the process by which our Board of Directors is informed regarding the risks facing the Company and coordinates with our legal counsel to ensure our Board of Directors receives regular risk assessment updates from management.
The Chief Information Security Officer (“CISO”) is responsible for identifying, assessing, and managing our risks from cybersecurity threats. The CISO has been with the Company for three years, bringing more than 30 years of technology experience, including 15 years in cybersecurity, and has held the CISO position at other companies before joining Exact Sciences. The CISO leads the cybersecurity team consisting of experts in strategy, governance, risk management, compliance, engineering and development, security operations, and incident management.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag] true
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Business
Business
Exact Sciences Corporation (together with its subsidiaries, “Exact” or the “Company”) was incorporated in February 1995. A leading provider of cancer screening and diagnostic tests, Exact Sciences gives patients and health care professionals the clarity needed to take life-changing action earlier. Building on the success of Cologuard® and Oncotype DX® tests, Exact Sciences is investing in its pipeline to develop innovative solutions for use before, during, and after a cancer diagnosis.
Basis of Presentation and Principles of Consolidation
Basis of Presentation and Principles of Consolidation
The accompanying consolidated financial statements include the accounts of Exact Sciences Corporation and those of its wholly owned subsidiaries. All intercompany transactions and balances have been eliminated upon consolidation.
Use of Estimates
Use of Estimates
The preparation of the consolidated financial statements in conformity with accounting principles generally accepted in the United States (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Critical accounting policies are those that affect the Company's financial statements materially and involve difficult, subjective or complex judgments by management, and actual results could differ from those estimates. These estimates include revenue recognition, valuation of intangible assets and goodwill, contingent consideration, and accounting for income taxes.
Cash and Cash Equivalents
Cash and Cash Equivalents
The Company considers cash on hand, demand deposits in a bank, money market funds, and all highly liquid investments with an original maturity of 90 days or less to be cash and cash equivalents.
Marketable Securities
Marketable Securities
Management determines the appropriate classification of debt securities at the time of purchase and re-evaluates such designation as of each balance sheet date. Debt securities carried at amortized cost are classified as held-to-maturity when the Company has the positive intent and ability to hold the securities to maturity. Debt securities not classified as held-to-maturity are classified as available-for-sale. Available-for-sale securities are carried at fair value. The unrealized gains and losses, net of tax, on the Company's debt securities are reported in other comprehensive income. Marketable equity securities are measured at fair value and the unrealized gains and losses, net of tax, are recognized in other income (expense) in the consolidated statements of operations. The amortized cost of debt securities in this category is adjusted for amortization of premiums and accretion of discounts to maturity computed under the effective interest rate method. Such amortization is included in investment income, net. Realized gains and losses and declines in value as a result of credit losses on available-for-sale securities are included in the consolidated statements of operations as investment income, net. The cost of securities sold is based on the specific identification method. Interest and dividends on securities classified as available-for-sale are included in the consolidated statements of operations as investment income, net.
The Company’s investment policy limits investments to certain types of instruments issued by institutions with investment grade credit ratings and places restrictions on maturities and concentration by type and issuer. Investments in which the Company has the ability and intent, if necessary, to liquidate in order to support its current operations (including those with a contractual term greater than one year from the date of purchase) are classified as current.
The Company periodically evaluates its available-for-sale debt securities in unrealized loss positions to determine whether any impairment is a result of a credit loss or other factors. This evaluation includes, but is not limited to, significant quantitative and qualitative assessments and estimates regarding credit ratings, significance of a security’s loss position, adverse conditions specifically related to the security, and the payment structure of the security.
Allowance for Doubtful Accounts
Allowance for Doubtful Accounts
The Company estimates an allowance for doubtful accounts against accounts receivable using historical collection trends, aging of accounts, current and future implications surrounding the ability to collect such as economic conditions, and regulatory changes. The allowance for doubtful accounts is evaluated on a regular basis and adjusted when trends, significant events, or other substantive evidence such as an adverse change in a payer's ability to pay indicate that expected collections will be less than previously estimated. At December 31, 2025 and 2024, the allowance for doubtful accounts recorded was not significant to the Company’s consolidated balance sheets. For the years ended December 31, 2025, 2024 and 2023, there was an insignificant amount of bad debt expense written off against the allowance and charged to operating expense.
Inventory
Inventory
Inventory is stated at the lower of cost or net realizable value. The Company determines the cost of inventory using the first-in, first out method (“FIFO”). The Company estimates the recoverability of inventory by reference to internal estimates of future demands and product life cycles, including expiration. The Company periodically analyzes its inventory levels to identify inventory that may expire prior to expected sale, no longer meets quality specifications, or has a cost basis in excess of its estimated realizable value and records a charge to cost of sales for such inventory as appropriate.
Direct and indirect manufacturing costs incurred during process validation with probable future economic benefit are capitalized. Validation costs incurred for other research and development activities, which are not permitted to be sold, are expensed to research and development in the Company’s consolidated statements of operations.
Materials that may be used for either research and development or commercial purposes are classified as inventory until the material is consumed or otherwise allocated for research and development. Materials that have alternative uses outside of commercial purposes are classified within prepaid expenses and other current assets on the consolidated balance sheet. If the material is used for research and development, it is expensed as research and development once that determination is made.
When future commercialization of new products is considered probable and the future economic benefit is expected to be realized, based on management’s judgment, pre-launch inventory costs are capitalized prior to regulatory approval. Prior to the capitalization of inventory costs, the Company records such material costs within either prepaid expenses and other current assets or research and development expenses on the Company’s consolidated balance sheets and consolidated statements of operations, respectively.
Property, Plant and Equipment
Property, Plant and Equipment
Property, plant and equipment are stated at cost and depreciated using the straight-line method over the assets’ estimated useful lives. Land is stated at cost and does not depreciate. Additions and improvements are capitalized, including direct and indirect costs incurred to validate equipment and bring to working conditions. Revalidation costs, including maintenance and repairs, are expensed when incurred.
Software Development Costs
Software Development Costs
Costs related to internal use software, including hosted arrangements, are incurred in three stages: the preliminary project stage, the application development stage, and the post-implementation stage. Costs incurred during the preliminary project and post-implementation stages are expensed as incurred. Costs incurred during the application development stage that meet the criteria for capitalization are capitalized and amortized, when the software is ready for its intended use, using the straight‑line method over the estimated useful life of the software, or the duration of the hosting agreement.
Investments in Privately Held Companies
Investments in Non-Marketable Securities
The Company determines whether its investments in non-marketable securities are debt or equity based on their characteristics. The Company also evaluates the investee to determine if the entity is a variable interest entity (“VIE”) and, if so, whether the Company is the primary beneficiary of the VIE, in order to determine whether consolidation of the VIE is required. If consolidation is not required and the Company does not have voting control of the entity, the investment is evaluated to determine if the equity method of accounting should be applied. The equity method applies to investments in common stock or in substance common stock where the Company exercises significant influence over the investee.
Investments in non-marketable securities determined to be equity securities without readily determinable fair values are accounted for under the measurement alternative method as permitted in Accounting Standards Codification (“ASC”) 321, Investments - Equity Securities. The Company adjusts the carrying value of its non-marketable equity securities for changes from observable transactions for identical or similar investments of the same issuer, less impairment. All gains and losses on non-marketable equity securities, realized and unrealized, are recognized in investment income, net in the consolidated statements of operations.
Investments in non-marketable securities determined to be debt securities are accounted for as available-for-sale or held-to-maturity securities unless the fair value option is elected.
Derivative Financial Instruments
Derivative Financial Instruments
The Company hedges a portion of its foreign currency exposures related to outstanding monetary assets and liabilities using foreign currency forward contracts. The foreign currency forward contracts are included in prepaid expenses and other current assets or in accrued liabilities in the consolidated balance sheets, depending on the contracts’ net position. These contracts are not designated as hedges, and as a result, changes in their fair value are recorded in other income (expense) in the consolidated statements of operations.
Business Combinations and Asset Acquisitions
Business Combinations and Asset Acquisitions
Business Combinations are accounted for under the acquisition method in accordance with Accounting Standards Codification (“ASC”) 805, Business Combinations. The acquisition method requires identifiable assets acquired and liabilities assumed and any non-controlling interest in the business acquired be recognized and measured at fair value on the acquisition date, which is the date that the acquirer obtains control of the acquired business. The amount by which the fair value of consideration transferred as the purchase price exceeds the net fair value of assets acquired and liabilities assumed is recorded as goodwill. Acquisitions that do not meet the definition of a business combination under ASC 805 are accounted for as asset acquisitions. Asset acquisitions are accounted for by allocating the cost of the acquisition to the individual assets acquired and liabilities assumed on a relative fair value basis. Goodwill is not recognized in an asset acquisition with any consideration in excess of net assets acquired allocated to acquired assets on a relative fair value basis. Transaction costs are expensed in a business combination and are considered a component of the cost of the acquisition in an asset acquisition.
Intangible Assets
Intangible Assets
Purchased intangible assets are recorded at fair value. The Company uses a discounted cash flow model to value intangible assets. The discounted cash flow model requires assumptions about the timing and amount of future net cash flows, risk, the cost of capital, terminal values and market participants. The Company’s finite-lived intangible assets are being amortized on a straight-line basis over their estimated useful lives.
Patent costs are capitalized as incurred, only if the Company determines that there is some probable future economic benefit derived from the transaction. A capitalized patent is amortized over its estimated useful life, beginning when such patent is approved. Capitalized patent costs are expensed upon disapproval, upon a decision by the Company to no longer pursue the patent or when the related intellectual property is either sold or deemed to be no longer of value to the Company. The Company determined that all patent costs incurred during the years ended December 31, 2025, 2024, and 2023 should be expensed and not capitalized as the future economic benefit derived from the patent costs incurred cannot be determined.
Acquired In-process Research and Development (IPR&D)
Acquired In-process Research and Development (“IPR&D”)
Acquired IPR&D represents the fair value assigned to research and development assets that have not reached technological feasibility. The primary basis for determining technological feasibility of these projects is obtaining regulatory approval to market the underlying product. The amounts capitalized are accounted for as indefinite-lived intangible assets and are subject to impairment testing until completion or abandonment of the research and development efforts associated with the projects. Upon successful completion of the project, the capitalized amount is amortized over its estimated useful life. If a project is abandoned, all remaining capitalized amounts are written off immediately. The value assigned to acquired IPR&D is determined using the multi-period excess earnings method approach, which utilizes significant unobservable inputs (Level 3 inputs) including projected revenues, projected gross margin, projected operating expenses, discount rate, tax rate, obsolescence factor, and probability of commercial success. There are often major risks and uncertainties associated with IPR&D projects as the Company is required to obtain regulatory approvals in order to market the resulting products. Such approvals require completing clinical trials that demonstrate the product's effectiveness. Consequently, the eventual realized value of the IPR&D project may vary from its fair value at the date of acquisition, and IPR&D impairment charges may occur in future periods.
Capitalized IPR&D projects are tested for impairment annually in the fourth quarter, whenever events or changes in circumstances indicate that the carrying amount may not be recoverable, and upon successful completion of the project. The Company considers various factors for potential impairment, including the current legal and regulatory environment, current and future strategic initiatives, and the competitive landscape. Adverse clinical trial results, significant delays in obtaining marketing approval, the inability to bring a product to market and the introduction or advancement of competitors' products could result in partial or full impairment of the related intangible assets.
Contingent Consideration
Contingent Consideration Liabilities
Certain of the Company’s business combinations involve potential payment of future consideration that is contingent upon the achievement of certain regulatory and product development milestones being achieved. The Company records contingent consideration at fair value at the date of acquisition based on the consideration expected to be transferred, estimated as the probability-weighted future cash flows, discounted back to present value. The fair value of contingent consideration is measured using projected probabilities of success, projected payment dates, present value-factors, and projected revenues (for revenue-based considerations). Changes in probabilities of success, present-value factors, and projected payment dates may result in adjustments to the fair value measurements. Contingent consideration is remeasured each reporting period using Level 3 inputs, and the change in fair value, including accretion for the passage of time, is recognized as income or expense within general and administrative expenses on the Company’s consolidated statements of operations. Cash contingent consideration payments up to the acquisition date fair value of the contingent consideration liability are classified as financing activities in the consolidated statements of cash flows, and amounts paid in excess of the original acquisition date fair value are classified as operating activities in the consolidated statements of cash flows.
Contingent Consideration Asset
The sale of the Company’s intellectual property and know-how related to the Company’s Oncotype DX Genomic Prostate Score test (“GPS test”) resulted in the recognition of variable consideration in accordance with ASC 606. The Company estimates the amount of variable consideration that it is entitled to each quarter using the most likely amount method and considers whether there are any constraints on the consideration. If it is probable that a significant reversal of a gain would not occur, the Company will record a gain. To determine the classification of the consideration, the Company determines if the consideration is conditional on something other than the passage of time. Revenue-based contingent consideration that is conditional on something other than the passage of time, including future revenues from sales related to the GPS test, result in the variable consideration being classified as a contract asset. At the time the amount earned is determined, and passage of time is the only condition remaining, the contract asset is reclassified to a receivable.
Collateralized Debt Instruments
Collateralized Debt Instruments
Debt instruments that are collateralized by security interests in financial assets held by the Company are accounted for as a secured borrowing and therefore: (i) the asset balances pledged as collateral are included within the applicable balance sheet line item and the borrowings are included within long-term debt in the consolidated balance sheet; (ii) interest expense is included within the consolidated statements of operations; and (iii) in the case of collateralized accounts receivable, receipts from customers related to the underlying accounts receivable are reflected as operating cash flows, and (iv) borrowings and repayments under the collateralized loans are reflected as financing cash flows within the consolidated statements of cash flows.
Goodwill
Goodwill
The Company evaluates goodwill for possible impairment at the reporting unit level on an annual basis during the fourth quarter, or more frequently if events or changes in circumstances indicate that the carrying amount of such assets may not be recoverable. Qualitative factors considered in this assessment include industry and market conditions, overall financial performance, and other relevant events and factors affecting the Company's business. Based on the qualitative assessment, if it is determined that the fair value of goodwill is more likely than not to be less than its carrying amount, the fair value of a reporting unit will be calculated and compared with its carrying amount and an impairment charge will be recognized for the amount that the carrying value exceeds the fair value.
Impairment of Long-Lived Assets
Impairment of Long-Lived Assets
The Company evaluates the fair value of long-lived assets, which include property, plant and equipment, leases, and finite-lived intangible assets for impairment whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be fully recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future undiscounted net cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell.
Net Loss Per Share
Net Loss Per Share
Basic net loss per common share was determined by dividing net loss applicable to common stockholders by the weighted average common shares outstanding during the period. Basic and diluted net loss per share is the same because all outstanding common stock equivalents have been excluded, as they are anti-dilutive as a result of the Company’s losses.
Accounting for Stock-Based Compensation
Accounting for Stock-Based Compensation
The Company requires all share-based payments to employees, including grants of employee stock options, restricted stock, restricted stock units, shares purchased under an employee stock purchase plan (if certain parameters are not met), and performance share units to be recognized in the financial statements based on their grant date fair values. The estimated fair value of these awards is recognized to expense using the straight-line method over the requisite service period, which is generally the vesting period. The Company will recognize expense on an accelerated basis for restricted stock units upon an employee's death, disability, or upon retirement eligibility, provided certain criteria are met. Forfeitures of any share-based awards are recognized as they occur.
The fair values and recognition of the Company’s share-based payment awards are determined as follows:
The fair value of each service-based option award is estimated on the date of grant using the Black-Scholes option-pricing model. The Black-Scholes pricing model utilizes the following assumptions:
Expected Term—Expected life of an option award is the average length of time over which the Company expects employees will exercise their options, which is based on historical experience with similar grants.
Expected Volatility—Expected volatility is based on the Company’s historical stock volatility data over the expected term of the awards.
Risk-Free Interest Rate—The Company bases the risk-free interest rate on the implied yield currently available on U.S. Treasury zero-coupon issues with an equivalent expected term.
The fair value of service-based awards for each restricted stock unit award is determined on the date of grant using the closing stock price on that day.
The fair value of performance-based equity awards that do not include a market condition is determined on the date of grant using the closing stock price on that day. The fair value of performance-based equity awards that include a market condition is determined on the date of grant using a Monte Carlo valuation technique. The expense recognized each period is also dependent on the probability of what performance conditions will be met which is determined by management's evaluation of internal and external factors. Determining the appropriate amount to expense based on the anticipated achievement of the stated goals requires judgment, including forecasting future financial results. The estimate of the timing of the expense recognition is revised periodically based on the probability of achieving the goals and adjustments are made as appropriate. The cumulative impact of any revision is reflected in the period of the change. If the financial performance targets and operational milestones are not achieved, the award would not vest resulting in no stock-based compensation being recognized and any previously recognized stock-based compensation expense being reversed.
Research and Development Costs
Research and Development Costs
Research and development costs are expensed as incurred. These expenses include the costs of the Company's proprietary research and development efforts, as well as costs of IPR&D projects acquired as part of an asset acquisition that have no alternative future use. Acquired IPR&D assets that are acquired in an asset acquisition and which have no alternative future use are classified as an investing cash outflow in the consolidated statements of cash flows. Upfront and milestone payments due to third parties in connection with research and development collaborations prior to regulatory approval are expensed as incurred. Milestone payments due to third parties upon, or subsequent to, regulatory approval are capitalized and amortized into research and development costs over the shorter of the remaining license or product patent life, when there are no corresponding revenues related to the license or product. Nonrefundable advance payments for goods and services that will be used in future research and development activities are expensed when the activity has been performed or when the goods have been received, rather than when the payment is made.
Advertising Costs
Advertising Costs
Advertising costs are expensed as incurred. The Company expensed approximately $199.2 million, $180.3 million, and $137.9 million of media advertising during the years ended December 31, 2025, 2024, and 2023, respectively, which is recorded in sales and marketing expenses on the Company’s consolidated statements of operations.
Fair Value Measurements
Fair Value Measurements
The Financial Accounting Standards Board (“FASB”) has issued authoritative guidance that requires fair value to be based on the assumptions market participants would use when pricing an asset or liability and establishes a fair value hierarchy that prioritizes the information used to develop those assumptions. Under that standard, fair value measurements are separately disclosed by level within the fair value hierarchy. The fair value hierarchy establishes and prioritizes the inputs used to measure fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs. Observable inputs are inputs that reflect the assumptions that market participants would use in pricing the asset or liability developed based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the assumptions market participants would use in pricing the asset or liability developed based on the best information available in the circumstances.
Leases
Leases
The Company acts as lessee in its lease agreements, which include operating leases for corporate offices, laboratory space, warehouse space, vehicles, and certain laboratory and office equipment, and finance leases for certain equipment and vehicles.
The Company determines whether an arrangement is, or contains, a lease at inception. The Company records the present value of lease payments as right-of-use (“ROU”) assets and lease liabilities on the consolidated balance sheets. ROU assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent an obligation to make lease payments based on the present value of lease payments over the lease term. Classification of lease liabilities as either current or non-current is based on the expected timing of payments due under the Company’s obligations.
As the implicit interest rate is not readily determinable in most of the Company’s leases, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. The incremental borrowing rate is the rate of interest that a lessee would have to pay to borrow on a collateralized basis over a similar term and at an amount equal to the lease payments in a similar economic environment and credit profile.
The ROU asset also consists of any lease incentives received. The lease terms used to calculate the ROU asset and related lease liability include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. “Reasonably certain” is assessed internally based on economic, industry, company, strategic and contractual factors. The leases have remaining lease terms of 1 year to 15 years, some of which include options to extend the lease for up to 10 years, and some of which include options to terminate the lease within 1 year. Operating lease expense and amortization of finance lease ROU assets are recognized on a straight-line basis over the lease term as an operating expense. Finance lease interest expense is recorded as interest expense on the Company’s consolidated statements of operations.
The Company accounts for leases acquired in business combinations by measuring the lease liability at the present value of the remaining lease payments as if the acquired lease were a new lease for the Company. This measurement includes recognition of a lease intangible for any below-market terms present in the leases acquired. The below-market lease intangible is included in the ROU asset on the consolidated balance sheets and are amortized over the remaining lease term. The Company has not acquired any leases with above-market terms.
The Company has taken advantage of certain practical expedients offered to registrants at adoption of ASC 842. The Company does not apply the recognition requirements of ASC 842 to short-term leases. Instead, those lease payments are recognized in profit or loss on a straight-line basis over the lease term. Further, as a practical expedient, all lease contracts are accounted for as one single lease component, as opposed to separating lease and non-lease components to allocate the consideration within a single lease contract.
Revenue Recognition
Revenue Recognition
Revenues are recognized when the satisfaction of the performance obligation occurs, in an amount that reflects the consideration the Company expects to collect in exchange for those services. The Company’s revenue is primarily generated by its laboratory testing services utilizing its Cologuard, Oncotype DX, and PreventionGenetics LLC (“PreventionGenetics”) tests. The services are considered completed when the performance obligation is fulfilled, which is upon release of an approved patient test result to the healthcare provider. The Company follows ASC 606, Revenue from Contracts with Customers, to account for its laboratory service revenues.
Laboratory testing services
The Company’s customer is primarily the patient, but the Company does not enter into a formal reimbursement contract with a patient. The Company establishes a contract with a patient in accordance with other customary business practices, which is the point in time an order is received from a provider and a patient specimen has been returned to the laboratory for testing. Payment terms are a function of a patient’s existing insurance benefits, including the impact of coverage decisions with Center for Medicare & Medicaid Services (“CMS”) and applicable reimbursement contracts established between the Company and payers. However, when a patient is considered self-pay, or in the context of certain lab service or reference agreements, the Company requires payment prior to the commencement of the Company's performance obligations.
Additionally, the Company periodically engages with third party international distributor partners to provide patients access to the Company’s laboratory testing services and is considered the principal in these arrangements as control over the intellectual property, lab processing activities, and result delivery remain with the Company. Revenues from these contracts are recorded at gross in an amount that reflects the amount ultimately paid to the distributor for the testing services if known or, if this is unknown or unable to be estimated, is recorded at an effective net fixed transaction price equal to the amount billed to and received from the distributor.
The Company’s contracts have a single performance obligation, which is satisfied upon rendering of services, which culminates in the release of a patient’s test result to the ordering healthcare provider.
The Company’s transaction price is comprised of variable consideration and is allocated entirely to a single performance obligation defined as the point in time an approved patient test result is released to the ordering healthcare provider. Variable consideration is primarily derived from payer and patient billing and can be impacted by several factors such as the amount of contractual adjustments, any patient co-payments, deductibles or patient adherence incentives, the existence of secondary payers, and claim denials. Estimates of variable consideration are calculated using the expected value method and is the sum of probability-weighted amounts in a range of possible consideration amounts. Several factors are evaluated during this process, such as historical collections experience, current contractual and statutory requirements, customer mix, patient insurance eligibility and payer reimbursement contracts, and known or anticipated reimbursement trends not yet reflected in the data. The Company limits the amount of variable consideration included in the transaction price to the unconstrained portion of such consideration. In other words, the Company recognizes revenue up to the amount of variable consideration that is not subject to a significant reversal until additional information is obtained or the uncertainty associated with the additional payments or refunds is subsequently resolved. Differences between original estimates and subsequent revisions, including final settlements, represent changes in the estimate of variable consideration and are included in the period in which such revisions are made.
The Company monitors its estimates of transaction price to depict conditions that exist at each reporting date. If the Company subsequently determines that it will collect more or less consideration than it originally estimated for a contract with a patient, it will account for the change as an increase or decrease in the estimate of the transaction price (i.e., an upward or downward revenue adjustment) in the period identified.
When the Company does not have significant historical experience or that experience has limited predictive value, the constraint over estimates of variable consideration may result in no revenue being recognized upon completion of the performance obligations associated with the Company's tests, with recognition, generally occurring at the date of cash receipt.
Contract Balances
The timing of revenue recognition, billings, and cash collections results in billed accounts receivable and deferred revenue on the consolidated balance sheets. Generally, billing occurs after the release of an approved patient test result to the healthcare provider, resulting in an account receivable. However, the Company sometimes receives advance payment from a patient or a direct bill payer before services are performed, resulting in deferred revenue. The deferred revenue recorded is recognized as revenue at the point in time an approved patient test result is released to the patient's healthcare provider.
Practical Expedients
The Company does not adjust the transaction price for the effects of a significant financing component, as at contract inception, the Company expects the collection cycle to be one year or less.
The Company expenses sales commissions when incurred because the amortization period would have been one year or less. These costs are recorded within sales and marketing expenses in the Company’s consolidated statements of operations.
The Company incurs certain other costs that are incurred regardless of whether a contract is obtained. Such costs are primarily related to legal services and patient communications (e.g. adherence reminder letters). These costs are expensed as incurred and recorded within general and administrative expenses in the Company’s consolidated statements of operations.
Foreign Currency Transactions
Foreign Currency Transactions
The functional currency for most of the Company’s international subsidiaries is the United States (“U.S.”) dollar. When the functional currency differs from the local currency, monetary assets and liabilities are remeasured at the current period-end exchange rate, while non-monetary assets and liabilities are remeasured at the historical rate. The gains and losses as a result of exchange rate adjustments of these subsidiaries are recognized in the consolidated statements of operations. Net foreign currency transaction gains or losses were not significant to the consolidated statements of operations for the periods presented.
For the Company’s international subsidiaries where the functional currency is other than the U.S. dollar, the financial statements are translated into the U.S. dollar, and the cumulative adjustments resulting from the translation into the U.S. dollar are included in the Company's consolidated balance sheet as a component of accumulated other comprehensive income (loss) (“AOCI”).
Concentration of Credit Risk
Concentration of Credit Risk
Financial instruments that subject the Company to credit risk consist of cash, cash equivalents, and marketable securities. As of December 31, 2025, the Company had cash and cash equivalents deposited in financial institutions in which the balances exceed the federal government agency insured limit of $250,000 by approximately $892.6 million. The Company has not experienced any losses in such accounts and management believes it is not exposed to any significant credit risk.
Through December 31, 2025, the Company’s revenues have been primarily derived from the sale of Cologuard and Oncotype tests. The following is a breakdown of revenue and accounts receivable from major payers:
% Revenue for the years ended December 31,% Accounts Receivable at December 31,
Major Payer202520242023202520242023
Centers for Medicare and Medicaid Services15%16%17%8%10%10%
UnitedHealthcare13%12%12%8%9%10%
Tax Positions
Tax Positions
A valuation allowance to reduce the deferred tax assets is reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. The Company has incurred significant losses since its inception and due to the uncertainty of the amount and timing of future taxable income, the Company has determined that a valuation allowance at December 31, 2025 and 2024 is necessary to reduce the tax assets to the amount that is more likely than not to be realized. Due to the existence of the valuation allowance, future changes in the Company's unrecognized tax benefits will not impact the Company's effective tax rate.
Recent Accounting Pronouncements
Recent Accounting Pronouncements
Recently Adopted Accounting Pronouncements
In December 2023, the FASB issued Accounting Standards Update (“ASU”) No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This update improves income tax disclosure requirements, primarily through enhanced transparency and decision usefulness of disclosures. The amendments in this update should be applied prospectively with the option to apply retrospectively and are effective for fiscal years beginning after December 15, 2024. The Company adopted and prospectively applied the amendments in this update during the fourth quarter of fiscal year 2025.
Recently Issued Accounting Pronouncements Not Yet Adopted
In October 2023, the FASB issued ASU No. 2023-06, Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure Update and Simplification Initiative. This update modifies the disclosure or presentation requirements of a variety of topics in the ASC to conform with certain Securities and Exchange Commission (“SEC”) amendments in Release No. 33-10532, Disclosure Update and Simplification. The amendments in this update should be applied prospectively, and the effective date for each amendment will be the date on which the SEC’s removal of that related disclosure from Regulation S-X or S-K becomes effective. However, if the SEC has not removed the related disclosure from its regulations by June 30, 2027, the amendments will be removed from the Codification and not become effective. Early adoption is prohibited. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In November 2024, the FASB issued ASU No. 2024-03, Income Statement – Reporting Comprehensive Income – Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses. This update enhances financial statement disclosures by requiring public business entities to disclose specified information about certain costs and expenses including the amounts of (a) purchases of inventory, (b) employee compensation, (c) depreciation, and (d) intangible asset amortization included in each relevant expense caption. The update also requires disclosure of certain amounts that are already required to be disclosed under current GAAP, disclosure of a qualitative description of the amounts remaining in relevant expense captions that are not separately disaggregated quantitatively, and disclosure of the total amount of selling expenses and, in annual reporting periods, an entity’s definition of selling expenses. The amendments in this update may be applied either prospectively or retrospectively and are effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In May 2025, the FASB issued ASU No. 2025-03, Business Combinations (Topic 805) and Consolidation (Topic 810): Determining the Accounting Acquirer in the Acquisition of a Variable Interest Entity. This guidance clarifies the framework for identifying the accounting acquirer in transactions involving variable interest entities that meet the definition of a business. The amendments should be applied prospectively and are effective for fiscal years beginning after December 15, 2026, including interim periods within those fiscal years. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In July 2025, the FASB issued ASU No. 2025-05, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses for Account Receivable and Contract Assets. This update introduces a practical expedient for all entities when estimating expected credit losses on current accounts receivable and current contract assets arising from revenue transactions accounted for under Topic 606. The expedient allows entities to assume current conditions as of the balance sheet date remain unchanged over the remaining life of the asset. The amendments are required to be applied prospectively and are effective for annual and interim periods beginning after December 15, 2025. Early adoption is permitted. The Company is currently evaluating adoption of the practical expedient.
In September 2025, the FASB issued ASU No. 2025-06, Intangibles—Goodwill and Other— Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. This update provides amendments to clarify and modernize the accounting for costs incurred to develop or acquire internal-use software. The amendments address the capitalization of implementation costs by utilizing a principles-based approach and consolidates website development guidance under Subtopic 350-40. The amendments can be applied prospectively, modified prospectively, or retrospectively and are effective for annual and interim periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
In September 2025, the FASB issued ASU No. 2025-07, Derivatives and Hedging (Topic 815) and Revenue from Contracts with Customers (Topic 606): Derivatives Scope Refinements and Scope Clarification for Share-Based Noncash Consideration from a Customer in a Revenue Contract. This update introduces a scope exception to derivative accounting for certain contracts with underlyings tied to operations or activities specific to one of the parties. Additionally, the update clarifies that share-based noncash consideration received from a customer should be accounted for under Topic 606 until the right to receive or retain the consideration becomes unconditional. The amendments can be applied prospectively or modified retrospectively and are effective for annual and interim periods beginning after December 15, 2026. The Company is currently evaluating the potential impact of this guidance and the timing of adoption. The provisions related to Topic 606 are not applicable.
In December 2025, the FASB issued ASU No. 2025-10, Government Grants (Topic 832): Accounting for Government Grants Received by Business Entities. This update establishes authoritative guidance for entities receiving government grants, replacing previous guidance that relied on analogies to IAS 20 or ASC 450. Under the new guidance, entities must first determine whether the grant is related to an asset or income. Grants related to assets can either adopt the deferred income approach or the cost accumulation approach while grants related to income should be recognized in earnings on a systematic and rational basis over the periods in which the costs are incurred. The amendments can be applied modified prospectively, modified retrospectively, or retrospectively and are effective for annual and interim periods beginning after December 15, 2028. Early adoption is permitted. The Company is currently evaluating the potential impact of the guidance and the timing of adoption.
In December 2025, the FASB issued ASU No. 2025-11, Interim Reporting (Topic 270): Narrow-Scope Improvements. This update clarifies that all entities issuing interim financial statements under U.S. GAAP fall within the scope of ASC 270. SEC registrants must follow the requirements of Regulation S-X, Rule 10-01, while non-SEC registrants may present interim financial statements, and related notes, under GAAP at the same level of detail as annual reporting. Additionally, entities issuing condensed interim financial statements must disclose material events occurring since the end of the prior fiscal year. The amendments can be applied prospectively or retrospectively, and are effective for annual and interim periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
In December 2025, the FASB issues ASU No. 2025-12, Codification Improvements. This update results from the Board's ongoing project to address suggestions received from stakeholders and to make technical corrections, clarifications, and other incremental improvements to GAAP. This evergreen project facilitates Codification updates for a broad range of ASC topics. The amendments are not expected to have a significant effect on current accounting practice. This ASU can be applied using a prospective or retrospective approach and are effective for annual and interim periods beginning after December 15, 2026. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
Cost of Goods and Service
Cost of Sales
Cost of sales reflects the aggregate costs incurred in delivering the Company's products and services and includes material and service costs, personnel costs, including stock-based compensation expense, equipment, and infrastructure expenses associated with laboratory testing services, shipping charges, allocated overhead such as rent, information technology costs, equipment depreciation, and utilities, and amortization of acquired developed technology or license intangible assets related to products commercialized by the Company. Costs associated with the shipment of Cologuard test collection kits are recognized upon shipment, and costs associated with performing the Company’s tests are recorded as the tests are performed regardless of whether revenue was recognized with respect to that test.
Guarantees and Indemnifications
Guarantees and Indemnifications
The Company, as permitted under Delaware law and in accordance with its bylaws, indemnifies its officers and directors for certain events or occurrences, subject to certain limits, while the officer or director is or was serving at the Company’s request in such capacity. The term of the indemnification period is for the officer’s or director’s lifetime. The maximum amount of potential future indemnification is unlimited; however, the Company has a directors and officers insurance policy that limits its exposure and may enable it to recover a portion of any future amounts paid. The Company believes the fair value of these indemnification agreements is minimal. Accordingly, the Company has not recorded any liabilities for these agreements as of December 31, 2025 and 2024.
Merger Agreement
Merger Agreement
On November 19, 2025, the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with Abbott Laboratories (“Abbott”) and Badger Merger Sub I, Inc., a direct, wholly owned subsidiary of Abbott (“Merger Sub”), providing for, among other things, the merger of Merger Sub with and into Exact (the “Merger”) on the terms and subject to the conditions set forth in the Merger Agreement. Upon the terms and subject to the conditions set forth in the Merger Agreement, at the effective time of the Merger (the “Effective Time”), the separate existence of Merger Sub will cease, and the Company will continue as the surviving corporation in the Merger and as a direct, wholly owned subsidiary of Abbott. At the Effective Time, on the terms and subject to the conditions set forth in the Merger Agreement, each share of Exact common stock (other than certain excluding shares) issued and outstanding immediately prior to the Effective Time will be converted into and will thereafter represent the right to receive $105.00 in cash, without interest, less any applicable withholding taxes. Following the Merger, Exact common stock will no longer be publicly traded or listed on The Nasdaq Stock Market LLC.
Under the terms of the Merger Agreement, the Company is subject to various customary covenants and obligations, including, among others, until the earlier of the Effective Time and the termination of the Merger Agreement, the obligation to use commercially reasonable efforts to conduct the Company's business in the ordinary course of business in all material respects and to refrain from taking certain actions without Abbott’s consent, subject to specified exceptions. The Company does not believe these restrictions will prevent the Company from meeting its debt service obligations, ongoing costs of operations, working capital needs or capital expenditure requirements.
Consummation of the Merger is subject to the satisfaction or waiver of certain conditions, including the adoption of the Merger Agreement by the affirmative vote of holders of a majority of the outstanding shares of Exact common stock entitled to vote thereon (the “Stockholder Approval”), receipt of specified regulatory approvals and the satisfaction of other customary closing conditions.
The Merger Agreement contains specified termination rights for Exact and Abbott, including, among others, the right of each party to terminate if (i) the Merger is not consummated by November 19, 2026, subject to extension in certain cases, (ii) any law or order restraining, enjoining, making illegal or otherwise prohibiting the consummation of the Merger is in effect and has become final and non-appealable, (iii) the Stockholder Approval is not obtained upon a vote taken on the adoption of the Merger Agreement at the meeting of the Company's stockholders held for the purpose of obtaining stockholder approval or any adjournment or postponement thereof, or (iv) the other party breaches or fails to perform its representations, warranties, agreements or covenants in the Merger Agreement in a manner that would cause the conditions to the consummation of the Merger to not be satisfied and does not cure such breach or failure within the applicable cure period, subject to certain exceptions. If the Merger Agreement is terminated under specified circumstances, the Company may be required to pay to Abbott a termination fee of approximately $628.7 million.
The foregoing description of the Merger Agreement and the transactions contemplated thereby does not purport to be complete and is qualified in its entirety by reference to the copy of the Merger Agreement that was attached as Exhibit 2.1 to the Company’s Current Report on Form 8-K filed on November 20, 2025 and that is incorporated by reference as an exhibit to this Annual Report on Form 10-K.
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Schedule of potentially issuable common shares not included in the computation of diluted net loss per share because they would have an anti-dilutive effect
The following potentially issuable common shares were not included in the computation of diluted net loss per share because they would have an anti-dilutive effect due to net losses for each period:
December 31,
(In thousands)202520242023
Shares issuable upon conversion of convertible notes23,223 26,526 23,231 
Shares issuable upon the release of restricted stock awards6,896 7,245 6,273 
Shares issuable upon the release of performance share units1,048 2,021 1,598 
Shares issuable upon exercise of stock options781 983 1,286 
31,948 36,775 32,388 
v3.25.4
REVENUE (Tables)
 12 Months Ended
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]  
Schedule of disaggregation by revenue source The following table presents the Company’s revenues disaggregated by revenue source:
Year Ended December 31,
(In thousands)202520242023
Screening
Medicare Parts B & C$955,075 $776,155 $701,400 
Commercial1,323,216 1,118,338 992,244 
Other251,575 209,375 171,057 
Total Screening2,529,866 2,103,868 1,864,701 
Precision Oncology
Medicare Parts B & C$196,468 $187,948 $188,689 
Commercial196,170 190,595 181,318 
International223,844 189,092 153,277 
Other100,642 87,364 105,826 
Total Precision Oncology717,124 654,999 629,110 
COVID-19 Testing$— $— $5,955 
Total$3,246,990 $2,758,867 $2,499,766 
v3.25.4
MARKETABLE SECURITIES (Tables)
 12 Months Ended
Dec. 31, 2025
Cash and Cash Equivalents [Abstract]  
Schedule of cash and cash equivalents
The following table sets forth the Company’s cash, cash equivalents, and marketable securities at December 31, 2025 and 2024:
December 31,
(In thousands)20252024
Cash and cash equivalents
Cash and money market$955,996 $595,548 
Cash equivalents— 5,341 
Total cash and cash equivalents955,996 600,889 
Marketable securities
Available-for-sale debt securities$— $431,165 
Equity securities8,715 5,972 
Total marketable securities8,715 437,137 
Total cash, cash equivalents, and marketable securities$964,711 $1,038,026 
Schedule of available-for-sale securities
Available-for-sale debt securities, including the classification within the consolidated balance sheet at December 31, 2024, consisted of the following:
(In thousands)Amortized Cost
Gains in AOCI (1)
Losses in AOCI (1)
Estimated Fair Value
Cash equivalents
Commercial paper$5,341 $— $— $5,341 
Total cash equivalents5,341 — — 5,341 
Marketable securities
Corporate bonds$206,063 $932 $(121)$206,874 
U.S. government agency securities140,992 160 (200)140,952 
Asset backed securities83,134 256 (51)83,339 
Total marketable securities430,189 1,348 (372)431,165 
Total available-for-sale debt securities$435,530 $1,348 $(372)$436,506 
_________________________________
(1)     There was no tax impact from the gains and losses in AOCI.
Schedule of gross unrealized losses and fair values of investments in an unrealized loss position
The following table summarizes the gross unrealized losses and fair values of available-for-sale debt securities in an unrealized loss position as of December 31, 2024, aggregated by investment category and length of time those individual securities have been in a continuous unrealized loss position:
Less than one year
One year or greater
Total
(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss
Marketable securities
U.S. government agency securities$39,542 $(199)$1,990 $(1)$41,532 $(200)
Corporate bonds25,979 (121)— — 25,979 (121)
Asset backed securities5,567 (28)2,666 (23)8,233 (51)
Total available-for-sale securities$71,088 $(348)$4,656 $(24)$75,744 $(372)
v3.25.4
INVENTORY (Tables)
 12 Months Ended
Dec. 31, 2025
Inventory Disclosure [Abstract]  
Schedule of inventory
Inventory consisted of the following:
December 31,
(In thousands)20252024
Raw materials$75,716 $69,730 
Semi-finished and finished goods90,485 92,653 
Total inventory$166,201 $162,383 
v3.25.4
PROPERTY, PLANT, AND EQUIPMENT (Tables)
 12 Months Ended
Dec. 31, 2025
Property, Plant and Equipment [Abstract]  
Schedule of property, plant and equipment, net
The carrying value and estimated useful lives of property, plant and equipment are as follows:
December 31,
(In thousands)Estimated Useful Life20252024
Property, plant and equipment
Landn/a$4,716 $4,716 
Leasehold and building improvements(1)257,503 227,885 
Land improvements15 years6,740 6,747 
Buildings
30 - 40 years
290,777 290,777 
Computer equipment and computer software3 years243,624 206,460 
Machinery and equipment
3 - 10 years
387,943 339,421 
Furniture and fixtures
3 - 10 years
37,347 37,176 
Assets under constructionn/a84,142 89,065 
Property, plant and equipment, at cost1,312,792 1,202,247 
Accumulated depreciation(604,128)(508,574)
Property, plant and equipment, net$708,664 $693,673 
_________________________________
(1)     Lesser of remaining lease term, building life, or estimated useful life.
v3.25.4
INTANGIBLE ASSETS AND GOODWILL (Tables)
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of net-book value and estimated remaining life and finite lived intangible assets
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2025:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at December 31, 2025
Finite-lived intangible assets
Acquired developed technology
5.6$887,518 $(495,986)$391,532 
Trade name9.9104,000 (42,403)61,597 
Patents and licenses8.662,442 (17,868)44,574 
Customer relationships5.04,000 (1,778)2,222 
Total finite-lived intangible assets1,057,960 (558,035)499,925 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,477,960 $(558,035)$919,925 
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2024:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated AmortizationNet Balance at December 31, 2024
Finite-lived intangible assets
Acquired developed technology
6.4$887,104 $(412,504)$474,600 
Trade name10.8104,000 (35,153)68,847 
Patents and licenses9.556,542 (12,963)43,579 
Customer relationships6.04,000 (1,333)2,667 
Total finite-lived intangible assets1,051,646 (461,953)589,693 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,471,646 $(461,953)$1,009,693 
Schedule of estimated future amortization expense, intangible assets
As of December 31, 2025, the estimated future amortization expense associated with the Company’s finite-lived intangible assets for each of the five succeeding fiscal years is as follows:
(In thousands)
2026$95,955 
202795,955 
202895,955 
202989,832 
203022,473 
Thereafter99,755 
Total$499,925 
Schedule of carrying amount of goodwill
The change in the carrying amount of goodwill for the years ended December 31, 2025 and 2024 is as follows:
(In thousands)
Balance, January 1, 2024$2,367,120 
Resolution Bioscience acquisition adjustments (1)
225 
Effects of changes in foreign currency exchange rates
(669)
Balance, December 31, 20242,366,676 
Effects of changes in foreign currency exchange rates1,372 
Balance, December 31, 2025$2,368,048 
_________________________________
(1)    Refer to Note 17 for further discussion on the Company’s acquisition of Resolution Bioscience, Inc. (“Resolution Bioscience”)
v3.25.4
FAIR VALUE MEASUREMENTS (Tables)
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
Schedule of fair value measurements along with the level within the fair value hierarchy in which the fair value measurements fall
The following table presents the Company’s fair value measurements as of December 31, 2025 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair value at December 31, 2025Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash and cash equivalents
Cash and money market$955,996 $955,996 $— $— 
Marketable securities
Equity securities
$8,715 $8,715 $— $— 
Non-marketable securities$52,538 $— $— $52,538 
Liabilities
Contingent consideration$(289,018)$— $— $(289,018)
Total$728,231 $964,711 $— $(236,480)
The following table presents the Company’s fair value measurements as of December 31, 2024 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at December 31, 2024Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash, cash equivalents, and restricted cash
Cash and money market$595,548 $595,548 $— $— 
Restricted cash (1)
5,747 5,747 — — 
U.S. government agency securities5,341 — 5,341 — 
Marketable securities
Corporate bonds$206,874 $— $206,874 $— 
U.S. government agency securities140,952 — 140,952 — 
Asset backed securities83,339 — 83,339 — 
Equity securities
5,972 5,972 — — 
Non-marketable securities$796 $— $— $796 
Liabilities
Contingent consideration$(282,212)$— $— $(282,212)
Total$762,357 $607,267 $436,506 $(281,416)
_________________________________
(1)Restricted cash primarily represented cash held by a third-party financial institution as part of a cash collateral agreement related to the Company’s credit card program. The restrictions lapsed in 2025 upon the removal of the cash collateral requirement by the third-parties.
Securities Owned Not Readily Marketable
Gains and losses recorded on non-marketable securities for which the fair value option has been elected are recognized in investment income, net in the consolidated statement of operations. The following table provides a reconciliation of the beginning and ending balances of non-marketable securities valued using the fair value option:
(In thousands)Non-Marketable Securities
Beginning balance, January 1, 2024
$7,650 
Changes in fair value
(604)
Settlement of non-marketable securities
(6,250)
Balance, December 31, 2024
796 
Purchases of non-marketable securities
51,250 
Changes in fair value492 
Ending balance, December 31, 2025
$52,538 
Other Investments Not Readily Marketable
Investments without readily determinable fair values had the following cumulative upward and downward adjustments and aggregate carrying amounts as of December 31, 2025 and 2024:
December 31,
(In thousands)
20252024
Cumulative upward adjustments (1)
$5,595 $5,102 
Cumulative downward adjustments and impairments (2)
(16,850)(16,850)
Aggregate carrying value54,941 50,448 
_________________________________
(1)    There were no material upward adjustments recorded for the years ended December 31, 2025, 2024, and 2023.
(2)    There were no material downward adjustments or impairments for the years ended December 31, 2025, 2024, and 2023.
Schedule of fair value of contingent consideration
The following table provides a reconciliation of the beginning and ending balances of contingent consideration:
Year Ended December 31,
(In thousands)202520242023
Beginning balance
$282,212 $288,657 $306,927 
Changes in fair value (1)
26,806 (3,345)(18,044)
Payments (2)
(20,000)(3,100)(226)
Ending balance
$289,018 $282,212 $288,657 
_________________________________
(1)    The change in fair value of the contingent consideration liability is included in general and administrative expenses in the consolidated statement of operations for the years ended December 31, 2025, 2024, and 2023.
(2)    Payments were made to settle the product development milestone contingent consideration liabilities previously recorded related to the Company's acquisitions of Ashion Analytics, LLC (“Ashion”) and OmicEra Diagnostics GmbH in the years ended December 31, 2025 and 2024, respectively.
Fair Value, by Balance Sheet Grouping
The following table summarizes the Company’s non-marketable securities, which are primarily included in other long-term assets on the consolidated balance sheet as of December 31, 2025 and December 31, 2024:
December 31,
(In thousands)20252024
Investments for which the fair value option has been elected$52,538 $796 
Investments without readily determinable fair values54,941 50,448 
Equity method investments7,843 7,488 
Total$115,322 $58,732 
v3.25.4
ACCRUED LIABILITIES (Tables)
 12 Months Ended
Dec. 31, 2025
Payables and Accruals [Abstract]  
Schedule of accrued expenses
Accrued liabilities at December 31, 2025 and 2024 consisted of the following:
December 31,
(In thousands)20252024
Compensation$276,660 $185,934 
Professional fees59,528 80,452 
Other27,445 23,529 
Research and trial related expenses25,161 16,043 
Licenses20,262 15,107 
Assets under construction7,417 7,227 
Total $416,473 $328,292 
v3.25.4
CONVERTIBLE NOTES (Tables)
 12 Months Ended
Dec. 31, 2025
CONVERTIBLE DEBT  
Schedule of debt, net of discounts and deferred financing costs
Convertible note obligations included in the consolidated balance sheet consisted of the following as of December 31, 2025:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(11,364)$609,345 $759,636 2
2030 Convertible Notes - 2.000%
572,993 (2,937)570,056 795,045 2
2028 Convertible Notes - 0.375%
589,380 (3,389)585,991 605,570 2
2027 Convertible Notes - 0.375%
563,822 (2,037)561,785 587,672 2
Convertible note obligations included in the consolidated balance sheet consisted of the following as of December 31, 2024:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(13,511)$607,198 $581,648 2
2030 Convertible Notes - 2.000%
572,993 (3,642)569,351 592,756 2
2028 Convertible Notes - 0.375%
589,380 (4,952)584,428 512,761 2
2027 Convertible Notes - 0.375%
563,822 (3,732)560,090 523,932 2
2025 Convertible Notes - 1.000% (2)
249,172 (19)249,153 246,705 2
____________________________
(1)     The fair values are based on observable market prices for this debt, which is traded in less active markets and therefore is classified as a Level 2 fair value measurement.
(2)    The Company’s convertible notes due in 2025 (the “2025 Notes”) matured on January 15, 2025 and were included in convertible notes, net, current portion on the consolidated balance sheet as of December 31, 2024. Upon maturity of the 2025 Notes on January 15, 2025, the Company made a cash payment of $250.4 million in settlement of the total principal of the 2025 Notes and accrued interest that was previously outstanding as of December 31, 2024.
Schedule of Allocation of Transaction Costs Related to Convertible Debt
Issuance costs are amortized to interest expense, net over the term of the Notes. The following table summarizes the original issuance costs at the time of issuance for each set of Notes:
(In thousands)
2031 Convertible Notes$6,780 
2030 Convertible Notes
4,938 
2028 Convertible Notes
24,453 
2027 Convertible Notes
14,285 
2025 Convertible Notes
17,646 
Schedule of Interest Expense
Interest expense on the Notes includes the following:
Year Ended December 31,
(In thousands)202520242023
Debt issuance costs amortization$4,609 $5,296 $5,350 
Debt discount amortization1,520 933 106 
Gain on settlement of convertible notes— (10,254)(10,324)
Coupon interest expense26,737 26,339 18,072 
Total interest expense on convertible notes$32,866 $22,314 $13,204 
The following table summarizes the effective interest rates of the Notes:
Year Ended December 31,
202520242023
2031 Convertible Notes2.14 %2.06 %— %
2030 Convertible Notes2.14 %2.09 %2.09 %
2028 Convertible Notes0.65 %0.63 %0.63 %
2027 Convertible Notes0.68 %0.67 %0.67 %
2025 Convertible Notes1.05 %1.16 %1.17 %
v3.25.4
STOCKHOLDERS' EQUITY (Tables)
 12 Months Ended
Dec. 31, 2025
Equity [Abstract]  
Schedule of business acquisitions, by acquisition
The acquisition date fair value of the consideration transferred for Resolution Bioscience was approximately $54.2 million, which consisted of the following:
(In thousands)
Cash$52,527 
Fair value of replaced equity awards1,675 
Total purchase price$54,202 
Schedule of amounts recognized in accumulated other comprehensive income (loss) (AOCI)
The amount recognized in AOCI for the years ended December 31, 2025, 2024 and 2023 were as follows:
(In thousands)Cumulative Translation Adjustment
Unrealized Gain (Loss) on Securities (1)
AOCI
Balance at January 1, 2023
$53 $(5,289)$(5,236)
Other comprehensive income before reclassifications
1,321 1,416 2,737 
Amounts reclassified from accumulated other comprehensive income (loss)
— 3,927 3,927 
Net current period change in accumulated other comprehensive income (loss)
1,321 5,343 6,664 
Balance at December 31, 2023$1,374 $54 $1,428 
Other comprehensive income (loss) before reclassifications(3,294)873 (2,421)
Amounts reclassified from accumulated other comprehensive income (loss)
— 49 49 
Net current period change in accumulated other comprehensive income (loss)
(3,294)922 (2,372)
Balance at December 31, 2024$(1,920)$976 $(944)
Other comprehensive income before reclassifications
4,278 — 4,278 
Amounts reclassified from accumulated other comprehensive income (loss)
— (976)(976)
Net current period change in accumulated other comprehensive income (loss)
4,278 (976)3,302 
Balance at December 31, 2025$2,358 $— $2,358 
_________________________________
(1)There was no tax impact from the amounts recognized in AOCI for the years ended December 31, 2025, 2024, and 2023. The unrealized gain (loss) recorded on available-for-sale securities is a non-cash investing activity.
Schedule of amounts reclassified from accumulated other comprehensive income (loss)
Amounts reclassified from AOCI for the years ended December 31, 2025, 2024, and 2023 were as follows:
Year Ended December 31,
Details about AOCI Components (In thousands)Affected Line Item in the
Statements of Operations		202520242023
Change in value of available-for-sale investments
Sales and maturities of available-for-sale investments
Investment income, net
$(976)$49 $3,927 
Total reclassifications$(976)$49 $3,927 
v3.25.4
STOCK-BASED COMPENSATION (Tables)
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Schedule of non-cash stock-based compensation expense by department A summary of non-cash stock-based compensation expense by expense category included in the Company’s consolidated statements of operations for the years ended December 31, 2025, 2024, and 2023 is as follows:
Year Ended December 31,
(In thousands)202520242023
Cost of sales$17,244 $20,518 $20,761 
Research and development37,379 39,684 41,242 
Sales and marketing66,762 68,236 73,016 
General and administrative96,281 86,447 96,293 
Total stock-based compensation$217,666 $214,885 $231,312 
Schedule of valuation assumptions
The fair value of shares purchased under the ESPP is based on the assumptions in the following table:
Year Ended December 31,
202520242023
Risk-free interest rates
4.22% - 5.15%
4.71% - 5.30%
4.68% - 4.71%
Expected term (in years)
0.50 - 1.25
1.17 - 1.25
1.25
Expected volatility
44.40% - 60.67%
44.40% - 63.13%
63.13% - 67.30%
Dividend yield0%0%0%
Summary of stock option activity under the Stock Plans
A summary of stock option activity under the Stock Plans is as follows:
OptionsSharesWeighted Average Exercise PriceWeighted Average Remaining Contractual Term (Years)Aggregate Intrinsic Value (1)
(Aggregate intrinsic value in thousands)
Outstanding, January 1, 2025
982,742 $53.60 3.1
Exercised(161,596)27.48 
Forfeited(39,857)85.58 
Outstanding, December 31, 2025
781,289 $57.37 2.4$34,528 
Vested and expected to vest, December 31, 2025
781,289 $57.37 2.4$34,528 
Exercisable, December 31, 2025
781,289 $57.37 2.4$34,528 
_________________________________
(1)     The total intrinsic value of options exercised, net of shares withheld for taxes, during the years ended December 31, 2025, 2024, and 2023 was $6.0 million, $7.8 million, and $11.7 million, respectively, determined as of the date of exercise.
Summary of restricted stock and restricted stock unit activity under the Stock Plans
A summary of restricted stock and RSU activity is as follows:
Restricted SharesWeighted Average Grant Date Fair Value (1)
Outstanding, January 1, 2025
7,244,796 $63.18 
Granted3,661,929 51.61 
Released (2)(3,102,685)66.18 
Forfeited(907,813)55.98 
Outstanding, December 31, 2025
6,896,227 $56.12 
_________________________________
(1)     The weighted average grant date fair value of the RSUs granted during the years ended December 31, 2024 and 2023 was $56.94 and $62.36, respectively.
(2)     The fair value of RSUs vested and converted to shares of the Company’s common stock was $205.3 million, $184.2 million, and $158.2 million for the years ended December 31, 2025, 2024, and 2023, respectively. The stock-based compensation expense associated with the RSUs that were accelerated and vested in 2025 related to the modification of awards to mitigate the potential impact of Sections 280G and 4999 of the Internal Revenue Code of 1986, as amended, as discussed in further detail above, will continue to be recognized over the substantive service period of the respective award.
Share-based Payment Arrangement, Performance Shares, Activity
A summary of PSU activity is as follows:
Performance Share Units (1)Weighted Average Grant Date Fair Value (2)
Outstanding, January 1, 20252,021,208 $75.86 
Granted1,283,717 59.49 
Released (3)(1,380,061)79.03 
Forfeited(876,997)81.24 
Outstanding, December 31, 20251,047,867 $62.20 
_________________________________
(1)     The PSUs listed above assumes attainment of maximum payout rates as set forth in the performance criteria. Applying actual or expected payout rates, the number of outstanding PSUs as of December 31, 2025 was 631,833.
(2)     The weighted average grant date fair value of the PSUs granted during the years ended December 31, 2024 and 2023 was $63.68 and $80.50, respectively.
(3)     The fair value of PSUs vested and converted to shares of the Company’s common stock was $77.2 million, $9.9 million, and $1.0 million for the years ended December 31, 2025, 2024, and 2023, respectively. The stock-based compensation expense associated with the PSUs that were accelerated and vested in 2025 related to the modification of awards to mitigate the potential impact of Sections 280G and 4999 of the Internal Revenue Code of 1986, as amended, as discussed in further detail above, will continue to be recognized over the substantive service period of the respective award.
Schedule of shares of common stock issued
A summary of ESPP activity is as follows:
Year Ended December 31,
(in thousands, except share and per share amounts)202520242023
Shares issued under the 2010 Purchase Plan685,693 955,392924,448
Cash received under the 2010 Purchase Plan$26,544 $31,227 $28,344 
Weighted average fair value per share of stock purchase rights granted during the period$19.17 $16.26 $16.32 
Schedule of Common Stock Issued
The 685,693 shares issued during the year ended December 31, 2025 were as follows:
Offering period endedNumber of SharesWeighted Average price per Share
April 30, 2025419,070 $38.26 
October 31, 2025266,623 $39.42 
Summary of shares of authorized common stock reserved for issuance
The Company has reserved shares of its authorized common stock for issuance pursuant to its employee stock purchase and equity plans, including all outstanding stock option grants noted above at December 31, 2025, as follows:
Shares reserved for issuance
2025 Stock Plan
12,357,179 
2010 Purchase Plan4,193,108 
16,550,287 
v3.25.4
COMMITMENTS AND CONTINGENCIES (Tables)
 12 Months Ended
Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]  
Components of lease expense
The components of lease expense were as follows:
Year Ended December 31,
(In thousands)202520242023
Finance lease cost
Amortization of right-of-use assets$6,554 $7,311 $3,845 
Interest on lease liabilities1,047 1,406 800 
Operating lease cost32,870 31,797 36,576 
Short-term lease cost946 1,036 750 
Variable lease cost8,218 9,055 8,449 
Total lease Cost$49,635 $50,605 $50,420 
Supplemental disclosure of cash flow information related to the Company’s cash and non-cash activities with its leases are as follows:
Year Ended December 31,
(In thousands)202520242023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$41,253$38,135$39,301
Operating cash flows from finance leases1,0831,359783
Finance cash flows from finance leases6,4216,8273,569
Non-cash investing and financing activities:
Right-of-use assets obtained in exchange for new operating lease liabilities29,27319,6744,986
Right-of-use assets obtained in exchange for new finance lease liabilities—16,4255,443
Weighted-average remaining lease term - operating leases (in years)6.887.376.87
Weighted-average remaining lease term - finance leases (in years)2.222.902.80
Weighted-average discount rate - operating leases6.50 %6.54 %6.59 %
Weighted-average discount rate - finance leases6.65 %6.69 %7.43 %
Operating lease maturity
Maturities of operating lease liabilities on an annual basis as of December 31, 2025 were as follows:
(In thousands)
2026$43,164 
202745,208 
202835,876 
202925,806 
203017,451 
Thereafter78,654 
Total minimum lease payments246,159 
Imputed interest(50,637)
Total$195,522 
Finance lease maturity
Maturities of finance lease liabilities on an annual basis as of December 31, 2025 were as follows:
(In thousands)
2026$6,284
20275,201
20281,282
202993
203093
Thereafter36
Total minimum lease payments12,989
Imputed interest(861)
Total$12,128
v3.25.4
Restructuring and Related Activities (Tables)
 12 Months Ended
Dec. 31, 2025
Restructuring and Related Activities [Abstract]  
Restructuring and Related Costs
The Company recorded the following charges related to the Plan for the year ended December 31, 2025.
(In thousands)
Restructuring charges
$22,169 
Business transformation costs (1)
51,044 
Total restructuring and business transformation
$73,213 
_________________________________
(1)Business transformation costs represent non-recurring expenses for strategic projects with anticipated long-term benefits to the Company focused on cost reduction and productivity improvement that do not meet the definition of restructuring charges. For the year ended December 31, 2025, these costs primarily include consulting services, and employee termination benefits.
Restructuring and Related Costs by Expense Caption
The restructuring charges were recorded as follows within the consolidated statement of operations for the year ended December 31, 2025:
(In thousands)
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$84 $554 $2,868 $10,884 $14,390 
Other costs
— — — 7,779 7,779 
Total restructuring charges$84 $554 $2,868 $18,663 $22,169 
Schedule of Restructuring Reserve by Type of Cost
The following table summarizes activity in the liability related to the Company’s restructuring initiatives:
(In thousands)Employee Termination Costs
Other Costs
Total
Balance, December 31, 2024
$— $— $— 
Charges (1)
14,390 7,779 22,169 
Payments(11,348)(7,470)(18,818)
Adjustments (2)
496 — 496 
Balance, December 31, 2025
$3,538 $309 $3,847 
_________________________________
(1)Inclusive of the reversal of employee termination related charges originally recorded in the third quarter of 2025 primarily due to certain employees identified for termination finding other positions within the Company or voluntarily separating prior to their scheduled termination date.
(2)Adjustments relate to the effects of foreign currency exchange rates.
v3.25.4
BUSINESS COMBINATIONS AND ASSET ACQUISITIONS (Tables)
 12 Months Ended
Dec. 31, 2025
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]  
Schedule of business acquisitions, by acquisition
The acquisition date fair value of the consideration transferred for Resolution Bioscience was approximately $54.2 million, which consisted of the following:
(In thousands)
Cash$52,527 
Fair value of replaced equity awards1,675 
Total purchase price$54,202 
Business combination, pro forma information
The following unaudited pro forma financial information summarizes the combined results of operations for the Company and Resolution Bioscience, as though the companies were combined as of the beginning of January 1, 2022.
Twelve Months Ended December 31,
(In thousands)20232022
Total revenues$2,507,111 $2,097,680 
Net loss before tax(237,854)(675,091)
v3.25.4
SEGMENT INFORMATION (Tables)
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Revenue from External Customers by Geographic Areas
The following table summarizes total revenue from customers by geographic region. Product revenues are attributed to countries based on ship-to location.
Year Ended December 31,
(In thousands)202520242023
United States$3,023,146 $2,569,775 $2,346,489 
Outside of United States223,844 189,092 153,277 
Total revenues$3,246,990 $2,758,867 $2,499,766 
v3.25.4
INCOME TAXES (Tables)
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Schedule of income before income tax, domestic and foreign
Loss before provision for taxes consisted of the following:
Year Ended December 31,
(In thousands)202520242023
Income (loss) before income taxes:
Domestic$(220,010)$(1,036,306)$(204,128)
Foreign16,122 145 2,382 
Total loss before income taxes$(203,888)$(1,036,161)$(201,746)
Schedule of expense (benefit) for income taxes
The expense (benefit) for income taxes consists of:
Year Ended December 31,
(In thousands)202520242023
Current expense (benefit):
Federal$— $— $— 
State1,516 933 2,266 
Foreign3,909 1,882 2,561 
Deferred tax expense (benefit):
Federal498 (4,775)2,395 
State(334)(5,145)(1,829)
Foreign(1,528)(199)(2,990)
Total income tax expense (benefit)$4,061 $(7,304)$2,403 
Schedule of components of the net deferred tax asset
The components of the net deferred tax asset with the approximate income tax effect of each type of carryforward, credit and temporary differences are as follows:
December 31,
(In thousands)20252024
Deferred tax assets:
Operating loss carryforwards$496,415 $452,410 
Tax credit carryforwards137,617 121,635 
Compensation related differences82,350 72,349 
Lease liabilities46,764 47,199 
Capitalized research and development186,957 251,760 
Other temporary differences9,497 7,271 
Tax assets before valuation allowance959,600 952,624 
Less - Valuation allowance(735,979)(708,788)
Total deferred tax assets223,621 243,836 
Deferred tax liabilities
Amortization$(174,182)$(205,764)
Property, plant and equipment(15,430)(7,160)
Lease assets(30,216)(31,266)
Other temporary differences(9,599)(6,816)
Total deferred tax liabilities(229,427)(251,006)
Net deferred tax liabilities$(5,806)$(7,170)
Summary of valuation allowance
Activity associated with the Company's valuation allowance is as follows:
December 31,
(In thousands)202520242023
Balance as of January 1, $(708,788)$(465,832)$(419,356)
Valuation allowances established(32,224)(241,849)(44,759)
Changes to existing valuation allowances5,033 (1,107)(1,242)
Acquisition and purchase accounting— — (475)
Balance as of December 31,$(735,979)$(708,788)$(465,832)
Schedule of differences between the effective income tax rate and the statutory tax rate
The effective tax rate differs from the statutory tax rate due to the following:
December 31, 2025
AmountPercent
U.S. Federal statutory rate$(42,817)21.0 %
State and local taxes, net of federal income tax effect (1)
768 (0.4)
Foreign tax effects(376)0.2 
Effect of cross border laws
Subpart F38 0.0 
Tax credits
Research and development(10,861)5.3 
Other(107)0.1 
Changes in valuation allowance29,385 (14.4)
Nontaxable or nondeductible items
Stock-based compensation expense(6,906)3.4 
Non-deductible executive compensation22,552 (11.1)
Transaction costs2,987 (1.5)
Meals and entertainment3,326 (1.6)
Contingent consideration5,568 (2.7)
Other non-deductible items574 (0.3)
Other adjustments(70)— 
Effective tax rate$4,061 (2.0)%
_________________________________
(1)The majority of taxes in the state and local income tax category are reported in Wisconsin and California.
December 31,
20242023
U.S. Federal statutory rate21.0 %21.0 %
State taxes3.0 3.9 
Federal and state tax rate changes— 1.1 
Foreign tax rate differential0.1 — 
Research and development tax credits1.6 7.6 
Stock-based compensation expense(1.0)(4.4)
Non-deductible executive compensation(0.5)(3.5)
Loss on extinguishment - convertible debt— (0.7)
Other adjustments(0.1)(2.5)
Valuation allowance(23.5)(23.7)
Effective tax rate0.6 %(1.2)%
Schedule of unrecognized tax benefits
The following is a tabular reconciliation of the amounts of unrecognized tax benefits:
December 31,
(In thousands)202520242023
January 1,$43,344 $36,399 $28,270 
Increase due to current year tax positions5,166 7,322 7,447 
Increase due to prior year tax positions— — 1,108 
Decrease due to prior year tax positions(1,051)(377)(426)
December 31,$47,459 $43,344 $36,399 
v3.25.4
Restructuring and Related Activities (Tables)
 12 Months Ended
Dec. 31, 2025
Restructuring and Related Activities [Abstract]  
Restructuring and Related Costs
The Company recorded the following charges related to the Plan for the year ended December 31, 2025.
(In thousands)
Restructuring charges
$22,169 
Business transformation costs (1)
51,044 
Total restructuring and business transformation
$73,213 
_________________________________
(1)Business transformation costs represent non-recurring expenses for strategic projects with anticipated long-term benefits to the Company focused on cost reduction and productivity improvement that do not meet the definition of restructuring charges. For the year ended December 31, 2025, these costs primarily include consulting services, and employee termination benefits.
Restructuring and Related Costs by Expense Caption
The restructuring charges were recorded as follows within the consolidated statement of operations for the year ended December 31, 2025:
(In thousands)
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$84 $554 $2,868 $10,884 $14,390 
Other costs
— — — 7,779 7,779 
Total restructuring charges$84 $554 $2,868 $18,663 $22,169 
Schedule of Restructuring Reserve by Type of Cost
The following table summarizes activity in the liability related to the Company’s restructuring initiatives:
(In thousands)Employee Termination Costs
Other Costs
Total
Balance, December 31, 2024
$— $— $— 
Charges (1)
14,390 7,779 22,169 
Payments(11,348)(7,470)(18,818)
Adjustments (2)
496 — 496 
Balance, December 31, 2025
$3,538 $309 $3,847 
_________________________________
(1)Inclusive of the reversal of employee termination related charges originally recorded in the third quarter of 2025 primarily due to certain employees identified for termination finding other positions within the Company or voluntarily separating prior to their scheduled termination date.
(2)Adjustments relate to the effects of foreign currency exchange rates.
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Net Loss Per Share (Details) - shares
shares in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Common shares not included in the computation of diluted net loss per share      
Antidilutive shares (in shares) 31,948 36,775 32,388
Shares issuable upon exercise of stock options      
Common shares not included in the computation of diluted net loss per share      
Antidilutive shares (in shares) 781 983 1,286
Shares issuable upon the release of restricted stock awards      
Common shares not included in the computation of diluted net loss per share      
Antidilutive shares (in shares) 6,896 7,245 6,273
Shares issuable upon the release of performance share units      
Common shares not included in the computation of diluted net loss per share      
Antidilutive shares (in shares) 1,048 2,021 1,598
Shares issuable upon conversion of convertible notes      
Common shares not included in the computation of diluted net loss per share      
Antidilutive shares (in shares) 23,223 26,526 23,231
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Research and Development Costs (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Accounting Policies [Abstract]      
Research and development $ 522,996 $ 431,210 $ 426,927
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Advertising Costs (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Accounting Policies [Abstract]      
Advertising expense $ 199.2 $ 180.3 $ 137.9
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Leases (Details)
 12 Months Ended
Dec. 31, 2025
Lessee, Lease, Description [Line Items]  
Operating lease, term extension 10 years
Operating lease, termination period 1 year
Minimum  
Lessee, Lease, Description [Line Items]  
Operating lease, remaining lease term 1 year
Maximum  
Lessee, Lease, Description [Line Items]  
Operating lease, remaining lease term 15 years
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Concentration of Credit Risk (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Concentration of Credit Risk      
Cash and cash equivalents, federal government agency insured limit $ 892.6    
Revenue | Customer Concentration Risk | Centers for Medicare and Medicaid Services      
Concentration of Credit Risk      
Concentration risk (as a percent) 15.00% 16.00% 17.00%
Revenue | Customer Concentration Risk | UnitedHealthcare      
Concentration of Credit Risk      
Concentration risk (as a percent) 13.00% 12.00% 12.00%
Accounts Receivable | Customer Concentration Risk | Centers for Medicare and Medicaid Services      
Concentration of Credit Risk      
Concentration risk (as a percent) 8.00% 10.00% 10.00%
Accounts Receivable | Customer Concentration Risk | UnitedHealthcare      
Concentration of Credit Risk      
Concentration risk (as a percent) 8.00% 9.00% 10.00%
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Tax Positions (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Accounting Policies [Abstract]      
Deferred tax asset valuation allowance $ 735,979 $ 708,788  
Increase (decrease) in valuation allowance 27,200 243,000  
Income tax benefit (expense) $ (4,061) $ 7,304 $ (2,403)
v3.25.4
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details)
$ / shares in Units, $ in Millions
Dec. 31, 2025
USD ($)
$ / shares
Accounting Policies [Abstract]  
Merger Agreement, Share Price | $ / shares $ 105.00
Termination Fee of Merger Agreement | $ $ 628.7
v3.25.4
REVENUE - Schedule of Disaggregation of Revenue (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Disaggregation of Revenue [Line Items]      
Revenue recognized $ 3,246,990 $ 2,758,867 $ 2,499,766
Screening      
Disaggregation of Revenue [Line Items]      
Revenue recognized 2,529,866 2,103,868 1,864,701
Screening | Medicare Parts B & C      
Disaggregation of Revenue [Line Items]      
Revenue recognized 955,075 776,155 701,400
Screening | Commercial      
Disaggregation of Revenue [Line Items]      
Revenue recognized 1,323,216 1,118,338 992,244
Screening | Other      
Disaggregation of Revenue [Line Items]      
Revenue recognized 251,575 209,375 171,057
Precision Oncology      
Disaggregation of Revenue [Line Items]      
Revenue recognized 717,124 654,999 629,110
Precision Oncology | Medicare Parts B & C      
Disaggregation of Revenue [Line Items]      
Revenue recognized 196,468 187,948 188,689
Precision Oncology | Commercial      
Disaggregation of Revenue [Line Items]      
Revenue recognized 196,170 190,595 181,318
Precision Oncology | Other      
Disaggregation of Revenue [Line Items]      
Revenue recognized 100,642 87,364 105,826
Precision Oncology | International      
Disaggregation of Revenue [Line Items]      
Revenue recognized 223,844 189,092 153,277
COVID-19 Testing      
Disaggregation of Revenue [Line Items]      
Revenue recognized $ 0 $ 0 $ 5,955
v3.25.4
REVENUE - Narrative (Details)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Variable consideration      
Disaggregation of Revenue [Line Items]      
Contract with Customer, Liability, Cumulative Catch-up Adjustment to Revenue, Change in Estimate of Transaction Price as a Percentage of Revenue (1.00%) 1.00% 2.00%
v3.25.4
MARKETABLE SECURITIES - Schedule of Cash and Cash Equivalents (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Marketable Securities [Line Items]      
Available-for-sale debt securities   $ 436,506  
Equity securities $ 8,715 5,972  
Total marketable securities 8,715 437,137  
Total cash, cash equivalents, and marketable securities 964,711 1,038,026  
Cash 955,996 595,548  
Cash and cash equivalents 955,996 600,889 $ 605,378
Cash Equivalents [Member]      
Marketable Securities [Line Items]      
Available-for-sale debt securities   5,341  
Short-Term Investments [Member]      
Marketable Securities [Line Items]      
Available-for-sale debt securities 0 431,165  
Cash Equivalents [Member]      
Marketable Securities [Line Items]      
Cash and cash equivalents $ 0 $ 5,341  
v3.25.4
MARKETABLE SECURITIES - Schedule of Available For Sale Securities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Available-for-sale securities    
Amortized Cost   $ 435,530
Gains in Accumulated Other Comprehensive Income (Loss)   1,348
Losses in Accumulated Other Comprehensive Income (Loss)   (372)
Estimated Fair Value   436,506
Cash Equivalents [Member]    
Available-for-sale securities    
Amortized Cost   5,341
Gains in Accumulated Other Comprehensive Income (Loss)   0
Losses in Accumulated Other Comprehensive Income (Loss)   0
Estimated Fair Value   5,341
Short-Term Investments [Member]    
Available-for-sale securities    
Amortized Cost   430,189
Gains in Accumulated Other Comprehensive Income (Loss)   1,348
Losses in Accumulated Other Comprehensive Income (Loss)   (372)
Estimated Fair Value $ 0 431,165
US Government Agencies Debt Securities [Member] | Short-Term Investments [Member]    
Available-for-sale securities    
Amortized Cost   140,992
Gains in Accumulated Other Comprehensive Income (Loss)   160
Losses in Accumulated Other Comprehensive Income (Loss)   (200)
Estimated Fair Value   140,952
Corporate Bond Securities [Member] | Short-Term Investments [Member]    
Available-for-sale securities    
Amortized Cost   206,063
Gains in Accumulated Other Comprehensive Income (Loss)   932
Losses in Accumulated Other Comprehensive Income (Loss)   (121)
Estimated Fair Value   206,874
Asset-Backed Securities [Member] | Short-Term Investments [Member]    
Available-for-sale securities    
Amortized Cost   83,134
Gains in Accumulated Other Comprehensive Income (Loss)   256
Losses in Accumulated Other Comprehensive Income (Loss)   (51)
Estimated Fair Value   83,339
Commercial Paper [Member] | Cash Equivalents [Member]    
Available-for-sale securities    
Amortized Cost   5,341
Gains in Accumulated Other Comprehensive Income (Loss)   0
Losses in Accumulated Other Comprehensive Income (Loss)   0
Estimated Fair Value   $ 5,341
v3.25.4
MARKETABLE SECURITIES - Schedule of Gross Unrealized Losses And Fair Value of Available For Sale Securities (Details)
$ in Thousands
Dec. 31, 2024
USD ($)
Marketable Securities [Line Items]  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months $ 71,088
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (348)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater 4,656
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater, accumulated loss (24)
Total fair value of available-for-sale securities in a continuous unrealized loss position 75,744
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position (372)
Short-Term Investments [Member] | Corporate Bond Securities [Member]  
Marketable Securities [Line Items]  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months 25,979
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (121)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater 0
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater, accumulated loss 0
Total fair value of available-for-sale securities in a continuous unrealized loss position 25,979
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position (121)
Short-Term Investments [Member] | US Government Agencies Debt Securities [Member]  
Marketable Securities [Line Items]  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months 39,542
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (199)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater 1,990
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater, accumulated loss (1)
Total fair value of available-for-sale securities in a continuous unrealized loss position 41,532
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position (200)
Short-Term Investments [Member] | Asset-Backed Securities [Member]  
Marketable Securities [Line Items]  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months 5,567
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (28)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater 2,666
Debt securities, available-for-sale, continuous unrealized loss position, 12 months or greater, accumulated loss (23)
Total fair value of available-for-sale securities in a continuous unrealized loss position 8,233
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position $ (51)
v3.25.4
INVENTORY (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Inventory Disclosure [Abstract]    
Raw materials $ 75,716 $ 69,730
Semi-finished and finished goods 90,485 92,653
Inventory $ 166,201 $ 162,383
v3.25.4
PROPERTY, PLANT AND EQUIPMENT - Schedule of Estimated Useful Lives (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Property, plant and equipment    
Property, plant and equipment, at cost $ 1,312,792 $ 1,202,247
Accumulated depreciation (604,128) (508,574)
Property, plant and equipment, net 708,664 693,673
Land    
Property, plant and equipment    
Property, plant and equipment, at cost 4,716 4,716
Leasehold and building improvements    
Property, plant and equipment    
Property, plant and equipment, at cost $ 257,503 227,885
Land improvements    
Property, plant and equipment    
Estimated Useful Life 15 years  
Property, plant and equipment, at cost $ 6,740 6,747
Buildings    
Property, plant and equipment    
Property, plant and equipment, at cost $ 290,777 290,777
Buildings | Minimum    
Property, plant and equipment    
Estimated Useful Life 30 years  
Buildings | Maximum    
Property, plant and equipment    
Estimated Useful Life 40 years  
Computer equipment and computer software    
Property, plant and equipment    
Estimated Useful Life 3 years  
Property, plant and equipment, at cost $ 243,624 206,460
Machinery and equipment    
Property, plant and equipment    
Property, plant and equipment, at cost $ 387,943 339,421
Machinery and equipment | Minimum    
Property, plant and equipment    
Estimated Useful Life 3 years  
Machinery and equipment | Maximum    
Property, plant and equipment    
Estimated Useful Life 10 years  
Furniture and fixtures    
Property, plant and equipment    
Property, plant and equipment, at cost $ 37,347 37,176
Furniture and fixtures | Minimum    
Property, plant and equipment    
Estimated Useful Life 3 years  
Furniture and fixtures | Maximum    
Property, plant and equipment    
Estimated Useful Life 10 years  
Assets under construction    
Property, plant and equipment    
Property, plant and equipment, at cost $ 84,142 $ 89,065
v3.25.4
PROPERTY, PLANT AND EQUIPMENT - Narrative (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Property, plant and equipment    
Property, plant and equipment, gross $ 1,312,792 $ 1,202,247
Assets under construction    
Property, plant and equipment    
Property, plant and equipment, gross 84,142 89,065
Assets under construction 84,100  
Machinery and equipment    
Property, plant and equipment    
Property, plant and equipment, gross 387,943 339,421
Assets under construction 42,000  
Leasehold and building improvements    
Property, plant and equipment    
Property, plant and equipment, gross 257,503 $ 227,885
Assets under construction 15,300  
Software Development    
Property, plant and equipment    
Assets under construction $ 26,800  
v3.25.4
INTANGIBLE ASSETS AND GOODWILL - Schedule of Finite Lived Intangible Assets Net Balances and Weighted Average Useful Lives (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items]    
Cost $ 1,057,960 $ 1,051,646
Accumulated Amortization (558,035) (461,953)
Finite-lived intangible assets, net 499,925 589,693
In-process research and development 420,000 420,000
Finite-lived and indefinite-lived intangible assets, gross 1,477,960 1,471,646
Finite-lived and indefinite-lived intangible assets, net $ 919,925 $ 1,009,693
Trade name    
Finite-Lived Intangible Assets [Line Items]    
Finite-Lived Intangible Asset, Useful Life 9 years 10 months 24 days 10 years 9 months 18 days
Cost $ 104,000 $ 104,000
Accumulated Amortization (42,403) (35,153)
Finite-lived intangible assets, net $ 61,597 $ 68,847
Customer relationships    
Finite-Lived Intangible Assets [Line Items]    
Finite-Lived Intangible Asset, Useful Life 5 years 6 years
Cost $ 4,000 $ 4,000
Accumulated Amortization (1,778) (1,333)
Finite-lived intangible assets, net $ 2,222 $ 2,667
Patents and licenses    
Finite-Lived Intangible Assets [Line Items]    
Finite-Lived Intangible Asset, Useful Life 8 years 7 months 6 days 9 years 6 months
Cost $ 62,442 $ 56,542
Accumulated Amortization (17,868) (12,963)
Finite-lived intangible assets, net $ 44,574 $ 43,579
Developed Technology Rights [Member]    
Finite-Lived Intangible Assets [Line Items]    
Finite-Lived Intangible Asset, Useful Life 5 years 7 months 6 days 6 years 4 months 24 days
Cost $ 887,518 $ 887,104
Accumulated Amortization (495,986) (412,504)
Finite-lived intangible assets, net $ 391,532 $ 474,600
v3.25.4
INTANGIBLE ASSETS AND GOODWILL - Schedule of Future Amortization Expense (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]    
2026 $ 95,955  
2027 95,955  
2028 95,955  
2029 89,832  
2030 22,473  
Thereafter 99,755  
Finite-lived intangible assets, net $ 499,925 $ 589,693
v3.25.4
INTANGIBLE ASSETS AND GOODWILL - Narrative (Details) - USD ($)
 3 Months Ended 12 Months Ended
Dec. 31, 2024
Sep. 30, 2024
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Jan. 05, 2021
Finite-Lived Intangible Assets [Line Items]            
Cost $ 1,051,646,000   $ 1,057,960,000 $ 1,051,646,000    
Finite-lived intangible assets, accumulated amortization 461,953,000   558,035,000 461,953,000    
Finite-lived Intangible assets, net 589,693,000   499,925,000 589,693,000    
Goodwill, impairment loss     0 0 $ 0  
Impairment of long-lived and indefinite-lived assets     7,200,000 869,460,000 621,000  
Impairment of long-lived and indefinite-lived assets   $ 18,700,000 7,200,000 869,460,000 621,000  
Impairment of Intangible Assets, Finite-Lived     0 0 $ 0  
In-process research and development            
Finite-Lived Intangible Assets [Line Items]            
Indefinite-Lived Intangible Assets (Excluding Goodwill), Fair Value Disclosure 420,000,000.0     420,000,000.0    
Impairment of long-lived and indefinite-lived assets 830,000,000.0          
Thrive            
Finite-Lived Intangible Assets [Line Items]            
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Indefinite-Lived Intangible Assets           $ 1,250,000,000
Developed Technology Rights [Member]            
Finite-Lived Intangible Assets [Line Items]            
Cost 887,104,000   887,518,000 887,104,000    
Finite-lived intangible assets, accumulated amortization 412,504,000   495,986,000 412,504,000    
Finite-lived Intangible assets, net $ 474,600,000   $ 391,532,000 $ 474,600,000    
v3.25.4
INTANGIBLE ASSETS AND GOODWILL - Schedule of Changes in Goodwill (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Carrying amount of goodwill    
Beginning of the period $ 2,366,676 $ 2,367,120
Goodwill, Foreign Currency Translation Gain (Loss) 1,372 669
Ending of the period 2,368,048 2,366,676
Goodwill $ 2,368,048 2,366,676
Resolution Bioscience    
Carrying amount of goodwill    
Acquisition   $ (225)
v3.25.4
FAIR VALUE MEASUREMENTS - Schedule of Fair Value (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Fair value measurements      
Equity securities $ 8,715 $ 5,972  
Non-marketable securities 52,538 796 $ 7,650
Contingent consideration   (19,700)  
Fair Value, Recurring      
Fair value measurements      
Equity securities 8,715 5,972  
Non-marketable securities 52,538 796  
Contingent consideration (289,018) (282,212)  
Total 728,231 762,357  
Fair Value, Recurring | Corporate Bond Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   206,874  
Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   140,952  
Fair Value, Recurring | Asset-Backed Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   83,339  
Fair Value, Recurring | Cash and money market      
Fair value measurements      
Total cash and cash equivalents 955,996 595,548  
Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Total cash and cash equivalents   5,341  
Fair Value, Recurring | Restricted Cash [Member]      
Fair value measurements      
Total cash and cash equivalents   5,747  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring      
Fair value measurements      
Equity securities 8,715 5,972  
Non-marketable securities 0 0  
Contingent consideration 0 0  
Total 964,711 607,267  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | Corporate Bond Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   0  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   0  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | Asset-Backed Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   0  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | Cash and money market      
Fair value measurements      
Total cash and cash equivalents 955,996 595,548  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Total cash and cash equivalents   0  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | Restricted Cash [Member]      
Fair value measurements      
Total cash and cash equivalents   5,747  
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring      
Fair value measurements      
Equity securities 0 0  
Non-marketable securities 0 0  
Contingent consideration 0 0  
Total 0 436,506  
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | Corporate Bond Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   206,874  
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   140,952  
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | Asset-Backed Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   83,339  
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | Cash and money market      
Fair value measurements      
Total cash and cash equivalents 0 0  
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Total cash and cash equivalents   5,341  
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | Restricted Cash [Member]      
Fair value measurements      
Total cash and cash equivalents   0  
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring      
Fair value measurements      
Equity securities 0 0  
Non-marketable securities 52,538 796  
Contingent consideration (289,018) (282,212)  
Total (236,480) (281,416)  
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | Corporate Bond Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   0  
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   0  
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | Asset-Backed Securities [Member]      
Fair value measurements      
Debt Securities, Available-for-Sale   0  
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | Cash and money market      
Fair value measurements      
Total cash and cash equivalents $ 0 0  
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | US Government Agencies Debt Securities [Member]      
Fair value measurements      
Total cash and cash equivalents   0  
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | Restricted Cash [Member]      
Fair value measurements      
Total cash and cash equivalents   $ 0  
v3.25.4
FAIR VALUE MEASUREMENTS - Non-marketable Securities (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Fair Value Disclosures [Abstract]      
Equity Securities without Readily Determinable Fair Value, Upward Price Adjustment, Cumulative Amount $ 5,595 $ 5,102  
Equity Securities without Readily Determinable Fair Value, Downward Price Adjustment, Cumulative Amount (16,850) (16,850)  
Other Investment Not Readily Marketable, Fair Value 54,941 50,448  
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]      
Other Assets, Fair Value Disclosure 115,322 58,732  
Non-marketable securities 52,538 796 $ 7,650
Other Investment Not Readily Marketable, Fair Value 54,941 50,448  
Equity Method Investments, Fair Value Disclosure 7,843 7,488  
Security Owned Not Readily Marketable [Line Items]      
Changes in fair value 492 (604)  
Settlements   (6,250)  
Purchases of non-marketable securities 51,250    
Non-marketable securities $ 52,538 $ 796 $ 7,650
v3.25.4
FAIR VALUE MEASUREMENTS - Fair Value of Contingent Consideration (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Fair Value Disclosures [Abstract]      
Beginning balance $ 282,212 $ 288,657 $ 306,927
Payment for Contingent Consideration Liability, Financing Activities 19,000 0 0
Ending balance 289,018 282,212 288,657
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]      
Business Combination, Contingent Consideration, Gain (Loss), Change in Fair Value 26,806 (3,345) (18,044)
Payment for Contingent Consideration Liability, Financing Activities 19,000 0 0
Ashion      
Fair Value Disclosures [Abstract]      
Payment for Contingent Consideration Liability, Financing Activities 20,000    
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]      
Payment for Contingent Consideration Liability, Financing Activities $ 20,000    
OmicEra      
Fair Value Disclosures [Abstract]      
Payment for Contingent Consideration Liability, Financing Activities   3,100  
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]      
Payment for Contingent Consideration Liability, Financing Activities   $ 3,100  
Biomatrica Inc      
Fair Value Disclosures [Abstract]      
Payment for Contingent Consideration Liability, Financing Activities     226
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]      
Payment for Contingent Consideration Liability, Financing Activities     $ 226
v3.25.4
FAIR VALUE MEASUREMENTS - Narrative (Details)
 12 Months Ended
Dec. 31, 2025
USD ($)
Aug. 04, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]          
Equity Method Investments, Fair Value Disclosure $ 7,843,000   $ 7,488,000    
Business Combination, Contingent Consideration, Liability, Current     19,700,000    
Business Combination, Contingent Consideration, Liability, Noncurrent     262,500,000    
Contingent consideration, liability 289,018,000   282,212,000 $ 288,657,000 $ 306,927,000
Venture Capital Investment Fund          
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]          
Committed capital 18,000,000.0        
Committed capital callable 9,400,000        
Equity Method Investments, Fair Value Disclosure 7,800,000   $ 7,500,000    
Freenome Holdings, Inc          
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]          
Investment Owned, Cost   $ 50,000,000      
Investment Interest Rate   500.00%      
Investment owned, fair value $ 50,100,000        
Weighted Average | Product Development and Other Milestone-based Payments | Measurement Input, Probability of Success          
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]          
Contingent consideration liability, measurement input 0.90   0.90    
Weighted Average | Product Development and Other Milestone-based Payments | Measurement Input, Present-value Factor          
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]          
Contingent consideration liability, measurement input 0.055   0.062    
Foreign Exchange Forward          
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]          
Derivative, notional amount $ 31,800,000   $ 44,200,000    
Derivative, fair value 0   0    
Gain (Loss) on Derivative Instruments, Net, Pretax 0        
Thrive, Ashion and OmicEra | Fair Value          
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]          
Contingent consideration, liability $ 289,000,000   $ 282,200,000    
v3.25.4
ACCRUED LIABILITIES (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Payables and Accruals [Abstract]    
Compensation $ 276,660 $ 185,934
Professional fees 59,528 80,452
Other 27,445 23,529
Assets under construction 7,417 7,227
Research and trial related expenses 25,161 16,043
Licenses 20,262 15,107
Accrued liabilities $ 416,473 $ 328,292
v3.25.4
LONG-TERM DEBT - Narrative (Details) - USD ($)
 6 Months Ended 12 Months Ended
Jan. 13, 2025
Jun. 30, 2024
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Jun. 29, 2024
Jun. 29, 2022
Long-term debt              
Repayments of Accounts Receivable Securitization     $ 0 $ 50,000,000 $ 0    
Revolving Credit Facility              
Long-term debt              
Borrowing capacity $ 500,000,000            
Line of Credit Facility, Maximum Amount Outstanding During Period $ 20,000,000            
Line of Credit Facility, Currency 50.0 million            
Line of Credit Facility, Uncommitted Incremental Facilities     $ 200,000,000        
Floating Rate Less SOFR Rate     10.00%        
Line of Credit Facility, Floating Rate Floor     0.00%        
Letters of Credit Outstanding, Amount     $ 5,900,000        
Remaining borrowing capacity     $ 494,100,000        
Revolving Credit Facility | Indebtedness              
Long-term debt              
Line of Credit Facility, Frequency of Payment and Payment Terms     300.0 million        
Revolving Credit Facility | Minimum              
Long-term debt              
Line of Credit Facility, Base Rate Margin     150.00%        
Line of Credit Facility, SOFR Base Rate Margin     250.00%        
Gross Leverage Ratio Covenant Term     $ 1        
Interest Charge Coverage Ratio Covenant Term     $ 3        
Revolving Credit Facility | Maximum              
Long-term debt              
Line of Credit Facility, Base Rate Margin     200.00%        
Line of Credit Facility, SOFR Base Rate Margin     300.00%        
Gross Leverage Ratio Covenant Term     $ 2.5        
Interest Charge Coverage Ratio Covenant Term     $ 1        
Securitized Receivables              
Long-term debt              
Repayments of Accounts Receivable Securitization   $ 50,000,000          
Borrowing capacity             $ 150,000,000
Line of Credit Facility, Interest Rate at Period End           6.89%  
Securitized Receivables | Minimum              
Long-term debt              
Long-term Debt, Excluding Current Maturities             $ 50,000,000
v3.25.4
CONVERTIBLE NOTES - Schedule of Convertible Notes (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Feb. 29, 2020
Mar. 31, 2019
Jun. 30, 2018
Jan. 31, 2018
Convertible Notes Payable2030            
Long-term debt            
Interest rate (as a percent) 2.00% 2.00%        
Principal Amount $ 572,993 $ 572,993        
Unamortized Debt Discount and Issuance Costs (2,937) (3,642)        
Net Carrying Amount 570,056 569,351        
Convertible Notes Payable2030 | Significant Other Observable Inputs (Level 2) | Fair Value            
Long-term debt            
Amount $ 795,045 $ 592,756        
2028 Convertible notes            
Long-term debt            
Interest rate (as a percent) 0.375% 0.375% 0.375%      
Principal Amount $ 589,380 $ 589,380        
Unamortized Debt Discount and Issuance Costs (3,389) (4,952)        
Net Carrying Amount 585,991 584,428        
2028 Convertible notes | Significant Other Observable Inputs (Level 2) | Fair Value            
Long-term debt            
Amount $ 605,570 $ 512,761        
2027 Convertible notes            
Long-term debt            
Interest rate (as a percent) 0.375% 0.375%   0.375%    
Principal Amount $ 563,822 $ 563,822        
Unamortized Debt Discount and Issuance Costs (2,037) (3,732)        
Net Carrying Amount 561,785 560,090        
2027 Convertible notes | Significant Other Observable Inputs (Level 2) | Fair Value            
Long-term debt            
Amount $ 587,672 $ 523,932        
2025 Convertible notes            
Long-term debt            
Interest rate (as a percent)   1.00%     1.00% 1.00%
Principal Amount   $ 249,172        
Unamortized Debt Discount and Issuance Costs   (19)        
Net Carrying Amount   249,153        
2025 Convertible notes | Significant Other Observable Inputs (Level 2) | Fair Value            
Long-term debt            
Amount   $ 246,705        
Convertible Notes Payable2031            
Long-term debt            
Interest rate (as a percent) 1.75% 1.75%        
Principal Amount $ 620,709 $ 620,709        
Unamortized Debt Discount and Issuance Costs (11,364) (13,511)        
Net Carrying Amount 609,345 607,198        
Convertible Notes Payable2031 | Significant Other Observable Inputs (Level 2) | Fair Value            
Long-term debt            
Amount $ 759,636 $ 581,648        
v3.25.4
CONVERTIBLE NOTES - Issuances and Settlements (Details) - USD ($)
shares in Millions
 1 Months Ended 12 Months Ended
Jan. 15, 2025
Apr. 30, 2024
Mar. 31, 2023
Feb. 29, 2020
Mar. 31, 2019
Jun. 30, 2018
Jan. 31, 2018
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Apr. 17, 2024
Mar. 06, 2023
Mar. 01, 2023
Debt Instrument [Line Items]                          
Net proceeds from issuance               $ 0 $ 266,750,000 $ 137,976,000      
Repayments of convertible debt               249,172,000 0 0      
Repayments of debt $ 250,400,000                        
Loss on extinguishment of debt   $ 10,300,000 $ 17,700,000 $ 50,800,000       $ 0 $ (10,254,000) $ (10,324,000)      
2025 Convertible notes                          
Debt Instrument [Line Items]                          
Stock issued in conversion of convertible notes (in shares)         2.2                
Value of stock after conversion of convertible notes         $ 182,400,000                
Repayments of convertible debt in cash and by issuance of shares         676,500,000                
Repayments of debt         493,400,000                
Accrued interest on notes         700,000                
Loss on extinguishment of debt     7,400,000   187,700,000                
2025 Convertible notes                          
Debt Instrument [Line Items]                          
Face amount           $ 218,500,000 $ 690,000,000            
Interest rate (as a percent)           1.00% 1.00%   1.00%        
Net proceeds from issuance           $ 225,300,000 $ 671,100,000            
Repayments of convertible debt       150,100,000                  
Accrued interest on notes       100,000                  
Amount settled     65,800,000 100,000,000.0                  
2027 Convertible notes                          
Debt Instrument [Line Items]                          
Face amount         $ 747,500,000                
Interest rate (as a percent)         0.375%     0.375% 0.375%        
Net proceeds from issuance         $ 729,500,000                
Amount settled     183,700,000                    
Debt Conversion, Converted Instrument, Potential Shares Issued               5.0          
2027 Convertible notes | 2025 Convertible notes                          
Debt Instrument [Line Items]                          
Repayments of convertible debt         $ 494,100,000                
2028 Convertible notes                          
Debt Instrument [Line Items]                          
Face amount       $ 1,150,000,000                  
Interest rate (as a percent)       0.375%       0.375% 0.375%        
Net proceeds from issuance       $ 1,130,000,000                  
Amount settled   359,700,000 201,000,000                    
Debt Conversion, Converted Instrument, Potential Shares Issued               4.8          
Convertible Notes Payable2030                          
Debt Instrument [Line Items]                          
Face amount                         $ 500,000,000
Interest rate (as a percent)               2.00% 2.00%        
Net proceeds from issuance     138,000,000                    
Proceeds from Debt, Net of Issuance Costs     $ 133,000,000                    
Debt Conversion, Converted Instrument, Potential Shares Issued               7.1          
Convertible Notes Payable2030 | 2025 Convertible notes                          
Debt Instrument [Line Items]                          
Face amount                       $ 73,000,000  
Convertible Notes Payable2031                          
Debt Instrument [Line Items]                          
Face amount                     $ 620,700,000    
Interest rate (as a percent)               1.75% 1.75%        
Net proceeds from issuance   266,800,000                      
Proceeds from Debt, Net of Issuance Costs   $ 259,800,000                      
Debt Conversion, Converted Instrument, Potential Shares Issued               6.2          
v3.25.4
CONVERTIBLE NOTES - Summary of Conversion Features (Details)
$ / shares in Units, shares in Millions, $ in Millions
 12 Months Ended
Dec. 31, 2025
USD ($)
$ / shares
shares
Debt Instrument [Line Items]  
Repurchase price, as percentage of principal amount, if company undergoes change of control 100
2027 Convertible notes  
Debt Instrument [Line Items]  
Conversion rate, number of shares to be issued per $1,000 of principal amount 8.96
Conversion price per share of common stock (in usd per share) | $ / shares $ 111.66
Debt Conversion, Converted Instrument, Potential Shares Issued | shares 5.0
2028 Convertible notes  
Debt Instrument [Line Items]  
Conversion rate, number of shares to be issued per $1,000 of principal amount 8.21
Conversion price per share of common stock (in usd per share) | $ / shares $ 121.84
Debt Conversion, Converted Instrument, Potential Shares Issued | shares 4.8
Convertible Notes Payable2030  
Debt Instrument [Line Items]  
Conversion rate, number of shares to be issued per $1,000 of principal amount 12.37
Conversion price per share of common stock (in usd per share) | $ / shares $ 80.83
Debt Conversion, Converted Instrument, Potential Shares Issued | shares 7.1
Debt Instrument, Convertible, If-converted Value in Excess of Principal | $ $ 147.0
Convertible Notes Payable2031  
Debt Instrument [Line Items]  
Conversion rate, number of shares to be issued per $1,000 of principal amount 10.06
Conversion price per share of common stock (in usd per share) | $ / shares $ 99.36
Debt Conversion, Converted Instrument, Potential Shares Issued | shares 6.2
Debt Instrument, Convertible, If-converted Value in Excess of Principal | $ $ 13.7
v3.25.4
CONVERTIBLE NOTES - Ranking of Convertible Notes (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
2027 Convertible notes  
Debt Instrument [Line Items]  
Total transaction costs $ 14,285
2028 Convertible notes  
Debt Instrument [Line Items]  
Total transaction costs 24,453
Convertible Notes Payable2030  
Debt Instrument [Line Items]  
Total transaction costs 4,938
2025 Convertible notes  
Debt Instrument [Line Items]  
Total transaction costs 17,646
Convertible Notes Payable2031  
Debt Instrument [Line Items]  
Total transaction costs $ 6,780
v3.25.4
CONVERTIBLE NOTES - Schedule of Interest Expense (Details) - USD ($)
$ / shares in Units, $ in Thousands
 1 Months Ended 12 Months Ended
Apr. 30, 2024
Mar. 31, 2023
Feb. 29, 2020
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Debt Instrument [Line Items]            
Debt issuance costs amortization       $ 4,609 $ 5,296 $ 5,350
Debt discount amortization       1,520 933 106
Gain on settlement of convertible notes $ 10,300 $ 17,700 $ 50,800 0 (10,254) (10,324)
Coupon interest expense       26,737 26,339 18,072
Total interest expense on convertible notes       $ 32,866 $ 22,314 $ 13,204
Share Price       $ 101.56    
2025 Convertible notes            
Debt Instrument [Line Items]            
Effective interest rate       1.05% 1.16% 1.17%
2027 Convertible notes            
Debt Instrument [Line Items]            
Effective interest rate       0.68% 0.67% 0.67%
Convertible debt, remaining discount amortization period       1 year 2 months 12 days    
2028 Convertible notes            
Debt Instrument [Line Items]            
Effective interest rate       0.65% 0.63% 0.63%
Convertible debt, remaining discount amortization period       2 years 2 months 1 day    
Convertible Notes Payable2030            
Debt Instrument [Line Items]            
Effective interest rate       2.14% 2.09% 2.09%
Convertible debt, remaining discount amortization period       4 years 2 months 1 day    
Convertible Notes Payable2031            
Debt Instrument [Line Items]            
Effective interest rate       2.14% 2.06% 0.00%
Convertible debt, remaining discount amortization period       5 years 3 months 14 days    
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS - Translational Genomics Research Institute (Details) - TARDIS Technology - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
May 01, 2024
Jan. 11, 2021
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]      
Payments contingent on milestones     $ 45,000
Contract termination fee   $ 27,600  
Contract Termination Fee Annual Installments   9,200  
Contract Termination Fee, Fair-Value   $ 25,800  
Contract Termination Fee, Unamortized Liability $ 1,800    
Contract Termination Fee, Liability $ 9,000    
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS - Mayo (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Oct. 31, 2017
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]        
Research and development $ 522,996 $ 431,210 $ 426,927  
Licensing Agreements | Mayo        
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]        
Time period after the last licensed patent expires that the license agreement will remain in effect 5 years      
Licensing Agreements | Mayo | Sales Milestone Range Three        
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]        
Amount agreed to be paid upon reaching the specified amount of net sales       $ 3,000
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS - Johns Hopkins University (Details)
$ in Millions
Jan. 05, 2021
USD ($)
Thrive | Licensing Agreements  
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]  
Payments contingent on milestones $ 45.0
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS - The Broad Institute (Details) - The Broad Institute, LLC - Licensing Agreements - USD ($)
$ in Thousands
Jun. 30, 2023
Jun. 30, 2024
Sales Milestone Range One    
Investments, All Other Investments [Abstract]    
Net sales of a licensed product $ 500,000  
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]    
Net sales of a licensed product $ 500,000  
Product Development and Other Milestone-based Payments    
Investments, All Other Investments [Abstract]    
Collaborative Arrangements Development Milestone Amount   $ 6,500
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]    
Collaborative Arrangements Development Milestone Amount   $ 6,500
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS - Watchmaker Genomics (Details) - Watchmaker Genomics, Inc - Licensing Agreements
$ in Millions
Jul. 31, 2023
USD ($)
Investments, All Other Investments [Abstract]  
Collaboration Arrangement, Milestones To Be Received $ 82.0
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]  
Collaboration Arrangement, Milestones To Be Received $ 82.0
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS - TwinStrand Biosciences (Details) - Licensing Agreements - TwinStrand Biosciences, Inc - USD ($)
$ in Millions
Jul. 01, 2024
Dec. 31, 2025
Investments, All Other Investments [Abstract]    
Finite-Lived Intangible Assets Acquired $ 45  
Finite-Lived Intangible Asset, Useful Life   10 years
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]    
Finite-Lived Intangible Assets Acquired $ 45  
Finite-Lived Intangible Asset, Useful Life   10 years
v3.25.4
LICENSE AND COLLABORATION AGREEMENTS - Freenome Holdings (Details) - Freenome Holdings, Inc - USD ($)
$ in Thousands
 1 Months Ended
Aug. 04, 2025
Nov. 30, 2025
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]    
Payments to Acquire Productive Assets   $ 75,000
Collaborative Arrangements Development Milestone Amount $ 700,000  
Research and Development Arrangement, Contract to Perform for Others, Costs Incurred, Gross 20,000  
Investment Owned, Cost 50,000  
First Milestone Payment    
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]    
Collaborative Arrangements Development Milestone Amount 100,000  
Second Milestone Payment    
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]    
Collaborative Arrangements Development Milestone Amount 100,000  
Third Milestone Payment    
Collaborative Arrangements and Non-collaborative Arrangement Transactions [Line Items]    
Collaborative Arrangements Development Milestone Amount $ 500,000  
v3.25.4
STOCKHOLDERS' EQUITY - Narrative (Details) - USD ($)
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Equity [Abstract]      
AOCI Tax, Attributable to Parent $ 0 $ 0 $ 0
v3.25.4
STOCKHOLDERS' EQUITY - Schedule of OCI (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
AOCI Attributable to Parent, Net of Tax [Roll Forward]      
Beginning balance $ 2,402,249 $ 3,145,305 $ 3,043,162
Other comprehensive income before reclassifications 4,278 (2,421) 2,737
Amounts reclassified from accumulated other comprehensive income (loss) (976) 49 3,927
Net current period change in accumulated other comprehensive income (loss) 3,302 (2,372) 6,664
Ending balance 2,401,052 2,402,249 3,145,305
AOCI      
AOCI Attributable to Parent, Net of Tax [Roll Forward]      
Beginning balance (944) 1,428 (5,236)
Ending balance 2,358 (944) 1,428
Cumulative Translation Adjustment      
AOCI Attributable to Parent, Net of Tax [Roll Forward]      
Beginning balance (1,920) 1,374 53
Other comprehensive income before reclassifications 4,278 (3,294) 1,321
Amounts reclassified from accumulated other comprehensive income (loss) 0 0 0
Net current period change in accumulated other comprehensive income (loss) 4,278 (3,294) 1,321
Ending balance 2,358 (1,920) 1,374
Unrealized Gain (Loss) on Securities (1)      
AOCI Attributable to Parent, Net of Tax [Roll Forward]      
Beginning balance 976 54 (5,289)
Other comprehensive income before reclassifications 0 873 1,416
Amounts reclassified from accumulated other comprehensive income (loss) (976) 49 3,927
Net current period change in accumulated other comprehensive income (loss) (976) 922 5,343
Ending balance $ 0 $ 976 $ 54
v3.25.4
STOCKHOLDERS' EQUITY - Schedule of amounts reclassified from AOCI (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Changes in Accumulated Other Comprehensive Income (Loss)      
Total reclassifications $ (976) $ 49 $ 3,927
Reclassification Out Of Accumulated Other Comprehensive Income | Unrealized Gain (Loss) on Securities (1)      
Changes in Accumulated Other Comprehensive Income (Loss)      
Investment income, net $ (976) $ 49 $ 3,927
v3.25.4
STOCK-BASED COMPENSATION - Stock-Based Compensation Plans (Details)
 12 Months Ended
Dec. 31, 2025
shares
Jun. 12, 2025
shares
Jun. 08, 2023
shares
Jun. 09, 2022
shares
Jul. 28, 2016
shares
Jul. 24, 2014
shares
Dec. 31, 2025
USD ($)
item
shares
Dec. 31, 2024
shares
Stock-based compensation                
Period by which all options to purchase common stock will accelerate upon an acquisition of the company             1 year  
Shares outstanding (in shares) 781,289           781,289 982,742
Shares available for future grant (in shares) 16,550,287           16,550,287  
Omnibus Long Term Incentive Plan 2019                
Stock-based compensation                
Further grants or awards after termination of plan (in shares)             0  
Shares available for future grant (in shares) 0           0  
Increase in number of shares reserved for issuance (in shares)     4,340,000 14,000,000        
Omnibus Long Term Incentive Plan 2019 | Minimum                
Stock-based compensation                
Vesting period             3 years  
Omnibus Long Term Incentive Plan 2019 | Maximum                
Stock-based compensation                
Vesting period             4 years  
Omnibus Long Term Incentive Plan 2019 | Stock Options                
Stock-based compensation                
Expiration period from the date of grant             10 years  
Shares outstanding (in shares) 270,749           270,749  
Omnibus Long Term Incentive Plan 2019 | Restricted Stock                
Stock-based compensation                
Shares outstanding (in shares) 7,874,434           7,874,434  
Omnibus Long Term Incentive Plan 2010                
Stock-based compensation                
Further grants or awards after termination of plan (in shares)             0  
Shares available for future grant (in shares) 0           0  
Omnibus Long Term Incentive Plan 2010 | Minimum                
Stock-based compensation                
Vesting period             3 years  
Omnibus Long Term Incentive Plan 2010 | Maximum                
Stock-based compensation                
Vesting period             4 years  
Omnibus Long Term Incentive Plan 2010 | Stock Options                
Stock-based compensation                
Expiration period from the date of grant             10 years  
Shares outstanding (in shares) 510,540           510,540  
Omnibus Long Term Incentive Plan 2010 | Restricted Stock                
Stock-based compensation                
Shares outstanding (in shares) 3,340           3,340  
Employee Stock Purchase Plan 2010                
Stock-based compensation                
Shares available for future grant (in shares) 4,193,108           4,193,108  
Increase in number of shares reserved for issuance (in shares)   4,000,000   3,000,000 2,000,000 500,000    
Option exercise price, expressed as a percentage of fair market value             85.00%  
Maximum value of shares that an employee is permitted to purchase | $             $ 25,000  
Stock issued under the Company's stock purchase plan (in shares) 5,606,892           685,693  
Employee Stock Purchase Plan 2010 | Minimum                
Stock-based compensation                
Number of hours per week of customary employment required to participate in the plan | item             20  
Number of months of customary employment required to participate in the plan             5 months  
Percentage of employee's compensation to be deducted from the employee's pay             1.00%  
Employee Stock Purchase Plan 2010 | Maximum                
Stock-based compensation                
Percentage of employee's compensation to be deducted from the employee's pay             15.00%  
Omnibus Long-Term Incentive Plan 2025                
Stock-based compensation                
Further grants or awards after termination of plan (in shares)             0  
Shares available for future grant (in shares) 12,357,179           12,357,179  
Omnibus Long-Term Incentive Plan 2025 | Minimum                
Stock-based compensation                
Vesting period             3 years  
Omnibus Long-Term Incentive Plan 2025 | Maximum                
Stock-based compensation                
Vesting period             4 years  
Omnibus Long-Term Incentive Plan 2025 | Stock Options                
Stock-based compensation                
Expiration period from the date of grant             10 years  
Shares outstanding (in shares) 0           0  
Omnibus Long-Term Incentive Plan 2025 | Restricted Stock                
Stock-based compensation                
Shares outstanding (in shares) 66,320           66,320  
v3.25.4
STOCK-BASED COMPENSATION - Stock-Based Compensation Expense (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Stock-based compensation expense      
Stock-based compensation expense $ 217,666 $ 214,885 $ 231,312
Cost of sales      
Stock-based compensation expense      
Stock-based compensation expense 17,244 20,518 20,761
Research and Development Expense [Member]      
Stock-based compensation expense      
Stock-based compensation expense 37,379 39,684 41,242
Sales and marketing      
Stock-based compensation expense      
Stock-based compensation expense 66,762 68,236 73,016
General and administrative      
Stock-based compensation expense      
Stock-based compensation expense $ 96,281 $ 86,447 $ 96,293
v3.25.4
STOCK-BASED COMPENSATION - Stock-Based Compensation Additional Information (Details)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2025
USD ($)
country
shares
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Stock-based compensation        
Unrecognized compensation cost | $ $ 314,900 $ 314,900    
Weighted average period for recognition of unrecognized compensation cost   2 years 3 months 29 days    
Share-Based Payment Arrangement, Noncash Expense | $   $ 217,666 $ 214,885 $ 231,312
Restricted Stock Unit [Member]        
Stock-based compensation        
Share-Based Compensation Arrangement by Share-Based Payment Award, Accelerated Vesting, Number | shares 454,811      
Share-Based Payment Arrangement, Plan Modification, Number of Grantees Affected | country 12      
Performance Share Units [Member]        
Stock-based compensation        
Share-Based Compensation Arrangement by Share-Based Payment Award, Accelerated Vesting, Number | shares 1,227,496      
Share-Based Payment Arrangement, Plan Modification, Number of Grantees Affected | country 14      
v3.25.4
STOCK-BASED COMPENSATION - Schedule of Fair Value of Options and ESPP (Details) - Employee Stock
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Valuation assumptions      
Risk-free interest rates, minimum 4.22% 4.71% 4.68%
Risk-free interest rates, maximum 5.15% 5.30% 4.71%
Expected volatility, minimum (as a percent) 44.40% 44.40% 63.13%
Expected volatility, maximum (as a percent) 60.67% 63.13% 67.30%
Share-Based Compensation Arrangement by Share-Based Payment Award, Fair Value Assumptions, Expected Dividend Rate 0.00% 0.00% 0.00%
Minimum      
Valuation assumptions      
Share-Based Compensation Arrangement by Share-Based Payment Award, Fair Value Assumptions, Expected Term 6 months 1 year 2 months 1 day  
Maximum      
Valuation assumptions      
Share-Based Compensation Arrangement by Share-Based Payment Award, Fair Value Assumptions, Expected Term 1 year 3 months 1 year 3 months 1 year 3 months
v3.25.4
STOCK-BASED COMPENSATION - Stock Option, Restricted Stock, and Performance Shares (Details) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Shares      
Outstanding at the beginning of the period (in shares) 982,742    
Exercised (in shares) (161,596)    
Forfeited (in shares) (39,857)    
Outstanding at the end of the period (in shares) 781,289 982,742  
Vested and expected to vest (in shares) 781,289    
Exercisable at the end of the period (in shares) 781,289    
Weighted Average Exercise Price      
Outstanding at the beginning of the period (in dollars per share) $ 53.60    
Exercised (in dollars per share) 27.48    
Forfeited (in dollars per share) 85.58    
Outstanding at the end of the period (in dollars per share) 57.37 $ 53.60  
Vested and expected to vest (in dollars per share) 57.37    
Exercisable at the end of the period (in dollars per share) $ 57.37    
Weighted Average Remaining Contractual Term      
Outstanding at the end of the period 2 years 4 months 24 days 3 years 1 month 6 days  
Vested and expected to vest at end of period 2 years 4 months 24 days    
Exercisable at the end of the period 2 years 4 months 24 days    
Aggregate Intrinsic Value      
Outstanding at the end of the period $ 34,528,000    
Vested and expected to vest at the end of the period 34,528,000    
Exercisable at the end of the period 34,528,000    
Additional disclosures      
Total intrinsic value of options exercised $ 6,000,000.0 $ 7,800,000 $ 11,700,000
Restricted Shares and RSUs      
Restricted Shares and Performance Shares      
Outstanding at the beginning of the period (in shares) 7,244,796    
Granted (in shares) 3,661,929    
Released (in shares) (3,102,685)    
Forfeited (in shares) (907,813)    
Outstanding at the end of the period (in shares) 6,896,227 7,244,796  
Weighted Average Grant Date Fair Value      
Outstanding at the beginning of the period (in dollars per share) $ 63.18    
Granted (in dollars per share) 51.61 $ 56.94 $ 62.36
Released (in dollars per share) 66.18    
Forfeited (in dollars per share) 55.98    
Outstanding at the end of the period (in dollars per share) $ 56.12 $ 63.18  
Fair value of equity instruments other than options $ 205,300,000 $ 184,200,000 $ 158,200,000
Performance Shares      
Restricted Shares and Performance Shares      
Outstanding at the beginning of the period (in shares) 2,021,208    
Granted (in shares) 1,283,717    
Released (in shares) (1,380,061)    
Forfeited (in shares) (876,997)    
Outstanding at the end of the period (in shares) 1,047,867 2,021,208  
Weighted Average Grant Date Fair Value      
Outstanding at the beginning of the period (in dollars per share) $ 75.86    
Granted (in dollars per share) 59.49 $ 63.68 $ 80.50
Released (in dollars per share) 79.03    
Forfeited (in dollars per share) 81.24    
Outstanding at the end of the period (in dollars per share) $ 62.20 $ 75.86  
Fair value of equity instruments other than options $ 77,200,000 $ 9,900,000 $ 1,000,000
Number of outstanding performance share units (in shares) 631,833    
v3.25.4
STOCK-BASED COMPENSATION - Issuance of Stock Under ESPP (Details) - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Stock-based compensation        
Cash received under the 2010 Purchase Plan   $ 26,544 $ 31,227 $ 28,344
Employee Stock Purchase Plan 2010        
Stock-based compensation        
Stock issued under the Company's stock purchase plan (in shares) 5,606,892 685,693    
Employee Stock | Employee Stock Purchase Plan 2010        
Stock-based compensation        
Stock issued under the Company's stock purchase plan (in shares)   685,693 955,392 924,448
Cash received under the 2010 Purchase Plan   $ 26,544 $ 31,227 $ 28,344
Weighted average fair value per share of options granted during the period (in dollars per share)   $ 19.17 $ 16.26 $ 16.32
v3.25.4
STOCK-BASED COMPENSATION - Schedule of Share Issued During Period (Details) - Employee Stock Purchase Plan 2010 - $ / shares
 12 Months Ended
Dec. 31, 2025
Oct. 31, 2025
Apr. 30, 2025
Dec. 31, 2025
Stock-based compensation        
Stock issued under the Company's stock purchase plan (in shares) 5,606,892     685,693
Offering Period End Date One        
Stock-based compensation        
Stock issued under the Company's stock purchase plan (in shares)     419,070  
Weighted average price per share (in dollars per share)     $ 38.26  
Offering Period End Date Two        
Stock-based compensation        
Stock issued under the Company's stock purchase plan (in shares)   266,623    
Weighted average price per share (in dollars per share)   $ 39.42    
v3.25.4
STOCK-BASED COMPENSATION - Shares Reserved for Issuance (Details)
Dec. 31, 2025
shares
Shares reserved for issuance  
Shares reserved for issuance (in shares) 16,550,287
Omnibus Long-Term Incentive Plan 2025  
Shares reserved for issuance  
Shares reserved for issuance (in shares) 12,357,179
Employee Stock Purchase Plan 2010  
Shares reserved for issuance  
Shares reserved for issuance (in shares) 4,193,108
v3.25.4
COMMITMENTS AND CONTINGENCIES - Lease Expense (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Finance lease cost      
Amortization of right-of-use assets $ 6,554 $ 7,311 $ 3,845
Interest on lease liabilities 1,047 1,406 800
Operating lease cost 32,870 31,797 36,576
Short-term lease cost 946 1,036 750
Variable lease cost 8,218 9,055 8,449
Total lease Cost $ 49,635 $ 50,605 $ 50,420
v3.25.4
COMMITMENTS AND CONTINGENCIES - Supplemental Disclosure of Cash Flow Information (Details) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Sep. 30, 2024
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash paid for amounts included in the measurement of lease liabilities:        
Finance cash flows from finance leases   $ 6,421 $ 6,827 $ 3,569
Operating cash flows from finance leases   1,083 1,359 783
Operating cash flows from operating leases   41,253 38,135 39,301
Non-cash investing and financing activities:        
Right-of-use assets obtained in exchange for new finance lease liabilities   0 16,425 5,443
Right-of-use assets obtained in exchange for new operating lease liabilities   $ 29,273 $ 19,674 $ 4,986
Weighted-average remaining lease term - operating leases (in years)   6 years 10 months 17 days 7 years 4 months 13 days 6 years 10 months 13 days
Weighted-average discount rate - finance leases   6.65% 6.69% 7.43%
Weighted-average discount rate - operating leases   6.50% 6.54% 6.59%
Weighted-average remaining lease term - finance leases (in years)   2 years 2 months 19 days 2 years 10 months 24 days 2 years 9 months 18 days
Impairment of long-lived and indefinite-lived assets $ 18,700 $ 7,200 $ 869,460 $ 621
Leasehold improvements        
Non-cash investing and financing activities:        
Impairment of Leasehold 6,900      
Assets        
Non-cash investing and financing activities:        
Operating Lease, Impairment Loss $ 11,800      
v3.25.4
COMMITMENTS AND CONTINGENCIES - Additional Information (Details) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Sep. 30, 2024
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]        
Recognition of ROU assets   $ 122,332 $ 116,952  
Recognition of lease liabilities   195,522 184,500  
Operating lease liability, current   33,591 27,405  
Operating lease liability, noncurrent   161,931 157,133  
Impairment of long-lived and indefinite-lived assets $ 18,700 7,200 869,460 $ 621
Finance lease, right-of-use asset   $ 11,100 $ 19,800  
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]   Other long-term assets, net Other long-term assets, net  
Finance lease obligations   $ 12,128 $ 21,000  
Finance lease liability, current   $ 5,700 $ 7,800  
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]   Other current liabilities Other current liabilities  
Finance lease liability, noncurrent   $ 6,400 $ 13,200  
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]   Other long-term liabilities Other long-term liabilities  
v3.25.4
COMMITMENTS AND CONTINGENCIES - Schedule of Maturities on Operating Lease Liabilities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Operating Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]    
2026 $ 43,164  
2027 45,208  
2028 35,876  
2029 25,806  
2030 17,451  
Thereafter 78,654  
Total minimum lease payments 246,159  
Imputed interest (50,637)  
Total $ 195,522 $ 184,500
v3.25.4
COMMITMENTS AND CONTINGENCIES - Schedule of Maturities on Finance Lease Liabilities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Finance Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]    
2026 $ 6,284  
2027 5,201  
2028 1,282  
2029 93  
2030 93  
Thereafter 36  
Total minimum lease payments 12,989  
Imputed interest (861)  
Total $ 12,128 $ 21,000
v3.25.4
Legal Matters - COMMITMENTS AND CONTINGENCIES (Details) - USD ($)
$ in Thousands
 12 Months Ended
Oct. 31, 2023
Sep. 30, 2023
Dec. 31, 2023
DOS Rule Investigation      
Loss Contingencies [Line Items]      
Payments for Legal Settlements   $ 32,500  
Litigation Settlement, Loss     $ 22,400
Qui Tam Suit      
Loss Contingencies [Line Items]      
Payments for Legal Settlements $ 13,800    
v3.25.4
Restructuring and Related Activities (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Restructuring and Related Activities [Abstract]  
Restructuring and Related Cost, Expected Cost Remaining $ 5,000
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 22,169
Business Transformation Costs 51,044
Restructuring and Related Cost, Incurred Cost 73,213
Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 14,390
Other Restructuring  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 7,779
Cost of sales  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 84
Cost of sales | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 84
Research and Development Expense [Member]  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 554
Research and Development Expense [Member] | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 554
Sales and marketing  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 2,868
Sales and marketing | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 2,868
General and administrative  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 18,663
General and administrative | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 10,884
General and administrative | Other Restructuring  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs $ 7,779
v3.25.4
EMPLOYEE BENEFIT PLAN (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Retirement Benefits [Abstract]      
Matching contribution by employer 100.00% 100.00% 100.00%
Percentage of participant's salary matched by employer 6.00% 6.00% 6.00%
Compensation expense in connection with the 401 (k) Plan $ 47.9 $ 44.1 $ 40.6
v3.25.4
BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Narrative (Details) - USD ($)
$ in Thousands
 12 Months Ended
Sep. 12, 2023
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2025
Aug. 23, 2023
Aug. 02, 2022
Acquired Finite-Lived Intangible Assets [Line Items]            
Contract with Customer, Receivable, after Allowance for Credit Loss   $ 56,600   $ 54,500    
Contract with Customer, Asset, after Allowance for Credit Loss   25,900        
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Oncotype DX Genomic Prostate Score Test            
Acquisition            
Disposal group, contingent consideration arrangements, range of outcomes, value, high         $ 82,500 $ 70,000
Acquired Finite-Lived Intangible Assets [Line Items]            
Disposal Group, Contingent Consideration Arrangements, Gain (Loss)   $ 9,200 $ 73,300      
Resolution Bioscience            
Acquisition            
Business Combination, Consideration Transferred $ 54,202          
Payments to Acquire Businesses, Gross 52,527          
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable $ 1,675          
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable Fair Value Method 4.6 million          
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable, Compensatory $ 2,900          
Acquired Finite-Lived Intangible Assets [Line Items]            
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable Fair Value Method 4.6 million          
v3.25.4
BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Business Combination, Pro-Forma Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]    
Business Acquisition, Pro Forma Revenue $ 2,507,111 $ 2,097,680
Business Acquisition, Pro Forma Net Income (Loss) $ (237,854) $ (675,091)
v3.25.4
BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Schedule of Divestiture (Details) - USD ($)
$ in Millions
 12 Months Ended
Jan. 09, 2026
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2025
Apr. 30, 2025
Noncash or Part Noncash Divestitures [Line Items]          
Contract with Customer, Receivable, after Allowance for Credit Loss   $ 56.6   $ 54.5  
Contract with Customer, Asset, after Allowance for Credit Loss   25.9      
Cash Collected from Disposal Group, Contingent Consideration Arrangements         $ 28.0
Other long-term assets          
Noncash or Part Noncash Divestitures [Line Items]          
Contract with Customer, Receivable, after Allowance for Credit Loss   28.7   24.8  
Other Current Assets          
Noncash or Part Noncash Divestitures [Line Items]          
Contract with Customer, Receivable, after Allowance for Credit Loss   27.9   $ 29.8  
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Oncotype DX Genomic Prostate Score Test          
Noncash or Part Noncash Divestitures [Line Items]          
Disposal Group, Contingent Consideration Arrangements, Gain (Loss)   $ 9.2 $ 73.3    
Disposal Group, Contingent Consideration Arrangements, Additional Consideration     $ 3.1    
Disposal Group, Disposed of by Sale, Not Discontinued Operations | Oncotype DX Genomic Prostate Score Test | Subsequent Event          
Noncash or Part Noncash Divestitures [Line Items]          
Disposal Group, Contingent Consideration Arrangements, Additional Consideration $ 4.7        
Disposal Group, Contingent Consideration Arrangements, First Cash Receipt 15.0        
Disposal Group, Contingent Consideration Arrangements, Second Cash Receipt 18.0        
Disposal Group, Contingent Consideration Arrangements, Third Cash Receipt $ 21.5        
v3.25.4
SEGMENT INFORMATION (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
reportable_segment
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Number of Reportable Segments | reportable_segment 1,000    
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration] Chief Executive Officer [Member]    
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description monitors the Company's operating performance and makes decisions regarding allocation of resources to its operations at the consolidated level.    
Revenue $ 3,246,990 $ 2,758,867 $ 2,499,766
United States      
Revenue 3,023,146 2,569,775 2,346,489
Outside of United States      
Revenue $ 223,844 $ 189,092 $ 153,277
v3.25.4
INCOME TAXES - Narrative (Details) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Operating Loss Carryforwards [Line Items]      
Operating loss carryforwards with expiration date $ 108,200,000    
Income tax benefit (expense) (4,061,000) $ 7,304,000 $ (2,403,000)
Deferred tax asset valuation allowance 735,979,000 708,788,000  
Deferred tax liability 5,806,000 7,170,000  
Increase (decrease) in valuation allowance $ 27,200,000 $ 243,000,000.0  
Effective tax rate (2.00%) 0.60% (1.20%)
Unrecognized tax benefit that would impact effective tax rate $ 47,500,000 $ 43,300,000 $ 36,400,000
Accrued interest or penalties 0 0 0
Recognized interest or penalties 0 0 0
Deferred tax asset      
Operating Loss Carryforwards [Line Items]      
Valuation allowances established 32,224,000 241,849,000 44,759,000
Acquisition and purchase accounting 0 $ 0 $ (475,000)
Research | California | State      
Operating Loss Carryforwards [Line Items]      
Tax credit carryforwards 25,900,000    
Federal      
Operating Loss Carryforwards [Line Items]      
Operating loss carryforwards 418,600,000    
Operating loss carryforwards with no expiration date 310,400,000    
Federal | Research      
Operating Loss Carryforwards [Line Items]      
Tax credit carryforwards 93,400,000    
State      
Operating Loss Carryforwards [Line Items]      
Operating loss carryforwards 66,900,000    
State | Research      
Operating Loss Carryforwards [Line Items]      
Tax credit carryforwards 43,200,000    
Foreign      
Operating Loss Carryforwards [Line Items]      
Operating loss carryforwards $ 10,900,000    
v3.25.4
INCOME TAXES - Income (Loss) Before Income Taxes, Domestic and Foreign (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]      
Domestic $ (220,010) $ (1,036,306) $ (204,128)
Foreign 16,122 145 2,382
Net loss before tax $ (203,888) $ (1,036,161) $ (201,746)
v3.25.4
INCOME TAXES - Additional Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Expense (benefit) for income taxes      
Deferred tax expense (benefit): $ (1,544) $ (10,119) $ (955)
Total income tax expense (benefit) 4,061 (7,304) $ 2,403
Deferred tax assets:      
Operating loss carryforwards 496,415 452,410  
Tax credit carryforwards 137,617 121,635  
Compensation related differences 82,350 72,349  
Lease liabilities 46,764 47,199  
Capitalized research and development 186,957 251,760  
Other temporary differences 9,497 7,271  
Tax assets before valuation allowance 959,600 952,624  
Less - Valuation allowance (735,979) (708,788)  
Total deferred tax assets 223,621 243,836  
Deferred tax liabilities      
Amortization (174,182) (205,764)  
Property, plant and equipment (15,430) (7,160)  
Lease assets (30,216) (31,266)  
Other temporary differences (9,599) (6,816)  
Total deferred tax liabilities (229,427) (251,006)  
Net deferred tax liabilities $ (5,806) $ (7,170)  
Differences between the effective income tax rate and the statutory tax rate      
U.S. Federal statutory rate 21.00% 21.00% 21.00%
State taxes (0.40%) 3.00% 3.90%
Federal and state tax rate changes   0.00% 1.10%
Foreign tax rate differential   0.10% 0.00%
Research and development tax credits (5.30%) 1.60% 7.60%
Stock-based compensation expense 3.40% (1.00%) (4.40%)
Non-deductible executive compensation   (0.50%) (3.50%)
Other adjustments   0.00% (0.70%)
Other adjustments 0.00% (0.10%) (2.50%)
Valuation allowance (14.40%) (23.50%) (23.70%)
Effective tax rate (2.00%) 0.60% (1.20%)
Reconciliation of the amounts of unrecognized tax benefits      
Beginning of the period $ 43,344 $ 36,399 $ 28,270
Increase due to current year tax positions 5,166 7,322 7,447
Increase due to prior year tax positions 0 0 1,108
Decrease due to prior year tax positions (1,051) (377) (426)
Ending of the period 47,459 $ 43,344 $ 36,399
Effective Income Tax Rate Reconciliation [Line Items]      
Effective Income Tax Rate Reconciliation at Federal Statutory Income Tax Rate, Amount $ (42,817)    
U.S. Federal statutory rate 21.00% 21.00% 21.00%
Effective Income Tax Rate Reconciliation, State and Local Income Taxes, Amount $ 768    
State taxes (0.40%) 3.00% 3.90%
Effective Income Tax Rate Reconciliation, Tax Credit, Foreign, Amount $ (376)    
Effective Income Tax Rate Reconciliation, Tax Credit, Foreign, Percent 0.20%    
Effective Income Tax Rate Reconciliation, Cross-Border Tax Effect, Amount $ 38    
Effective Income Tax Rate Reconciliation, Cross-Border Tax Effect, Percent 0.00%    
Effective Income Tax Rate Reconciliation, Tax Credit, Research, Amount $ (10,861)    
Research and development tax credit 5.30% (1.60%) (7.60%)
Effective Income Tax Rate Reconciliation, Tax Credit, Other, Amount $ (107)    
Effective Income Tax Rate Reconciliation, Tax Credit, Other, Percent 0.10%    
Effective Income Tax Rate Reconciliation, Change in Deferred Tax Assets Valuation Allowance, Amount $ 29,385    
Valuation allowance (14.40%) (23.50%) (23.70%)
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Share-Based Payment Arrangement, Amount $ (6,906)    
Stock-based compensation expense 3.40% (1.00%) (4.40%)
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Meals and Entertainment, Amount $ 3,326    
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Meals and Entertainment, Percent (1.60%)    
Effective Income Tax Rate Reconciliation, Other Adjustments, Amount $ (70)    
Other adjustments 0.00% (0.10%) (2.50%)
Tax expense (benefit) $ 4,061 $ (7,304) $ 2,403
Effective tax rate (2.00%) 0.60% (1.20%)
Executive Compensation      
Effective Income Tax Rate Reconciliation [Line Items]      
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Amount $ 22,552    
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Percent (11.10%)    
Transaction Costs      
Effective Income Tax Rate Reconciliation [Line Items]      
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Amount $ 2,987    
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Percent (1.50%)    
Contingent Consideration      
Effective Income Tax Rate Reconciliation [Line Items]      
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Amount $ 5,568    
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Percent (2.70%)    
Other      
Effective Income Tax Rate Reconciliation [Line Items]      
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Amount $ 574    
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Other, Percent (0.30%)    
Federal      
Expense (benefit) for income taxes      
Current expense (benefit): $ 0 $ 0 $ 0
Deferred tax expense (benefit): 498 (4,775) 2,395
State      
Expense (benefit) for income taxes      
Current expense (benefit): 1,516 933 2,266
Deferred tax expense (benefit): (334) (5,145) (1,829)
Foreign      
Expense (benefit) for income taxes      
Current expense (benefit): 3,909 1,882 2,561
Deferred tax expense (benefit): $ (1,528) $ (199) $ (2,990)
v3.25.4
INCOME TAXES - Deferred Tax Asset, Valuation Allowance RollForward (Details) - Deferred tax asset - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]      
Beginning balance $ (708,788) $ (465,832) $ (419,356)
Valuation allowances established (32,224) (241,849) (44,759)
Changes to existing valuation allowances 5,033 (1,107) (1,242)
Acquisition and purchase accounting 0 0 (475)
Ending balance $ (735,979) $ (708,788) $ (465,832)
v3.25.4
Restructuring and Related Activities (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs $ 22,169
Business Transformation Costs 51,044
Restructuring and Related Cost, Incurred Cost 73,213
Payments for Restructuring (18,818)
Restructuring Reserve, Accrual Adjustment 496
Restructuring Reserve 3,847
Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 14,390
Payments for Restructuring (11,348)
Restructuring Reserve, Accrual Adjustment 496
Restructuring Reserve 3,538
Other Restructuring  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 7,779
Payments for Restructuring (7,470)
Restructuring Reserve, Accrual Adjustment 0
Restructuring Reserve 309
Cost of sales  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 84
Cost of sales | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 84
Research and Development Expense [Member]  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 554
Research and Development Expense [Member] | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 554
Sales and marketing  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 2,868
Sales and marketing | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 2,868
General and administrative  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 18,663
General and administrative | Employee Severance  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs 10,884
General and administrative | Other Restructuring  
Restructuring Cost and Reserve [Line Items]  
Restructuring Costs $ 7,779