NATERA, INC., 10-Q filed on 5/8/2026
Quarterly Report
v3.26.1
Cover - shares
 3 Months Ended
Mar. 31, 2026
May 01, 2026
Cover [Abstract]    
Document Type 10-Q  
Document Quarterly Report true  
Document Period End Date Mar. 31, 2026  
Document Transition Report false  
Entity File Number 001-37478  
Entity Registrant Name NATERA, INC.  
Entity Incorporation, State or Country Code DE  
Entity Tax Identification Number 01-0894487  
Entity Address, Address Line One 13011 McCallen Pass  
Entity Address, Address Line Two Building A Suite 100  
Entity Address, City or Town Austin  
Entity Address, State or Province TX  
Entity Address, Postal Zip Code 78753  
City Area Code 650  
Local Phone Number 980-9190  
Title of 12(b) Security Common Stock, par value $0.0001 per share  
Trading Symbol NTRA  
Security Exchange Name NASDAQ  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Filer Category Large Accelerated Filer  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Shell Company false  
Entity Common Stock, Shares Outstanding   143,215,382
Entity Central Index Key 0001604821  
Amendment Flag false  
Document Fiscal Period Focus Q1  
Document Fiscal Year Focus 2026  
Current Fiscal Year End Date --12-31  
v3.26.1
Condensed Consolidated Balance Sheets - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Current assets:    
Cash, cash equivalents and restricted cash $ 1,087,932 $ 1,076,140
Accounts receivable, net of allowance of $7,927 and $8,018 at March 31, 2026 and December 31, 2025, respectively 417,595 296,528
Inventory 70,721 68,443
Prepaid expenses and other current assets 75,565 55,828
Total current assets 1,651,813 1,496,939
Property and equipment, net 269,379 241,184
Operating lease right-of-use assets 133,987 108,541
Goodwill 140,857 141,070
Intangible assets 367,362 373,713
Other assets 51,000 36,897
Total assets 2,614,398 2,398,344
Current liabilities:    
Accounts payable 62,397 33,156
Accrued compensation 143,810 92,603
Contingent consideration payable, current portion 22,350 21,580
Deferred revenue, current portion 36,852 24,907
Short-term debt financing 80,305 80,323
Other accrued liabilities 212,543 188,659
Total current liabilities 558,257 441,228
Contingent consideration payable, long-term portion 103,204 96,780
Deferred tax liability, long-term portion 701 701
Operating lease liabilities, long-term portion 144,953 118,473
Deferred revenue, long-term portion 16,999 17,062
Other liabilities 16,266 11,687
Total liabilities 840,380 685,931
Commitments and contingencies (Note 10)
Stockholders’ equity:    
Common stock, $0.0001 par value: 750,000 shares authorized at both March 31, 2026 and December 31, 2025; 142,734 and 139,693 shares issued and outstanding at March 31, 2026 and December 31, 2025, respectively 14 14
Additional paid-in capital 4,635,319 4,488,679
Accumulated deficit (2,861,113) (2,776,022)
Accumulated other comprehensive loss (202) (258)
Total stockholders’ equity 1,774,018 1,712,413
Total liabilities and stockholders’ equity $ 2,614,398 $ 2,398,344
v3.26.1
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($)
shares in Thousands, $ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Statement of Financial Position [Abstract]    
Allowances on accounts receivable $ 7,927 $ 8,018
Common stock, par value (in dollars per share) $ 0.0001 $ 0.0001
Common stock, shares authorized (in shares) 750,000 750,000
Common stock, shares issued (in shares) 142,734 139,693
Common stock, shares outstanding (in shares) 142,734 139,693
v3.26.1
Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($)
shares in Thousands, $ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Revenues    
Total revenues $ 696,644 $ 501,830
Cost and expenses    
Research and development 210,702 129,078
Selling, general and administrative 327,938 266,864
Amortization of acquired intangible assets 7,100 300
Total cost and expenses 790,160 581,007
Loss from operations (93,516) (79,177)
Interest expense (892) (1,005)
Interest and other income, net 9,600 13,419
Loss before income taxes (84,808) (66,763)
Income tax expense (283) (173)
Net loss (85,091) (66,936)
Unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment 56 147
Comprehensive loss $ (85,035) $ (66,789)
Net loss per share (Note 14):    
Basic (in dollars per share) $ (0.60) $ (0.50)
Diluted (in dollars per share) $ (0.60) $ (0.50)
Weighted-average number of shares used in computing basic and diluted net loss per share:    
Basic (in shares) 141,502 134,750
Diluted (in shares) 141,502 134,750
Foresight Diagnostics, Inc.    
Cost and expenses    
Amortization of acquired intangible assets $ 5,709 $ 0
Product revenues    
Revenues    
Total revenues 693,868 500,036
Cost and expenses    
Cost of revenues 245,203 184,613
Licensing and other revenues    
Revenues    
Total revenues 2,776 1,794
Cost and expenses    
Cost of revenues $ 608 $ 452
v3.26.1
Condensed Consolidated Statements of Stockholders' Equity - USD ($)
shares in Thousands, $ in Thousands
Total
Common Stock
Additional Paid-in Capital
Accumulated Deficit
Accumulated Other Comprehensive Loss
Beginning balance (in shares) at Dec. 31, 2024   132,646      
Beginning balance at Dec. 31, 2024 $ 1,195,420 $ 12 $ 3,763,614 $ (2,567,862) $ (344)
Increase (Decrease) in Stockholders' Equity [Roll Forward]          
Issuance of common stock upon exercise of stock options (in shares)   50      
Issuance of common stock upon exercise of stock options 544   544    
Vesting of restricted stock units (in shares)   3,014      
Vesting of restricted stock units 2 $ 2      
Stock-based compensation 78,435   78,435    
Issuance of common stock for bonus (in shares)   222      
Issuance of common stock for bonus 32,063   32,063    
Unrealized gain on available-for sale securities, net of tax and foreign currency translation adjustment 147       147
Net loss (66,936)     (66,936)  
Ending balance (in shares) at Mar. 31, 2025   135,932      
Ending balance at Mar. 31, 2025 $ 1,239,675 $ 14 3,874,656 (2,634,798) (197)
Beginning balance (in shares) at Dec. 31, 2025 139,693 139,693      
Beginning balance at Dec. 31, 2025 $ 1,712,413 $ 14 4,488,679 (2,776,022) (258)
Increase (Decrease) in Stockholders' Equity [Roll Forward]          
Issuance of common stock upon exercise of stock options (in shares) 346 346      
Issuance of common stock upon exercise of stock options $ 3,863   3,863    
Vesting of restricted stock units (in shares)   2,457      
Stock-based compensation 94,074   94,074    
Issuance of common stock for bonus (in shares)   229      
Issuance of common stock for bonus 47,026   47,026    
Issuance of common stock pursuant to asset acquisition, net (in shares)   10      
Issuance of common stock pursuant to asset acquisition, net 2,000   2,000    
Cancellation of escrow shares pursuant to business combination, net (in shares)   (1)      
Cancellation of escrow shares pursuant to business combination, net (323)   (323)    
Unrealized gain on available-for sale securities, net of tax and foreign currency translation adjustment 56       56
Net loss $ (85,091)     (85,091)  
Ending balance (in shares) at Mar. 31, 2026 142,734 142,734      
Ending balance at Mar. 31, 2026 $ 1,774,018 $ 14 $ 4,635,319 $ (2,861,113) $ (202)
v3.26.1
Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Operating activities    
Net loss $ (85,091) $ (66,936)
Adjustments to reconcile net loss to net cash provided by operating activities:    
Depreciation and amortization 14,517 9,237
Amortization of acquired intangible assets 7,100 300
Amortization of premiums and accretion of purchase discounts on investment securities 0 9
Non-cash lease expense 5,931 4,389
Non-cash settlement expense 1,226 0
Stock-based compensation 95,107 77,827
Change in fair value of warrants and preferred stock of related party equity investment (166) (3,235)
Revaluation of contingent consideration 6,120 0
Foreign exchange adjustment 258 138
Non-cash interest expense (18) (17)
Non-cash expense recovery (596) (361)
Changes in operating assets and liabilities:    
Accounts receivable (121,067) (4,068)
Inventory (2,278) (5,623)
Operating lease right-of-use assets 255 0
Prepaid expenses and other assets (17,064) (9,354)
Accounts payable 21,880 2,379
Accrued compensation 98,233 17,035
Operating lease liabilities (5,852) (4,505)
Other accrued liabilities 12,105 26,866
Deferred revenue 11,882 671
Other long-term liabilities (920) 0
Net cash provided by operating activities 40,171 44,452
Investing activities    
Proceeds from maturity of investments 0 5,000
Purchases of property and equipment, net (22,137) (21,815)
Investment in related party (10,000) 0
Net cash used in investing activities (32,137) (16,815)
Financing activities    
Proceeds from exercise of stock options 3,863 544
Stock issuance costs (105) 0
Net cash provided by financing activities 3,758 544
Net change in cash, cash equivalents and restricted cash 11,792 28,181
Cash, cash equivalents and restricted cash, beginning of period 1,076,140 945,587
Cash, cash equivalents and restricted cash, end of period 1,087,932 973,768
Supplemental disclosure of cash flow information:    
Cash paid for interest 889 1,005
Non-cash investing and financing activities:    
Purchases of property and equipment in accounts payable and accruals 18,216 4,223
Acquisition of warrants and warrants receivable 7,162 0
Consideration for business combination (213) 0
Issuance of common stock for IPR&D milestone 774 0
Issuance of common stock for bonuses 47,026 32,063
Stock-based compensation included in capitalized software development costs 391 608
Foresight Diagnostics, Inc.    
Adjustments to reconcile net loss to net cash provided by operating activities:    
Amortization of acquired intangible assets 5,709 $ 0
Revaluation of contingent consideration $ 7,200  
v3.26.1
Description of Business
 3 Months Ended
Mar. 31, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Description of Business Description of Business
Natera, Inc. (the “Company”) was formed in the state of California as Gene Security Network, LLC in November 2003 and incorporated in the state of Delaware in January 2007. The Company is a diagnostics company with proprietary molecular and bioinformatics technology that it is applying to change disease management worldwide. The Company’s cell-free DNA (“cfDNA”) technology combines its novel molecular assays, which reliably measure many informative regions across the genome, from samples as small as a single cell, with its statistical algorithms that incorporate data available from the broader scientific community to identify genetic variations, covering a wide range of serious conditions with high accuracy and coverage. The Company focuses on applying its technology to three main areas of healthcare – oncology, women’s health, and organ health. In oncology, the Company commercializes personalized blood-based DNA tests designed to optimize therapy decisions from diagnosis to survivorship. In the women’s health space, the Company develops and commercializes non- or minimally- invasive tests to support a range of women’s health needs, from prenatal testing to hereditary cancer screening. In organ health, the Company offers tests to assess kidney, heart, and lung transplant rejection as well as genetic testing for chronic kidney disease. The Company operates laboratories in Austin, Texas, San Carlos, California, and Boulder, Colorado, certified under the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”), providing a host of cell-free DNA-based molecular testing services. The Company determines its operating segments based on the way it organizes its business to make operating decisions and assess performance. The Company operates one segment, the development and commercialization of molecular testing services, applying its proprietary technology in the fields of women’s health, oncology and organ health.

The Company’s key product offerings include its Panorama Non-Invasive Prenatal Test (“Panorama”) that screens for chromosomal abnormalities of a fetus in single and twin pregnancies, typically with a blood draw from the mother; Horizon Carrier Screening (“Horizon”) to determine carrier status for a large number of severe genetic diseases that could be passed on to the carrier’s children; its Signatera molecular residual disease test (“Signatera”) to detect circulating tumor DNA in patients previously diagnosed with cancer to assess molecular residual disease, monitor for recurrence, and evaluate treatment response; and its Prospera test, to assess organ transplant rejection in patients who have undergone kidney, heart, or lung transplantation. All testing is available principally in the United States with Panorama testing available to customers outside of the United States, primarily in Europe. Additionally, the Company also offers a cloud-based software platform, Constellation, that enables laboratory customers to gain access through the cloud to the Company’s algorithms and bioinformatics to validate and launch their own tests based on the Company’s technology.
v3.26.1
Summary of Significant Accounting Policies
 3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Summary of Significant Accounting Policies Summary of Significant Accounting Policies
During the three months ended March 31, 2026, there were no material changes to the Company’s significant accounting policies as disclosed in the Company’s Annual Report on Form 10-K for the year ended December 31, 2025 (filed on February 27, 2026).
Basis of Presentation
The accompanying unaudited interim condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information. The unaudited interim condensed consolidated financial information includes only adjustments of a normal recurring nature necessary for a fair presentation of the Company’s results of operations, financial position, changes in stockholders’ equity, and cash flows. The results of operations for the three months ended March 31, 2026, are not necessarily indicative of the results for the full year or the results for any future periods. The condensed consolidated balance sheet as of December 31, 2025 has been derived from audited financial statements at that date. These financial statements should be read in conjunction with the audited financial statements, and related notes for the year ended December 31, 2025 included in the Company’s Annual Report on Form 10-K filed with the SEC on February 27, 2026.
Liquidity Matters
The Company has incurred net losses since its inception and anticipates net losses for the near future. The Company had a net loss of $85.1 million for the three months ended March 31, 2026 and an accumulated deficit of $2.9 billion as of March 31, 2026. As of March 31, 2026, the Company had $1.1 billion in cash and an $80.3 million outstanding balance on its Credit Line (as defined in Note 12, Debt) including accrued interest. The Company is required to maintain a minimum of at least $150.0 million in its UBS accounts as collateral for its Credit Line, which is classified as
cash, cash equivalents, and restricted cash in the condensed consolidated balance sheets. As of March 31, 2026, the Company had $20.0 million remaining and available on its Credit Line.
While the Company has introduced multiple products that are generating revenues, these revenues have not been sufficient to fund all operations and business plans. Accordingly, the Company has funded the portion of operating costs that exceeds revenues through a combination of equity issuances, debt issuances, and other financings.
The Company continues to invest in the development and commercialization of its existing and future products and, consequently, it will need to generate additional revenues to achieve future profitability and may need to raise additional equity or debt financing. If the Company raises additional funds by issuing equity securities, its stockholders will experience dilution. Additional debt financing, if available, may involve covenants restricting its operations or its ability to incur additional debt. Any additional debt financing or additional equity that the Company raises may contain terms that are not favorable to it or its stockholders and requires significant debt service payments, which diverts resources from other activities. Additional financing may not be available when necessary, or in amounts or on terms acceptable to the Company. If the Company is unable to obtain additional financing, it may be required to delay or slow its investment in the development and commercialization of its products and significantly scale back its business and operations.
Based on the Company’s current business plan, the Company believes that its existing cash will be sufficient to meet its anticipated cash requirements for at least 12 months after the date of issuance of the accompanying financial statements.
Principles of Consolidation
The accompanying condensed consolidated financial statements include all the accounts of the Company and its subsidiaries. All intercompany balances and transactions have been eliminated.
Use of Estimates
The preparation of financial statements in conformity with generally accepted accounting principles (GAAP) requires management to make judgments, estimates, and assumptions that could affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. The Company bases its estimates and assumptions on historical experience and on various other assumptions it believes to be applicable and evaluates them on an ongoing basis to ensure they remain reasonable under current conditions. Actual results could differ significantly from those estimates.

Business Combinations

The Company accounts for business combinations using the acquisition method of accounting, which requires, among other things, that results of operations for acquired companies are included in the Company’s results of operations beginning on the acquisition date and that assets acquired, and liabilities assumed are recognized at fair value as of the acquisition date. Any excess of the fair value of consideration transferred over the fair value of the identifiable assets acquired and liabilities assumed is recorded as goodwill. Management’s estimates of fair value are based upon assumptions believed to be reasonable, but which are inherently uncertain and unpredictable, and as a result, actual results may differ from estimates. During the measurement period, not to exceed one year from the date of acquisition, the Company may record adjustments to the assets acquired and liabilities assumed, with a corresponding offset to goodwill if new information is obtained related to facts and circumstances that existed as of the acquisition date. After the measurement period, any subsequent adjustments are reflected in the consolidated statements of operations. Acquisition-related expenses and post-combination integration and employee compensation costs are recognized separately from the business combination and are expensed as incurred.

Contingent consideration obligations incurred in connection with a business combination are recorded at their estimated fair values on the acquisition date and remeasured at their fair values each subsequent reporting period until the related contingencies have been resolved. The resulting changes in fair values are recorded in earnings. The determination of fair value requires management to make significant estimates, particularly with respect to identified acquired intangible assets. These estimates are inherently uncertain and subject to change as additional information is obtained during the measurement period, which lasts for up to one year from the acquisition date. Upon the conclusion of the measurement period, any subsequent adjustments are recorded in the consolidated statement of operations and comprehensive loss. See Note 3, Business Combination, for details.
Accounts Receivable, net of allowance
Trade accounts receivable and other receivables. The allowance for expected credit losses for trade accounts receivable is based on the Company’s assessment of the collectability of accounts related to its clinics and laboratory partner customers. The Company regularly reviews the allowance by considering factors such as historical experience, the age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. See Note 8, Balance Sheet Components, for a roll-forward of the allowance for expected credit losses related to trade accounts receivable for the three months ended March 31, 2026 and 2025.
With respect to revenue recognized related to genetic test services provided to patient customers whereby consideration is expected to be received from insurance or patient payors, the Company recognizes a constraint to the estimated variable consideration such that it is not probable that a significant revenue reversal will occur. When assessing the total consideration expected to be received from insurance carriers and patients, a certain percentage of revenues is further constrained for estimated refunds. After applying the ASU 2016-10, Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing (“ASC 606”) constraint, the Company assessed for credit losses under ASU 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASC 326”) and determined an incremental credit loss was not needed given the quality of the insurance payors from whom such receivables are expected to be collectible and the relatively short duration over which the majority of receivables are collected. Accordingly, the Company currently does not have an incremental credit loss reserve nor allowance for expected credit losses against accounts receivable for insurance and patient payors due to the average selling price calculations, which incorporate these risks as net receivables are recorded.
Inventory
Inventory is recorded at the lower of cost or net realizable value, determined on a first-in, first-out basis. Inventory consists entirely of supplies, which are consumed at the point biologic samples are collected and the Company provides genetic testing services, and therefore, the Company does not maintain any work-in-process or finished goods inventory. The Company enters into inventory purchases commitments so that it can meet future delivery schedules based on forecasted demand for its tests.
The Company analyzes its inventory to determine whether the composition of its inventory is obsolete or slow-moving. A write down of specifically identified unusable, or obsolete inventory in the period is recognized by considering product expiration dates and scrapped inventory. Any write-down of inventory to net realizable value establishes a new cost basis and will be maintained even if certain circumstances suggest the inventory is recoverable in subsequent periods. Costs associated with the write-down of inventory are recorded to cost of revenue on our consolidated statements of operations. Inventory reserves as of March 31, 2026 and December 31, 2025 were not material.

Goodwill and Intangible Assets

The excess of the fair value of consideration transferred over the fair value of the net assets acquired in a business combination is recorded as goodwill. Goodwill is not amortized and is tested for impairment, at least annually, at the reporting unit level. The test for impairment is conducted annually each October 1, or more frequently if events occur or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. The Company has one reporting unit, as described within Note 15, Segment Reporting. During the goodwill impairment review, the Company assesses qualitative factors to determine whether it is more likely than not that the fair value of its reporting unit is less than its carrying amount, including goodwill. The Company considers qualitative factors such as macroeconomic conditions, industry and market considerations, and overall financial performance of the Company. A quantitative assessment is performed if the qualitative assessment results in a more-likely-than-not determination or if a qualitative assessment is not performed. The quantitative assessment considers whether the carrying amount of the Company’s reporting unit exceeds its fair value, in which case an impairment loss is recognized to the extent that the reporting unit’s carrying value exceeds its fair value, limited to the total amount of goodwill.

Finite-lived intangible assets are recorded at cost, net of accumulated amortization, and, if applicable, impairment charges. Amortization of finite-lived intangible assets is recorded over the assets’ estimated useful lives on a straight-line basis or based on the pattern in which economic benefits are consumed, if reliably determinable. Amortization expense related to intangible assets acquired via business combinations are recorded in amortization of acquired intangible assets expense in the consolidated statements of operations and comprehensive loss. Amortization expense related to all other intangible assets was recorded to the functional category to which it primarily relates in the consolidated statements of operations and comprehensive loss. The Company assesses the impairment of long-lived intangible assets whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company has not recorded
impairment charges on its finite-lived intangible assets or goodwill for the periods presented in these condensed consolidated financial statements.

Accumulated Other Comprehensive Income (Loss)

Comprehensive loss and its components encompass all changes in equity other than those with stockholders, and include net loss, unrealized gains and losses on available-for-sale marketable securities and foreign currency translation adjustments.
Three months ended
March 31,
20262025
(in thousands)
Beginning balance$(258)$(344)
Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment56 147 
Ending balance$(202)$(197)
The change in net unrealized loss on available-for-sale securities is due to the impact of changes in interest rates on the value of fixed-rate investments and not due to any credit deterioration. Further, due to the short-term nature of these investments, the Company has the ability and intention to hold any such investments until maturity and does not expect to realize any material investment losses. Since the Company did not hold any investments at March 31, 2026 or December 31, 2025, an allowance for credit loss was not necessary.

Revenue Recognition

The Company recognizes revenue under, ASC 606, using the following five step process:
•Identification of a contract, or contracts, with a customer;
•Identification of the performance obligations in the contract;
•Determination of the transaction price;
•Allocation of the transaction price to the performance obligations in the contract; and
•Revenue recognition when, or as, the performance obligations are satisfied.
The Company uses the expected value method of estimating variable consideration. The total consideration which the Company expects to collect in exchange for the Company’s products is an estimate and may be fixed or variable, and is primarily based on historical cash collections for tests delivered, as adjusted for current expectations. Current expectations of cash collections factor in changes in reimbursement rate trends, past events not expected to recur, and future known changes such as anticipated contractual pricing changes or changes to insurance coverage. For insurance carriers and product types with similar reimbursement characteristics, the Company uses a portfolio approach to estimate variable consideration. When assessing the total variable consideration expected to be received from insurance carriers and patients, the Company considers both the magnitude and likelihood of a revenue reversal in the determination of the percentage of revenues to further constrain for estimated refunds.
See Note 4, Revenue Recognition, for detailed discussions of product revenues, licensing and other revenues, and how the five steps described above are applied.
Fair Value
The Company discloses the fair value of financial instruments for financial assets and liabilities for which the value is practicable to estimate. Fair value is defined as the price that would be received upon the sale of an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (exit price).
Related Party Transactions
On December 6, 2021, the Company participated along with certain other investors in the series B financing of MyOme, Inc. (“MyOme”) and purchased preferred shares and warrants in exchange for a cash payment of approximately $4.0 million which was allocated $2.2 million for preferred shares and $1.8 million for warrants. In August 2024, the Company participated in a subsequent round of the series B financing and purchased an additional $2.7 million of series B preferred shares at the same valuation as the initial round of financing in December 2021. The Company does not hold a seat on MyOme’s board of directors and does not participate or direct the day-to-day activities of MyOme. Because MyOme is a privately-held company without readily determinable fair values, the Company elected to account for its preferred Series B share investment in MyOme using the measurement alternative, which is cost, less any impairment, adjusted for changes in fair value resulting from observable transactions for identical or similar investments of the same issuer as of the respective transaction dates. When indicators exist and the estimated fair value of the investment is below its carrying amount, the Company would adjust the investment to fair value. The change in carrying value, resulting from the remeasurements, would be recognized in interest and other income, net on the consolidated statements of operations. The following are the Company’s related persons and the basis of each such related person’s relationship with MyOme:
•Matthew Rabinowitz, the Company’s executive chairman and co-founder, is the chairman of the board, founder, and the interim chief executive officer of MyOme, and a beneficial holder of approximately 19.4% of the outstanding shares of MyOme on a fully dilutive basis;
•Jonathan Sheena, the Company’s co-founder and a member of the Company’s board of directors, is a stockholder and a member of the board of directors of MyOme;
•Daniel Rabinowitz, the Company’s Secretary and Chief Legal Officer, is a stockholder of MyOme; and
•Roelof Botha, the Lead Independent Director of the Company’s board of directors, is a managing member of Sequoia Capital. Certain funds affiliated with Sequoia Capital also participated in MyOme’s series B financing.
None of the related party investments in MyOme by our executives and directors noted above were at the behest of the Company nor funded by the Company.
In February 2024, the Company entered into a collaboration and commercialization agreement (the “Collaboration Agreement”) with MyOme pursuant to which the parties agreed to partner to offer certain genetic testing services to be developed and funded solely by MyOme and overseen by a joint steering committee. The Company agreed to assist MyOme with commercial activities. In connection with the Collaboration Agreement, the Company received a 10-year warrant to purchase 3,058,485 shares of MyOme’s common stock at an exercise price of $0.25 per share, which is exercisable in whole or in part, commencing in February 2024, and can be converted to MyOme’s common stock upon the occurrence of MyOme’s initial public offering or a liquidation event (as such terms are defined in MyOme’s certificate of incorporation). Additionally, upon the achievement of certain product commercialization milestones, the Company is eligible to receive an additional warrant exercisable for 2,080,565 shares of MyOme’s series B preferred stock with an exercise price of $0.01 per share. During September 2024, the Company achieved certain product commercialization milestones such that the warrant for 2,080,565 shares of MyOme’s series B preferred stock was due from MyOme to the Company. These warrants were granted and issued by MyOme to the Company during the fourth quarter of 2024, and were exercisable in whole or in part in December 2024. In October 2025, the Company entered into an amendment to the Series B Preferred Stock Agreement with MyOme, resulting in the Company investing an additional $10.0 million in MyOme in January 2026. In January 2026, the Company achieved another product commercialization milestone and as such, an additional warrant for 1,977,769 shares of MyOme’s series B preferred stock was due from MyOme to the Company. However, the Company needs to perform ongoing collaboration in exchange for the warrant consideration. Accordingly, the warrants and warrant receivable have been included within other assets and allocated between short-term and long-term liabilities on the consolidated balance sheets. The Company is amortizing the liability as a reduction of selling and marketing expense upon commercialization and sale of the products contemplated under the Collaboration Agreement over the life of the contract. For the three months ended March 31, 2026 and 2025, the amortization of the non-cash liability was $0.6 million and $0.4 million, respectively.
The warrants and warrants receivable are accounted for as derivative instruments and recorded within other assets on the consolidated balance sheets at fair value on a recurring basis. The warrants and warrants receivable were valued using the Black-Scholes valuation model as of each reporting period, including the date of issuance. To the extent the genetic testing services are successfully commercialized, the Company will owe certain royalty payments to MyOme. For
the three months ended March 31, 2026 and 2025, the royalties to MyOme were not material. As of March 31, 2026 and December 31, 2025, the Company’s carrying amount of preferred shares in MyOme was $16.7 million and $6.7 million, respectively, on its consolidated balance sheets. The fair market value of the warrants and warrants receivable as of March 31, 2026 and December 31, 2025 was $20.0 million and $12.7 million, respectively, on the consolidated balance sheets.
Risk and Uncertainties
Financial instruments that potentially subject the Company to credit risk consist of cash, cash equivalents, and restricted cash, accounts receivable and investments. The Company limits its exposure to credit loss by placing its cash in financial institutions with high credit ratings. The Company’s cash may consist of deposits held with banks that may at times exceed federally insured limits. The Company performs evaluations of the relative credit standing of these financial institutions and limits the amount of credit exposure with any one institution.
For the three months ended March 31, 2026, and 2025, there were no customers exceeding 10% of total revenues on an individual basis. As of March 31, 2026 and December 31, 2025, there were no customers with an outstanding balance exceeding 10% of net accounts receivable.
For the three months ended March 31, 2026 and 2025, approximately 14.8% and 14.0%, respectively, of total revenue were paid by traditional Medicare on behalf of multiple customers. As of March 31, 2026 and December 31, 2025, approximately 14.6% and 14.1%, respectively, of accounts receivable are expected to be paid by traditional Medicare on behalf of multiple customers.
Recent Accounting Pronouncements
From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (“FASB”) under its accounting standard codifications or other standard setting bodies and adopted by the Company as of the specified effective date.
Recently Adopted Accounting Pronouncements

In July 2025, ASU 2025-05, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses for Accounts Receivable and Contract Assets, was issued, which introduces a practical expedient to calculating current expected credit loss by assuming that the current conditions as of the balance sheet date will not change for the remaining life of the asset. This update is effective for fiscal years beginning after December 15, 2025. Adoption of this standard occurred on January 1, 2026 and did not have a material impact on the Company’s consolidated financial statements.
New Accounting Pronouncements Not Yet Adopted
In November 2024, ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40) was issued, which requires disaggregation of any relevant expense caption presented on the face of the income statement for certain expense categories. The new guidance is effective for fiscal years beginning after December 15, 2026, and interim periods within fiscal years beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.
In May 2025, ASU 2025-03, Business Combinations (Topic 805) and Consolidation (Topic 810), Determining the Accounting Acquirer in the Acquisition of a Variable Interest Entity, was issued, which revised current guidance for determining the accounting acquirer for a transaction effected primarily by exchanging equity interests in which the legal acquiree is a VIE that meets the definition of a business. The amendments require that an entity consider the same factors that are currently required for determining which entity is the accounting acquirer in other acquisition transactions. The amendments in this Update require an entity involved in an acquisition transaction effected primarily by exchanging equity interests when the legal acquiree is a VIE that meets the definition of a business to consider the factors in paragraphs 805-10-55-12 through 55-15 to determine which entity is the accounting acquirer. The amendments in this Update are effective for all entities for annual reporting periods beginning after December 15, 2026, and interim reporting periods within those annual reporting periods. The amendments in this Update require that an entity apply the new guidance prospectively to any acquisition transaction that occurs after the initial application date. Early adoption is permitted as of
the beginning of an interim or annual reporting period. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.

In September 2025, ASU 2025-06, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software was issued, which amends the guidance in ASC 350-40, Intangibles-Goodwill and Other-Internal-Use Software. The amendments modernize the recognition and disclosure framework for internal-use software costs, removing the previous "development stage" model and introducing a more judgment-based approach. This ASU 2025-06 is effective for fiscal years beginning after December 15, 2027, and for interim periods within those annual reporting periods. Early adoption is permitted. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.

In September 2025, ASU 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” was issued. The new guidance excludes non-exchange-traded contracts with underlyings based on operations or activities specific to one of the parties to the contract from derivative accounting. This guidance is effective for fiscal years and interim periods beginning after December 15, 2026, with early adoption permitted. These requirements may be applied prospectively or on a modified retrospective basis through a cumulative-effect adjustment to the opening balance of retained earnings. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.
v3.26.1
Business Combination
 3 Months Ended
Mar. 31, 2026
Business Combination, Asset Acquisition, Transaction between Entities under Common Control, and Joint Venture Formation [Abstract]  
Business Combination Business Combination
Foresight Diagnostics, Inc.

On December 4, 2025, the Company completed the acquisition of Foresight Diagnostics, Inc. (“Foresight Diagnostics”), a leader in ultrasensitive molecular residual disease (“MRD”) detection. Foresight Diagnostics is a cancer diagnostics company and CLIA-registered laboratory. Their circulating tumor DNA (ctDNA)-based MRD tests leverage its patented PhasED-Seq™ technology, targeting phased variants. The acquisition was completed primarily to expand the Company’s intellectual property portfolio for tumor-informed and personalized MRD products including in phased variants and to build on Foresight’s clinical research momentum in B-cell lymphomas.

The total purchase consideration for the acquisition of Foresight Diagnostics was $424.5 million, which included the issuance of 1,127,982 shares of common stock, par value of $0.0001 per share, at a fair value based on the acquisition date closing price of $242.06 per share of the Company’s common stock. Former Foresight Diagnostics shareholders received 0.0280 shares of the Company’s common stock for each share of Foresight Diagnostics capital stock issued and outstanding as of immediately prior to the closing of the acquisition. Additionally, the Company assumed outstanding stock options of Foresight Diagnostics (“Assumed Options”). Each Assumed Option was converted into an option to purchase shares of the Company’s common stock based on the exchange ratio specified in the acquisition agreement. The Assumed Options generally retained their original vesting conditions, contractual terms, and expiration dates in effect immediately prior to the acquisition. In accordance with ASC 805, Business Combinations, and ASC 718, Compensation—Stock Compensation, the total fair value of the Assumed Options was allocated between pre-combination and post-combination service. The portion of the fair value attributable to pre-combination service was included in the total purchase consideration. The portion attributable to post-combination service was excluded from purchase consideration and will be recognized as stock-based compensation expense over the remaining requisite service period. Other components of purchase consideration included the fair value of contingent consideration of $118.4 million, cash paid at closing to settle Foresight Diagnostics’ existing debt of $6.0 million and seller transaction costs paid by the Company on behalf of Foresight Diagnostics of $7.2 million. The Company also assumed promised stock options to eligible Foresight employees which were converted, based on the exchange ratio specified in the acquisition agreement, to RSUs for shares of the Company’s common stock and granted upon closing of the acquisition. These equity awards were not included in the total purchase consideration.

Certain former Foresight Diagnostics employees are entitled to receive contingent consideration in the form of additional shares of the Company’s common stock in the aggregate amount of up to $175.0 million, based on the achievement of certain specified milestones. The Company measured the fair value of the contingent consideration obligation on the acquisition date to be $118.4 million, for which the Company recorded $21.6 million and $96.8 million as a current liability and noncurrent liability, respectively. The Company determined the estimated fair value of (i) certain milestone payments using a Monte Carlo simulation, which requires the use of projected financial information and discount rates, and (ii) certain other milestone payments based on a probability weighted expected return method. The fair value of the contingent consideration will be remeasured each reporting period until the contingencies are settled, with changes in the fair value recognized within selling, general and administrative expenses on the consolidated statements of operations and comprehensive loss. During the three months ended March 31, 2026, the Company remeasured the fair value of the contingent consideration obligation and recorded an increase to the contingent consideration obligation of $7.2 million,
with a corresponding amount recorded in selling, general and administrative expenses. The balance recorded as of March 31, 2026 is $22.4 million and $103.2 million as a current liability and noncurrent liability, respectively.

In connection with the acquisition, the Company deposited 9,505 shares having an aggregate value of $2.3 million in the escrow account for purchase price adjustments and deposited $1.0 million in an expense account for purposes of reimbursing the stockholder representative for expenses incurred related to the acquisition. Acquisition-related costs of $3.9 million were recorded in selling, general and administrative expenses on the consolidated statements of operations and $0.1 million were recorded in additional paid in capital on the consolidated balance sheets during the year ended December 31, 2025.

The acquisition of Foresight Diagnostics has been accounted for using the acquisition method of accounting in accordance with authoritative guidance for business combinations, with Natera treated as the accounting acquirer, which requires, among other things, that the assets acquired and liabilities assumed be recognized at their fair value on the acquisition date.

The following table summarizes the fair value of consideration transferred and the fair values of the assets acquired and liabilities assumed:

(in thousands)
Fair value of common stock issued to Foresight Diagnostics shareholders$273,038 
Pre-combination portion of Natera replacement equity awards12,088 
Fair value of contingent consideration118,360 
Estimated fair value of the adjustment escrow shares2,300 
Stockholder representative allocable expenses1,000 
Foresight Diagnostics’ transaction expenses settled by the Company7,232 
Foresight Diagnostics’ indebtedness settled by the Company5,974 
Settlement of preexisting relationships4,542 
Cash payment for fractional shares2 
Total Foresight Diagnostics consideration$424,536 
Cash and cash equivalents$2,727 
Current assets8,126 
Property and equipment, net7,224 
Goodwill141,070 
Developed technology intangible asset335,300 
Customer relationships intangible asset900 
Trademarks / trade names intangible asset500 
Operating lease right-of-use assets11,261 
Other assets1,291 
Liabilities assumed(22,397)
Deferred tax liability(61,466)
Total purchase price$424,536 

Certain working capital and tax accounts are subject to potential adjustment as the Company obtains additional information during the measurement period regarding new information obtained related to facts and circumstances that existed as of the acquisition date, not to exceed one year from the date of acquisition. After the measurement period, any subsequent adjustments will be reflected in the consolidated statements of operations. During the three months ended March 31, 2026, the Company recorded a measurement period adjustment to reduce goodwill and purchase consideration by $0.2 million. The related 1,087 escrow shares were returned to the Company in the second quarter of 2026.

The excess of the acquisition date consideration over the fair values assigned to the assets acquired and the liabilities assumed was recorded as goodwill. Goodwill represents Foresight Diagnostics’ assembled workforce and expected synergies the Company believes will result from the acquisition. Goodwill is not deductible for tax purposes. The
fair value of the finite-lived acquired developed technology intangible asset was determined using the multi-period excess earnings income approach. This approach determines fair value based on estimated cash flow projections which are discounted to present value using a risk-adjusted rate of return. Management’s estimated cash flow projections include significant assumptions, including forecasted clinical revenue and related growth rate. The discount rate used to determine the fair value of the developed technology was 12%.

The assumed settlement of pre-existing relationships was determined based on the contractual amounts of payables and receivables between the parties as such amounts approximate fair value.

Pro forma information and results of Foresight Diagnostics since acquisition date have not been presented, as the results of Foresight Diagnostics are not material in relation to the consolidated financial statements of the Company.
v3.26.1
Revenue Recognition
 3 Months Ended
Mar. 31, 2026
Revenue from Contract with Customer [Abstract]  
Revenue Recognition Revenue Recognition
The Company recognizes revenues when, or as, performance obligations in the contracts are satisfied, in the amount reflecting the expected consideration to be received from the goods or services transferred to the customers.
Product Revenues
Product revenues are derived by performing genetic testing services and the Company’s performance obligation is complete when test results are delivered to a laboratory or patient (each a customer).
A performance obligation represents a promise in a contract to transfer a distinct good or service to a customer, which represents a unit of accounting in accordance with ASC 606. A performance obligation is considered distinct from other obligations in a contract when it provides a benefit to the customer either on its own or together with other resources that are readily available to the customer and is separately identified in the contract. The Company considers a performance obligation satisfied once the Company has transferred control of a good or service to the customer, meaning the customer has the ability to use and obtain the benefit of the good or service. A portion of the consideration should be allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. The Company evaluates its contracts with laboratory partners and patients and identifies the performance obligations in those contracts, which are the delivery of the test results.
The total consideration the Company expects to collect in exchange for the Company’s products is an estimate and may be fixed or variable. Consideration includes reimbursement from both patients and insurance carriers, adjusted for variable consideration related to disallowed cases, percent of patient responsibility collected, refunds and reserves, and is estimated using the expected value method. For insurance carriers and product types with similar reimbursement characteristics, the Company uses a portfolio of relevant historical data to estimate variable consideration and total collections for the Company’s products. The Company constrains the estimated variable consideration when it determines it is probable that a significant reversal in the amount of cumulative revenue recognized may occur in future periods. The consideration expected from laboratory partners usually includes a fixed amount, but it can be variable depending on the volume of tests performed, and the Company determines the variable consideration using the expected value approach. For laboratory partners and patients, the Company allocates the total consideration to a single performance obligation, which is the delivery of the test results to the customers.
The Company enters into contracts with insurance carriers with primarily payment terms related to tests provided to patients who have health insurance coverage. Insurance carriers are considered third-party payers on behalf of the patients, and the patients are considered the customers who receive genetic test services. Tests may be billed to insurance carriers, patients, or a combination of insurance carriers and patients. Further, the Company sells tests to a number of domestic and international laboratory partners and identifies the laboratory partners as customers, provided that there is a test services agreement between the two parties.
The Company generally bills an insurance carrier, a laboratory partner or a patient upon delivery of test results. The Company also bills patients directly for out-of-pocket costs involving co-pays and deductibles that they are responsible for. The Company may or may not get reimbursed for the full amount billed. Further, the Company may not get reimbursed at all for tests performed if such tests are not covered under the insurance carrier’s reimbursement policies or the Company is not a qualified provider to the insurance carrier, or if the tests were not previously authorized.
Product revenue is recognized in an amount equal to the total consideration (as described above) expected to be received at a point in time when the test results are delivered. Approximately 90% of cash collections attributable to such product revenue occurs within 9 months, with the remaining collections generally taking an additional 6 months. During this time, management routinely reassesses its estimates of actual to expected cash collections, which are based on historical collection rates and adjusted for current information and trends. To the extent cash collections for tests delivered in prior periods are trending higher than expectations, the Company will increase revenue recognized when sufficient evidence is obtained to conclude the additional revenue will not result in a significant reversal of revenue in a future period. If cash collections for tests delivered in prior periods are trending below expectations, the Company will reduce revenue to the amount expected to be collected based on the latest information and expectations. Increases or decreases to the amount of cash expected to be collected for tests delivered in prior periods are recognized in product revenue with a corresponding impact to accounts receivable during the period such determination is made. During the three months ended March 31, 2026 and 2025, the Company increased revenue by a net of $61.0 million and $34.3 million, respectively, for changes in estimate that increased revenue for tests delivered in prior periods that were fully collected, which increased revenue and decreased net loss by a corresponding amount and decreased loss per share by $0.43 and $0.25 for the three months ended March 31, 2026 and 2025, respectively.
Licensing and Other Revenues
The Company recognizes licensing revenues from its cloud-based distribution service offering, Constellation, by granting licenses to its licensees to use certain of the Company’s proprietary intellectual properties and cloud-based software and in vitro diagnostic (“IVD”) kits. The Company also recognizes revenues from its strategic collaboration agreements, such as those with BGI Genomics Co., Ltd. (“BGI Genomics”). The Company recognizes licensing and other revenues through agreements with pharmaceutical companies in support of potential clinical trials managed by the pharmaceutical companies.
Constellation
The laboratory partners with whom the Company enters into a licensing arrangement represent the licensees and are identified as customers. The licensees do not have the right to possess the Company’s software, but rather receive services through the cloud software. These arrangements often include: (i) the delivery of the services through the cloud software, (ii) the necessary support and training, and (iii) the IVD kits to be consumed as tests are processed. The Company does not consider the software as a service, the support or the training as being distinct in the context of such arrangements, and therefore, they are combined as a single performance obligation. The software, support and training are delivered simultaneously to the licensees over the term of the arrangement.
The Company bills the majority of licensees, who process the tests in their laboratories, a fixed price for each test processed. Licensing revenues are recognized as the performance obligations are satisfied (i.e., upon the delivery of each test) and reported in licensing and other revenues in the Company’s statements of operations and comprehensive loss.
BGI Genomics
In February 2019, the Company entered into a License Agreement (the “BGI Genomics Agreement”) with BGI Genomics to develop, manufacture, and commercialize next generation sequencing-based genetic testing assays for clinical and commercial use. The BGI Genomics Agreement has a term of ten years and expires in February 2029. Pursuant to the BGI Genomics Agreement, the Company licensed its intellectual property to and provided development services for BGI Genomics. Following completion of development services, the Company began providing assay interpretation services over the term of the agreement.
The Company has a single remaining performance obligation related to oncology assay interpretation services to be provided to BGI Genomics, to which $20.0 million of transaction consideration was allocated and prepaid by BGI Genomics. During the three months ended March 31, 2026 and 2025, the Company recognized $0.1 million related to oncology assay interpretation services which was recognized against deferred royalties. The Company has $16.7 million and $16.8 million in deferred revenue related to the BGI Genomics Agreement as of March 31, 2026 and December 31, 2025, respectively.
Disaggregation of Revenues
The following table shows disaggregation of revenues by payer types:
Three months ended
March 31,
20262025
(in thousands)
Insurance carriers$658,089 $472,647 
Laboratory partners28,817 20,832 
Patients9,738 8,351 
Total revenues$696,644 $501,830 
The following table presents total revenues by geographic area based on the location of the Company’s payers:
Three months ended
March 31,
20262025
(in thousands)
United States$685,598 $492,305 
Americas, excluding U.S.2,402 1,692 
Europe, Middle East, India, Africa6,425 6,049 
Asia Pacific and Other2,219 1,784 
Total revenues$696,644 $501,830 
The following table summarizes the changes in the balance of deferred revenues during the three months ended March 31, 2026 and 2025:
Balance at
March 31,
20262025
(in thousands)
Beginning balance$41,969 $36,592 
Increase in deferred revenues28,431 10,163 
Revenue recognized during the period included in deferred revenues at the beginning of the period(11,305)(9,418)
Revenue recognized from performance obligations satisfied within the same period(5,234)(75)
Ending balance$53,861 $37,262 
v3.26.1
Fair Value Measurements
 3 Months Ended
Mar. 31, 2026
Fair Value Disclosures [Abstract]  
Fair Value Measurements Fair Value Measurements
The Company’s financial assets and liabilities carried at fair value are comprised of investment assets that include money market and investments.
The fair value accounting guidance requires that assets and liabilities be carried at fair value and classified in one of the following three categories:
Level I: Quoted prices in active markets for identical assets and liabilities that the Company has the ability to access;
Level II: Observable market-based inputs or unobservable inputs that are corroborated by market data, such as quoted prices, interest rates, and yield curves; and
Level III: Inputs that are unobservable data points that are not corroborated by market data.
This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value.
Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis
The following table represents the fair value hierarchy for the Company’s financial assets and financial liabilities measured at fair value on a recurring basis:
March 31, 2026December 31, 2025
Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
(in thousands)
Financial Assets:
Cash, cash equivalents and restricted cash (1)
$1,087,932 $— $— $1,087,932 $1,076,140 $— $— $1,076,140 
Warrants— — 19,987 19,987 — — 12,659 12,659 
Total financial assets$1,087,932 $— $19,987 $1,107,919 $1,076,140 $— $12,659 $1,088,799 
Financial Liabilities:
Contingent consideration(2)
$— $— $125,554 $125,554 $118,360 $118,360 
Total financial liabilities$— $— $125,554 $125,554 $— $— $118,360 $118,360 
(1)Cash equivalents includes money market deposits and liquid demand deposits.
(2)As of March 31, 2026, contingent consideration includes $22.4 million classified as current and $103.2 million classified as non-current. As of December 31, 2025, contingent consideration includes $21.6 million classified as current and $96.8 million classified as non-current.

The MyOme warrants issued to the Company are accounted for as derivatives and recorded at fair value on a recurring basis and are classified within Level III of the fair value hierarchy because the valuation methods include certain unobservable inputs.

The Company measured the fair value of the contingent consideration obligation resulting from its acquisition of Foresight Diagnostics on the December 4, 2025 acquisition date using significant unobservable inputs, classified as Level III. See Note 3, Business Combination. There were no significant changes in the fair value of the contingent consideration obligation as of December 31, 2025. Each reporting period thereafter, these obligations are revalued and changes in their fair values are recorded as selling, general, and administrative expenses, net within the consolidated statements of operations and comprehensive loss. Changes in the fair value of the contingent consideration can result from changes in assumed discount periods and rates, and from changes pertaining to the estimated or actual achievement of the defined milestones. Judgment is required in determining the appropriateness of these assumptions as of the acquisition date and for each subsequent period. Accordingly, future business and economic conditions, as well as changes in any of the assumptions described above, can materially impact the fair value of the contingent consideration obligation. During the quarter ended March 31, 2026, the Company recorded an increase to the contingent consideration obligation of $7.2 million, with a corresponding amount recorded in selling, general and administrative expenses.

Fair Value of Short-Term and Long-Term Debt

As of March 31, 2026 and December 31, 2025, the estimated fair value of the total principal outstanding and accrued interest of the Credit Line was $80.3 million for both periods, and were based upon observable Level 2 inputs, including the interest rate based on the 30-day Secured Overnight Financing Rate (“SOFR”) average, plus 0.5%. The estimated fair value approximates the carrying value due to the short-term duration and variable interest rate.
v3.26.1
Goodwill and Intangible Assets
 3 Months Ended
Mar. 31, 2026
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Intangible Assets Goodwill and Intangible Assets
Goodwill
On December 4, 2025, upon the acquisition of Foresight Diagnostics the Company recorded $141.1 million of goodwill. See Note 3, Business Combination, for additional information. During the three months ended March 31, 2026, the Company recorded a measurement period adjustment to reduce goodwill and purchase consideration by $0.2 million.

Intangible Assets

The Company’s intangible assets with definite lives are amortized on a straight-line basis over their estimated useful lives, which range from 3 to 15 years. Intangible assets with finite lives are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of such assets may not be recoverable. The Company determined that no events occurred or circumstances changed during the reporting periods ended March 31, 2026 and December 31, 2025 that would indicate that its intangible assets with finite lives may not be recoverable. However, if certain events occur or circumstances change, it may be necessary to record impairment charges in the future.

Intangible assets are comprised of the following:

March 31,December 31,
    Useful Life20262025
(in thousands)
Developed technology15 years$335,300 $335,300 
Customer-relationships
3-10 years
12,795 12,795 
License and trademarks 
6-10 years
 31,274  30,500 
Total 379,369  378,595 
Less: Accumulated amortization  (12,007) (4,882)
Total Intangible Assets, net$367,362 $373,713 

Intangible assets are amortized assuming no expected residual value. Amortization expense related to intangible assets was $7.1 million and $0.3 million for the three months ended March 31, 2026 and 2025, respectively.

The estimated future aggregate amortization expense as of March 31, 2026 is as follows:

(in thousands)
Year ending December 31:
2026 (remaining 9 months)$21,477 
202728,636 
202828,613 
202928,336 
203028,336 
2031 and thereafter231,964 
Total$367,362 
v3.26.1
Financial Instruments
 3 Months Ended
Mar. 31, 2026
Investments, Debt and Equity Securities [Abstract]  
Financial Instruments Financial Instruments
The Company elected to invest a portion of its cash assets in conservative, income-earning, and liquid investments. Cash, cash equivalents, and restricted cash consisted of the following:
March 31, 2026December 31, 2025
Amortized
Cost		Gross
Unrealized
Gain		Gross
Unrealized
Loss		Estimated Fair ValueAmortized
Cost		Gross
Unrealized
Gain		Gross
Unrealized
Loss		Estimated Fair Value
(in thousands)
Cash, cash equivalents and restricted cash (1)
$1,087,932 $— $— $1,087,932 $1,076,140 $— $— $1,076,140 
Total$1,087,932 $— $— $1,087,932 $1,076,140 $— $— $1,076,140 
(1)Cash equivalents includes liquid demand deposits and money market funds.
The Company invests in U.S. Treasuries, U.S. agency and high-quality municipal bonds which mature at par value and are all paying their coupons on schedule. The Company has therefore concluded an allowance for expected credit losses of its investments was not necessary and will continue to recognize unrealized gains and losses in other comprehensive income (loss). During the three months ended March 31, 2026 and 2025, the Company did not sell any investments. The Company uses the specific investment identification method to calculate realized gains and losses and amounts reclassified out of other comprehensive income (loss) to net loss. As of March 31, 2026, the Company did not hold any investments. Accordingly, the Company did not record a credit loss reserve as of March 31, 2026 or December 31, 2025.
v3.26.1
Balance Sheet Components
 3 Months Ended
Mar. 31, 2026
Balance Sheet Related Disclosures [Abstract]  
Balance Sheet Components Balance Sheet Components
Allowance for Expected Credit Losses
The following is a roll-forward of the allowances for expected credit losses related to trade accounts receivable for the three months ended March 31, 2026 and 2025:
Three Months Ended
March 31,
20262025
(in thousands)
Beginning balance$8,018 $7,259 
Provision for (Reversal of) expected credit losses222 195 
Write-offs(313)(20)
Total$7,927 $7,434 
Property and Equipment, net
The Company’s property and equipment consists of the following:
Useful LifeMarch 31,
2026		December 31,
2025
(in thousands)
Machinery and equipment
3-5 years
$183,050 $171,270 
Computer equipment3 years3,993 3,629 
Purchased and capitalized software held for internal use3 years20,117 21,195 
Leasehold improvementsLesser of useful life or lease term62,455 62,152 
Construction-in-process120,176 94,016 
389,791 352,262 
Less: Accumulated depreciation and amortization(120,412)(111,078)
Total property and equipment, net$269,379 $241,184 
The Company’s long-lived assets are located in the United States.
The Company did not incur any impairment charges during the three months ended March 31, 2026 or 2025. Depreciation expense for the three months ended March 31, 2026 and 2025 was $12.6 million and $8.2 million, respectively.
Other Accrued Liabilities
The Company’s other accrued liabilities consisted of the following:
March 31,
2026		December 31,
2025
(in thousands)
Reserves for refunds to insurance carriers$9,651 $9,507 
Accrued charges for third-party testing3,446 20,874 
Testing and laboratory materials from suppliers21,090 12,353 
Marketing and corporate affairs27,617 20,215 
Legal, audit and consulting fees58,976 56,077 
Accrued shipping charges2,043 3,419 
Sales and income tax payable9,390 8,365 
Accrued third-party service fees20,484 9,758 
Clinical trials and studies19,605 14,467 
Operating lease liabilities, current portion14,823 15,581 
Property and equipment purchases22,390 11,270 
Other accrued expenses3,028 6,773 
Total other accrued liabilities$212,543 $188,659 
v3.26.1
Leases
 3 Months Ended
Mar. 31, 2026
Leases [Abstract]  
Leases Leases
In September 2015, the Company entered into a long-term lease agreement for laboratory and office space totaling approximately 94,000 square feet in Austin, Texas. The original lease term was 132 months beginning in December 2015 and expiring in November 2026, with monthly payments beginning in December 2016. In December 2021, the Company entered into an amendment of the Austin lease agreement, which extended the lease of the current premises through March 2033. The amendment also includes two additional office spaces (the “First Expansion Premises” and the “Second Expansion Premises”). The First Expansion Premises consists of 32,500 rentable square feet and commenced in February
2022. The Second Expansion Premises consists of 65,222 rentable square feet and commenced in September 2022. The terms of the First and Second Expansion Premises expire in March 2033. In March 2025, the Company entered into a lease agreement for additional premises of approximately 57,100 rentable square feet in Austin, Texas through March 2033 with an annual rent expense of approximately $0.9 million. In August 2025, the Company entered into a lease agreement for additional premises of approximately 45,800 rentable square feet in Austin, Texas through March 2033 with an annual rent expense of approximately $0.7 million. In December 2025, the Company exercised its expansion right for an additional premises of approximately 28,468 rentable square feet in Austin, Texas through March 2033 with an annual rent expense of approximately $0.4 million.
In October 2016, the Company entered into a lease directly with its landlord for laboratory and office spaces at its facilities located in San Carlos, California. The Company currently occupies approximately 136,000 square feet comprised of two office spaces (the “First Space” and the “Second Space”). The First Space covers approximately 88,000 square feet, and the Second Space totals approximately 48,000 square feet. In January 2021, the Company entered into an amendment of the lease to extend the term for 48 months to October 2027. In July 2024, the Company entered into an amendment of the San Carlos lease to extend the term for 60 months to October 2032. The annual rent will be approximately $9.7 million beginning January 2025, escalating annually and may be increased if the Company elects to utilize additional tenant improvement allowances. In January 2025, the Company entered into a lease agreement for additional premises of approximately 40,700 rentable square feet in San Carlos, California, through November 2028 with an annual rent expense of approximately $1.5 million. In January 2026, the Company entered in a lease for an additional premises in San Carlos, California which occupies approximately 63,000 square feet with a lease term of ten years. Subject to certain requirements, the annual rent payment starts in May 2028 at approximately $4.4 million per year and escalates annually.
The Company entered into a lease agreement in November 2020 to lease 11,395 square feet of space located in South San Francisco, California over a 36-month term. The premises are used for general office, laboratory and research use. The annual lease payment started at $0.9 million and escalates annually after commencing in December 2021. In December 2022, the Company exercised the renewal option of the South San Francisco lease agreement. In January 2023, the Company entered in an amendment to extend the lease term of the South San Francisco premises by three years, through November 2026.

The Company entered into a lease agreement in September 2023 to lease 16,319 square feet of space located in Pleasanton, California over a 60-month term. The premises are used for laboratory and research use and commenced in December 2023. In December 2025, the Company entered in an amendment to extend the existing premises and expand to an additional premises of 15,485 rentable square feet in Pleasanton, California through March 2034. The combined annual lease payment started at $0.9 million and escalates annually.

In December 2025, as part of the business combination, the Company assumed a lease agreement for approximately 25,718 square feet of space located in Boulder, Colorado. The premises are used for general office, laboratory, and research use. The lease term extends through June 2034, and the annual lease payments commence at approximately $1.5 million and escalate annually.

The Company has also historically entered into leases of individual workspaces and storage spaces at various locations on both a month-to-month basis without an established lease term and, more recently for certain locations, has committed to terms approximating one to five years. For the facilities without a committed lease term, the Company has elected to not recognize them as right-of-use assets on the consolidated balance sheets as they are all considered short-term leases. For individual workspaces where the committed lease term exceeds one year, the Company has recorded a right-of-use asset on the consolidated balance sheets.

For the three months ended March 31, 2026, the Company had $29.2 million in noncash operating activities related to additional right-of-use assets resulting from entering into new lease agreements and extension of existing leases under ASC, Topic 842, Leases (“ASC 842”). For the three months ending March 31, 2025, the Company had $10.9 million in noncash operating activities related to additional right-of-use assets.
The operating lease right-of-use assets are classified as noncurrent assets in the consolidated balance sheets. The corresponding lease liabilities are separated into current and long-term portions as follows:
March 31,
2026		December 31,
2025
(in thousands)
Operating lease liabilities, current portion included in other accrued liabilities$14,823 $15,581 
Operating lease liabilities, long-term portion144,953 118,473 
Total operating lease liabilities$159,776 $134,054 
As of March 31, 2026, the weighted-average remaining lease term was 7.23 years and the weighted-average discount rate was 6.5%.
The Company continues to recognize lease expense on a straight-line basis. The lease expense includes the amortization of the right-of-use assets with the associated interest component estimated by applying the effective interest method. For the three months ended March 31, 2026 and 2025, total lease expense of $5.9 million and $4.4 million was recognized in the condensed statements of operations and comprehensive loss, respectively. Cash paid for settlement of operating lease liabilities totaled $5.9 million and $4.5 million for the three months ended March 31, 2026 and 2025, respectively.
The present value of the future minimum lease payments under all non-cancellable operating leases as of March 31, 2026 are as follows:
Operating Leases
(in thousands)
As of March 31, 2026
2026 (remaining 9 months)$18,619 
202724,570 
202827,463 
202927,627 
203028,031 
2031 and thereafter78,182 
Total future minimum lease payments204,492 
Less: imputed interest(44,716)
Operating lease liabilities$159,776 
v3.26.1
Commitments and Contingencies
 3 Months Ended
Mar. 31, 2026
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies Commitments and Contingencies
Legal Proceedings
The Company is or has been involved in legal matters, including investigations, subpoenas, demands, disputes, litigation, requests for information, and other regulatory or administrative actions or proceedings, including those with respect to intellectual property, testing and test performance, billing, reimbursement, marketing, short seller and media allegations, employment, and other matters. The Company is responding to ongoing regulatory and governmental investigations, subpoenas and inquiries, and contesting its current legal matters, but cannot provide any assurance as to the ultimate outcome with respect to any of the foregoing. There are many uncertainties associated with these matters.
The Company assesses legal contingencies to determine the degree of probability and range of possible loss for potential accrual in its financial statements. When evaluating legal contingencies, the Company may be unable to provide a reasonable estimate due to a number of factors, including the procedural status of the matter in question, the presence of complex or novel legal theories, and/or the ongoing discovery and development of information important to the matters. In addition, damage amounts claimed in litigation or other matters may be unsupported, exaggerated or unrelated to possible outcomes, and as such are not meaningful indicators of its potential liability. Loss contingencies, including claims and legal
actions arising in the ordinary course of business, are recorded as liabilities when the likelihood of loss is probable and an amount or range of loss can be reasonably estimated. As of March 31, 2026 and December 31, 2025, the aggregate accrual for legal contingencies that are probable and reasonably estimable is approximately $33.0 million and $32.6 million, respectively. The Company is unable to predict the ultimate outcome of the matters described below and is unable to make a reasonable estimate of the amount or range of loss, if any, that could result from an unfavorable outcome of any such matter in excess of any amounts accrued.
Intellectual Property Litigation Matters

The Company has been involved in two patent litigations against CareDx, Inc. (“CareDx”) in the United States District Court for the District of Delaware (“CareDx Patent Cases”). In the first CareDx Patent Case, CareDx alleged, in a complaint filed jointly with the Board of Trustees of the Leland Stanford Junior University in March 2019 and amended in March 2020, that the Company infringed three patents (the “CareDx Patents”). The complaint sought unspecified damages and injunctive relief. In September 2021, the Court granted the Company’s motion for summary judgment, finding all three CareDx Patents invalid. This finding was affirmed on appeal by the United States Court of Appeals for the Federal Circuit. CareDx’s petition for rehearing by the Federal Circuit, and its subsequent petition for certiorari to the United States Supreme Court, were both denied. In the second CareDx Patent Case, the Company alleged, in suits filed in January 2020 and May 2022, infringement by CareDx of certain of the Company’s patents, seeking unspecified damages and injunctive relief. In January 2024, after trial, the jury returned a verdict in favor of the Company, finding both asserted patents valid and one patent infringed by CareDx (the “Infringed Patent”) and awarding damages to the Company for lost profits and past royalties totaling $96.3 million. In February 2025, the Court granted CareDx’s motion for judgment as a matter of law and invalidated both asserted Natera patents, including the Infringed Patent. The Company filed a notice of appeal to the Court of Appeals for the Federal Circuit in March 2025. Separately, in October 2024, an ex-parte re-examination petition was filed by CareDx with the United States Patent and Trademark Office (“USPTO”) challenging the validity of the Infringed Patent; but the USPTO ultimately denied the petition and upheld the challenged claims of the Infringed Patent. In June 2025, another ex-parte re-examination petition challenging the validity of the ‘724 Patent was filed with the USPTO, which issued a non-final office action in December 2025. The Company has filed a response to the office action.

In January 2020, the Company filed suit against ArcherDX, Inc. (“ArcherDX”) in the United States District Court for the District of Delaware. In January 2021, the Company named an additional Archer DX entity, ArcherDx LLC, and Invitae as defendants. The Company alleged, among other things, that certain ArcherDX products, including the Personalized Cancer Monitoring (“PCM”) test, infringed three of the Company’s patents (the “ArcherDX Case”) and sought unspecified monetary damages and injunctive relief. Following a jury trial in May 2023 and a bench trial in June 2023, all three asserted patents were found to be valid and infringed by ArcherDX and Invitae, and the jury awarded damages totaling $19.4 million to the Company. In November 2023, the Court granted in part the Company’s motion for a permanent injunction against the PCM test, which the defendants have appealed. In February 2024, Invitae and ArcherDX filed a voluntary Chapter 11 petition in the U.S. Bankruptcy Court for the District of New Jersey, resulting in an automatic bankruptcy stay in the case. The stay was lifted, and post-trial proceedings resumed, in November 2024. Defendants’ interim appeals remain stayed pending the Court’s final resolution of the post-trial motions. In April 2026, the Court granted defendants’ motion in part by eliminating damages associated with certain non-PCM products, reducing the prior damages award by approximately $10.0 million; the Court also awarded the Company approximately $1.23 million in supplemental pre-verdict damages for PCM products, pre- and post-judgment interest, and imposed an ongoing royalty of 30% on revenues from defendants’ post-judgment use of the adjudicated PCM products.

The Company is the subject of a lawsuit filed against it by Ravgen, Inc. (“Ravgen”) in June 2020 in the United States District Court for the Western District of Texas, alleging infringement of two Ravgen patents and seeking monetary damages and injunctive relief. In January 2024, after trial, the jury returned a verdict of non-willful infringement by the Company and found damages of $57.0 million. Judgment has not been entered by the Court. The Company intends to appeal certain of the rulings. In addition, various parties, including the Company, have filed petitions challenging the validity of the asserted patents with the United States Patent and Trademark Office, all of which were instituted for review, and some of which were decided in favor of upholding the challenged claims. The petitions filed by the Company and certain others remain pending.
In October 2020, the Company filed suit against Genosity Inc. (“Genosity”), in the United States District Court for the District of Delaware, alleging that various Genosity products infringe one of the Company’s patents and seeking unspecified monetary damages and injunctive relief. The case has been stayed pending the entry of a final judgment in the ArcherDX Case, in which the subject patent is also asserted. In February 2024, Genosity filed a voluntary Chapter 11 petition in the U.S. Bankruptcy Court for the District of New Jersey.
The Company was the subject of lawsuits filed against it by Invitae in the United States District Court of the District of Delaware alleging, in complaints filed in May and November of 2021, infringement of three patents and seeking monetary damages and injunctive relief. In February 2024, as a result of Invitae’s voluntary Chapter 11 petition described above, the Court continued the trial to September 2025. Labcorp Holdings Inc. (“LabCorp”) subsequently acquired the patents at issue in this case and substituted in as the plaintiff. In September 2025, the Company and LabCorp settled the case.
The Company filed suits against Inivata, Inc. and Inivata Ltd. (collectively “Inivata”) in the United States District Court for the District of Delaware in January 2021 and December 2022, alleging that certain of Inivata’s oncology products infringe certain of the Company’s patents and seeking unspecified monetary damages and injunctive relief. The two suits were consolidated. In March 2024, the Court stayed the case in light of the Company’s case against NeoGenomics Laboratories, Inc. (“NeoGenomics”), which acquired Inivata in 2021, discussed below. In October 2025, the Company voluntarily dismissed the December 2022 suit without prejudice. In February 2026, the January 2021 suit was dismissed.
In July 2023, the Company filed suit against NeoGenomics in the United States District Court for the Middle District of North Carolina (the “District Court”), alleging infringement of two Natera patents (the “’035 Patent” and the “’454 Patent”) by NeoGenomics’ commercialization of the RaDaR test and seeking monetary damages and injunctive relief. In December 2023, the Court denied NeoGenomics’ motion to dismiss the complaint, and granted the Company’s motion for preliminary injunction. The injunction went into effect as of January 12, 2024 and was affirmed on appeal in July 2024 by the Federal Circuit Court of Appeals. NeoGenomics filed a petition with the USPTO to review the validity of the ’454 Patent, which was denied in June 2024. NeoGenomics also filed a petition with the USPTO to review the validity of the ‘035 Patent, which proceeding was terminated in October 2024. Pursuant to the terms of a partial settlement of the case, the District Court entered a permanent injunction against NeoGenomics, and it has withdrawn its RaDaR test from the market. The case remains pending with respect to an updated version of the RaDaR test and the ‘454 Patent, as well as an additional Natera patent (the “596 patent”) that was added to the case in December 2024. In August 2025, the Court granted summary judgment of invalidity of the ‘454 Patent and the ‘596 Patent, and final judgment in favor of NeoGenomics was entered in September 2025. Neogenomics has filed an inter partes review challenging the validity of the ‘596 patent. The USPTO declined to institute a review and dismissed the challenge to the ‘596 patent.
Other Litigation Matters

CareDx filed suit against the Company in April 2019 in the United States District Court for the District of Delaware, alleging false advertising, and related claims based on statements describing studies that concern the Company’s technology and CareDx’s technology, seeking unspecified damages and injunctive relief. The Company filed a counterclaim against CareDx in the United States District Court for the District of Delaware, alleging false advertising, unfair competition and deceptive trade practices and seeking unspecified damages and injunctive relief. In March 2022, after trial, the jury returned a verdict that the Company was liable to CareDx and found damages of $44.9 million. The jury also returned a verdict against CareDx, finding that CareDx had engaged in false advertising. In July 2023, the Court granted in part the Company’s motion for judgment as a matter of law requesting that the Court set aside the portions of the jury verdict adverse to the Company, ruling that CareDx is not entitled to any damages. The jury verdict of false advertising by CareDx remains in place. The Third Circuit affirmed the District Court’s ruling that CareDx is not entitled to any damages. CareDx petitioned for rehearing en banc, which was denied. In February 2026, CareDx filed a petition for a Writ of Certiorari with the United States Supreme Court.

The Company has been involved in two lawsuits against Guardant Health, Inc. (“Guardant”). In May 2021, Guardant filed suit against the Company in the United States District Court of the Northern District of California alleging false advertising and related claims and seeking unspecified damages and injunctive relief. Also in May 2021, the Company filed suit against Guardant in the Western District of Texas, alleging false advertising and related claims. The Company has voluntarily dismissed its Texas suit against Guardant and has asserted the claims from the Texas action as counterclaims in the California action, seeking unspecified damages and injunctive relief. In August 2021, Guardant moved to dismiss the Company’s counterclaims, which motion was denied in all material respects. Both parties filed cross-motions for summary judgment, which were granted in part and denied in part. In November 2024, after trial, the jury returned a verdict finding the Company liable for false advertising and found damages of $292.5 million. In July 2025, the Court entered a final order regarding the parties’ post-trial motions, which largely upheld the jury verdict. The Court has not issued a final judgment at this time. The Company plans to appeal the final judgment to the Ninth Circuit Court of Appeals. In February 2025, Guardant filed suit against the Company and two of its former employees who recently joined the Company in the United States District Court for the Northern District of California, alleging trade secret misappropriation, breach of contract and related tort claims, seeking unspecified damages and injunctive relief. Concurrently with the filing
of the complaint, Guardant also moved for a temporary restraining order and expedited discovery, which motions Guardant subsequently withdrew. In April 2025, Guardant voluntarily dismissed its claims against the Company and the employee defendants without prejudice.
In November 2021, a purported class action lawsuit was filed against the Company in the United States District Court for the Northern District of California, by a patient alleging various causes of action relating to the Company’s patient billing and seeks, among other relief, class certification, injunctive relief, restitution and/or disgorgement, attorneys’ fees, and costs. In May 2023, the Court granted the Company’s motion to dismiss the lawsuit, and the case was dismissed without prejudice. In July 2023, the plaintiff filed analogous claims in the Superior Court of California, County of San Mateo, and subsequently filed an amended claim with an additional plaintiff. Based on the additional plaintiff, the case was transferred back to the United States District Court for the Northern District of California. The parties subsequently agreed that claims brought by the original plaintiff be remanded back to the Superior Court of California, County of San Mateo, and that the action be stayed pending the outcome of the action in the United States District Court for the Northern District of California. The Company has finalized and submitted to the Court for preliminary approval a settlement resolving these matters.
In February 2022, two purported class action lawsuits were filed against the Company in the United States District Court for the Northern District of California. Each suit was filed by an individual patient alleging various causes of action related to the marketing of Panorama and seeking, among other relief, class certification, monetary damages, attorneys’ fees, and costs. These matters have been consolidated. The Company filed a motion to dismiss the consolidated lawsuit, which resulted in the plaintiffs filing an amended complaint in April 2023. The Company and the plaintiffs have reached a settlement of all claims. The proposed settlement has been submitted to the District Court for approval, and class notices were sent to class members in January 2026.

In March 2022, a purported class action lawsuit was filed against the Company and certain of its management in the Supreme Court of the State of New York, County of New York, asserting claims under Sections 11, 12, and 15 of the Securities Act of 1933. The complaint alleged, among other things, that the Company failed to disclose certain information regarding its Panorama test. The complaint sought, among other relief, monetary damages, attorneys’ fees, and costs. This matter was dismissed and the claims raised in this matter have been included in the lawsuit discussed below.

A purported class action lawsuit was filed against the Company and certain of its management in the United States District Court for the Western District of Texas, asserting claims under Sections 10(b) and 20(a) of the Securities Act of 1934 and Rule 10b-5 thereunder. The complaint, filed in April 2022 and amended in October 2022 (to include, among others, the claims raised in the lawsuit discussed in the preceding paragraph), alleges, among other things, that the management defendants made materially false or misleading statements, and/or omitted material information that was required to be disclosed, about certain of the Company’s products and operations. The complaint seeks, among other relief, monetary damages, attorneys’ fees, and costs. The Company filed a motion to dismiss this lawsuit, which was granted in part and denied in part. The Court has certified the class.

In each of October 2023 and January 2024, shareholder derivative complaints were filed in the United States District Court for the Western District of Texas and the United States District Court for the District of Delaware, respectively, against the Company as nominal defendant and certain of the Company’s management. Each complaint alleges, among other things, that the management defendants made materially false or misleading statements, and/or omitted material information that was required to be disclosed, about certain of the Company’s products and operations. Each complaint seeks, among other relief, monetary damages, attorneys’ fees, and costs.

In October 2024, a purported class action lawsuit was filed against the Company in the United States District Court for the Northern District of California, by patients alleging various causes of action relating to the Company’s preimplantation genetic test for aneuploidies. They request, among other relief, class certification, injunctive relief, restitution and/or disgorgement, attorneys’ fees, and costs. The Company has filed a motion to dismiss the lawsuit, which was granted in August 2025, and the case was dismissed without prejudice. In August 2025, the plaintiffs filed an amended complaint.

Indemnifications
As permitted under Delaware law, and as set forth in the Company’s Amended and Restated Certificate of Incorporation and its Amended and Restated Bylaws, the Company indemnifies its directors, executive officers, other officers, employees and other agents for certain events or occurrences that may arise while in such capacity. In addition,
agreements entered into by the Company may include indemnification provisions that may subject the Company to costs and damages in the event of a claim against an indemnified third party.
The maximum potential future payments the Company could be required to make under these indemnifications is unlimited; however, the Company has insurance policies and indemnification agreements that may limit its exposure and may enable it to recover a portion of any future amounts paid. Assuming the applicability of coverage, the willingness of the insurer or partner to assume coverage, and subject to certain retention, loss limits and other policy provisions, the Company believes that it is not probable that any obligations under this indemnification would be material, or in excess of any recorded accruals.
No assurances can be given that the covering insurers will not attempt to dispute the validity, applicability, or amount of coverage without expensive litigation against these insurers, in which case the Company may incur substantial liabilities as a result of these indemnification obligations.
Third-Party Payer Reimbursement Audits
From time to time, the Company receives recoupment requests from third-party payers for alleged overpayments. The Company disagrees with the contentions of pending requests and/or has recorded an estimated reserve for the alleged overpayments if probable and estimable.
Contractual Commitments
The following table sets forth the Company’s material contractual commitments as of March 31, 2026:
PartyCommitmentsExpiry Date
(in thousands)
Laboratory instruments supplier$16,232 December 2027
Material suppliers136,147 November 2030
Application service providers16,397 February 2034
Cloud platform service provider20,211 March 2029
Other material suppliers72,417 Various
Total$261,404 
In conjunction with the Company’s acquisition of Foresight Diagnostics, the Company may also be required to pay up to $175.0 million to the former holders of Foresight Diagnostic’s outstanding equity interests, subject to the achievement of certain milestones through December 31, 2027. As of March 31, 2026 and December 31, 2025, the Company recognized a $125.6 million and $118.4 million in contingent consideration liability based on the fair value. Payments will be settled in shares of the Company’s common stock and are estimated to occur in years 2026 and 2027. See Note 3, Business Combination, for additional information.

In January 2024, the Company acquired from Invitae Corp. (“Invitae”) certain assets relating to Invitae’s non-invasive prenatal screening and carrier screening business. The transaction price of $10.5 million consisted of $10.0 million in upfront payment costs and approximately $0.5 million of other transaction costs which were capitalized as intangible assets over an estimated useful life of ten years. An additional payment of up to $42.5 million may be made should the Company achieve certain customer volume retention targets and based on certain legal outcomes.

During November 2024, the Company entered into an agreement to acquire clinical samples and data for oncology development. As of March 31, 2026, the Company has paid $15.0 million in cash, has recorded a payable for $3.7 million, and is committed to an additional $1.3 million, which is included in commitments above. An additional $50.0 million in potential payments owed to the third-party vendor, not included above, will depend on whether certain approvals are obtained and commercial volume milestones are achieved.
v3.26.1
Stock-Based Compensation
 3 Months Ended
Mar. 31, 2026
Share-Based Payment Arrangement [Abstract]  
Stock-Based Compensation Stock-Based Compensation
Stock-Based Compensation Expense
The following table presents stock-based compensation expense recorded in the three months ended March 31, 2026 and 2025.
Three months ended March 31,
20262025
(in thousands)
Cost of revenues$6,625 $5,270 
Research and development33,409 26,511 
Selling, general and administrative55,073 46,046 
Total$95,107 $77,827 
The stock-based compensation expense presented above includes $1.4 million of liability-classified awards (including $1.1 million related to Foresight contingent consideration) for the three months ended March 31, 2026. There was no such expense for the three months ended March 31, 2025.

Stock Options

The following table summarizes option activity for the three months ended March 31, 2026:
Number of
Shares
Outstanding
Weighted-
Average
Exercise
Price
(in thousands, except for per share data)
December 31, 20253,591 $27.03 
Options exercised(346)$10.96 
Options forfeited/cancelled(3)$33.12 
March 31, 20263,242 $28.77 
Restricted Stock Units and Performance-Based Awards
The following table summarizes unvested RSU and PSU activity during the three months ended March 31, 2026:
Shares
Weighted-
Average
Grant Date
Fair Value
(in thousands, except for per share data)
Balance at December 31, 20258,323 $100.44 
Awards granted2,457 $215.12 
Awards vested(2,686)$81.18 
Awards forfeited/cancelled(145)$103.52 
Balance at March 31, 20267,949 $128.11 
The above table of unvested RSU and PSU activity reflects unvested PSUs at 100% of their target vesting amount; however, vesting can vary from 0% to 200% of target, depending on the level of achievement of performance criteria.
The Company grants certain senior-level executives performance stock units which vest based on performance and time-based service conditions, which are referred to herein as performance-based awards. During the three months ended March 31, 2026 and 2025, the Company granted 0.2 million and 0.4 million performance-based awards with an aggregate grant date fair value at 100% of their target vesting of $42.4 million and $64.9 million, respectively. Stock-based compensation for these performance-based awards milestones are assessed to be 200% of the grant value for 2025 and prior unvested awards and 100% of grant value for 2026 awards.
The Company has recognized $21.9 million and $18.7 million for performance-based awards for the three months ended March 31, 2026 and 2025, respectively.
v3.26.1
Debt
 3 Months Ended
Mar. 31, 2026
Debt Disclosure [Abstract]  
Debt Debt
Credit Line Agreement
In September 2015, the Company entered into a credit line with UBS (the “Credit Line”) providing for a $50.0 million revolving line of credit. The Credit Line was subsequently changed from $50.0 million to $100.0 million. The Credit Line is secured by a first priority lien and security interest in the Company’s money market and marketable securities held in its managed investment account with UBS. The Company is required to maintain a minimum of at least $150.0 million in its UBS accounts as collateral, which is classified as cash, cash equivalents, and short-term investments in the consolidated balance sheets. UBS has the right to demand full or partial payment of the Credit Line obligations and terminate the Credit Line, in its discretion and without cause, at any time. The interest rate for the Credit Line is the 30-day SOFR average, plus 0.5%. As of March 31, 2026, the Company has drawn down a total of $80.0 million, and there is $20.0 million remaining and available on the Credit Line.
For the three months ended March 31, 2026 and 2025, the Company recorded interest expense on the Credit Line of $0.9 million and $1.0 million, respectively. As of March 31, 2026 and December 31, 2025, the total principal amount outstanding with accrued interest was $80.3 million for both periods.
v3.26.1
Income Taxes
 3 Months Ended
Mar. 31, 2026
Income Tax Disclosure [Abstract]  
Income Taxes Income Taxes
During the three months ended March 31, 2026 and 2025, the Company recorded total income tax expense of approximately $0.3 million and $0.2 million, respectively. The income tax expense is primarily attributable to state income tax and foreign income tax. Due to the Company’s history of cumulative operating losses, the Company concluded that, after considering all the available objective evidence, it is not more likely than not that all of the Company’s net deferred tax assets will be realized. Accordingly, all of the Company’s deferred tax assets, which includes net operating loss carryforwards and tax credits related primarily to research and development, continue to be subjected to a valuation
allowance as of March 31, 2026. The Company will continue to maintain a valuation allowance until there is sufficient evidence to support recoverability of its deferred tax assets.
Interest and/or penalties related to income tax matters are recognized as a component of income tax expense. As of March 31, 2026 and December 31, 2025, there were no accrued interest and penalties related to uncertain tax positions.
On July 4, 2025, the U.S. government enacted The One Big Beautiful Bill Act of 2025 which includes, among other provisions, changes to the U.S. corporate income tax system including the allowance of immediate expensing of qualifying research and development expenses and permanent extensions of certain provisions within the Tax Cuts and Jobs Acts. Due to the Company’s expected losses and valuation allowance, the Company does not expect the impact from this legislation to be significant to its financial statements.
v3.26.1
Net Loss per Share
 3 Months Ended
Mar. 31, 2026
Earnings Per Share [Abstract]  
Net Loss per Share Net Loss per Share
The following table shows total outstanding potentially dilutive shares excluded from the computation of diluted loss per share as their effect would be anti-dilutive, as of March 31, 2026 and 2025:
March 31,
20262025
(in thousands)
Options to purchase common stock3,242 3,822 
Performance-based awards and restricted stock units7,949 9,974 
Employee stock purchase plan79 98 
Contingent consideration628 — 
Total11,898 13,894 
As of March 31, 2026, the Company finalized a post-closing working capital adjustment related to the acquisition of Foresight Diagnostics. Certain escrowed shares that were returned to the Company in the second quarter of 2026 have been excluded from the calculation of basic and diluted earnings per share.
v3.26.1
Segment Reporting
 3 Months Ended
Mar. 31, 2026
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
The Company currently operates as a single reporting segment entity with the Chief Executive Officer as the chief operating decision maker (the “CODM”). The CODM relies on the financial statements presented within the annual report Form 10-K and quarterly Form 10-Q to evaluate the Company’s financial performance and make key operating decisions. The key area of focus of the CODM for the allocation of resources is the cash and investments used in supporting the Company’s business. These financial statements provide a comprehensive view of the Company’s overall financial condition, including information on expenses, assets, and liabilities. The significant expense categories are consistent with those presented on the face of the statements of operations and comprehensive loss. The CODM does not receive or use any other segmented or disaggregated financial or any significant expense information for decision-making purposes. Additionally, gross margin is regularly provided to the CODM and is derived based on the consolidated statements of operations and comprehensive loss as follows:
Three months ended March 31,
20262025
(in thousands except percentages)
Revenue$696,644 $501,830 
Cost of product revenues245,203 184,613 
Cost of licensing and other revenues608 452 
Gross margin$450,833 $316,765 
Gross margin percentage64.7%63.1%
v3.26.1
Subsequent Events
 3 Months Ended
Mar. 31, 2026
Subsequent Events [Abstract]  
Subsequent Events Subsequent Events
None.
v3.26.1
Insider Trading Arrangements
 3 Months Ended
Mar. 31, 2026
shares
Trading Arrangements, by Individual  
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
Steve Chapman [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement
On March 5, 2026, Steve Chapman, our chief executive officer, modified a Rule 10b5-1 Trading Plan to provide for the potential sale of 180,643 shares of our common stock pursuant to the terms of the plan between June 4, 2026 and March 31, 2028. A significant portion of the shares subject to the plan would not be sold unless the Company achieves specified performance targets.
Name Steve Chapman
Title chief executive officer
Rule 10b5-1 Arrangement Adopted true
Adoption Date March 5, 2026
Expiration Date March 31, 2028
Arrangement Duration 666 days
Aggregate Available 180,643
Matthew Rabinowitz [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement
On March 13, 2026, Matthew Rabinowitz, our executive chairman, adopted a trading arrangement for the sale of shares of our common stock (a “Rule 10b5-1 Trading Plan”) that is intended to satisfy the affirmative defense conditions of Securities Exchange Act Rule 10b5-1(c). Dr. Rabinowitz’ Rule 10b5-1 Trading Plan provides for the potential sale of up to 100,000 shares of our common stock pursuant to the terms of the plan between June 12, 2026 and December 17, 2026.
Name Matthew Rabinowitz
Title executive chairman
Rule 10b5-1 Arrangement Adopted true
Adoption Date March 13, 2026
Expiration Date December 17, 2026
Arrangement Duration 188 days
Aggregate Available 100,000
v3.26.1
Summary of Significant Accounting Policies (Policies)
 3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Basis of Presentation
Basis of Presentation
The accompanying unaudited interim condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information. The unaudited interim condensed consolidated financial information includes only adjustments of a normal recurring nature necessary for a fair presentation of the Company’s results of operations, financial position, changes in stockholders’ equity, and cash flows. The results of operations for the three months ended March 31, 2026, are not necessarily indicative of the results for the full year or the results for any future periods. The condensed consolidated balance sheet as of December 31, 2025 has been derived from audited financial statements at that date. These financial statements should be read in conjunction with the audited financial statements, and related notes for the year ended December 31, 2025 included in the Company’s Annual Report on Form 10-K filed with the SEC on February 27, 2026.
Principles of Consolidation
Principles of Consolidation
The accompanying condensed consolidated financial statements include all the accounts of the Company and its subsidiaries. All intercompany balances and transactions have been eliminated.
Use of Estimates
Use of Estimates
The preparation of financial statements in conformity with generally accepted accounting principles (GAAP) requires management to make judgments, estimates, and assumptions that could affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. The Company bases its estimates and assumptions on historical experience and on various other assumptions it believes to be applicable and evaluates them on an ongoing basis to ensure they remain reasonable under current conditions. Actual results could differ significantly from those estimates.
Business Combinations
Business Combinations

The Company accounts for business combinations using the acquisition method of accounting, which requires, among other things, that results of operations for acquired companies are included in the Company’s results of operations beginning on the acquisition date and that assets acquired, and liabilities assumed are recognized at fair value as of the acquisition date. Any excess of the fair value of consideration transferred over the fair value of the identifiable assets acquired and liabilities assumed is recorded as goodwill. Management’s estimates of fair value are based upon assumptions believed to be reasonable, but which are inherently uncertain and unpredictable, and as a result, actual results may differ from estimates. During the measurement period, not to exceed one year from the date of acquisition, the Company may record adjustments to the assets acquired and liabilities assumed, with a corresponding offset to goodwill if new information is obtained related to facts and circumstances that existed as of the acquisition date. After the measurement period, any subsequent adjustments are reflected in the consolidated statements of operations. Acquisition-related expenses and post-combination integration and employee compensation costs are recognized separately from the business combination and are expensed as incurred.

Contingent consideration obligations incurred in connection with a business combination are recorded at their estimated fair values on the acquisition date and remeasured at their fair values each subsequent reporting period until the related contingencies have been resolved. The resulting changes in fair values are recorded in earnings. The determination of fair value requires management to make significant estimates, particularly with respect to identified acquired intangible assets. These estimates are inherently uncertain and subject to change as additional information is obtained during the measurement period, which lasts for up to one year from the acquisition date. Upon the conclusion of the measurement period, any subsequent adjustments are recorded in the consolidated statement of operations and comprehensive loss. See Note 3, Business Combination, for details.
Accounts Receivable, net of allowance
Accounts Receivable, net of allowance
Trade accounts receivable and other receivables. The allowance for expected credit losses for trade accounts receivable is based on the Company’s assessment of the collectability of accounts related to its clinics and laboratory partner customers. The Company regularly reviews the allowance by considering factors such as historical experience, the age of the accounts receivable balances, and current economic conditions that may affect a customer’s ability to pay. See Note 8, Balance Sheet Components, for a roll-forward of the allowance for expected credit losses related to trade accounts receivable for the three months ended March 31, 2026 and 2025.
With respect to revenue recognized related to genetic test services provided to patient customers whereby consideration is expected to be received from insurance or patient payors, the Company recognizes a constraint to the estimated variable consideration such that it is not probable that a significant revenue reversal will occur. When assessing the total consideration expected to be received from insurance carriers and patients, a certain percentage of revenues is further constrained for estimated refunds. After applying the ASU 2016-10, Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing (“ASC 606”) constraint, the Company assessed for credit losses under ASU 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASC 326”) and determined an incremental credit loss was not needed given the quality of the insurance payors from whom such receivables are expected to be collectible and the relatively short duration over which the majority of receivables are collected. Accordingly, the Company currently does not have an incremental credit loss reserve nor allowance for expected credit losses against accounts receivable for insurance and patient payors due to the average selling price calculations, which incorporate these risks as net receivables are recorded.
Inventory
Inventory
Inventory is recorded at the lower of cost or net realizable value, determined on a first-in, first-out basis. Inventory consists entirely of supplies, which are consumed at the point biologic samples are collected and the Company provides genetic testing services, and therefore, the Company does not maintain any work-in-process or finished goods inventory. The Company enters into inventory purchases commitments so that it can meet future delivery schedules based on forecasted demand for its tests.
The Company analyzes its inventory to determine whether the composition of its inventory is obsolete or slow-moving. A write down of specifically identified unusable, or obsolete inventory in the period is recognized by considering product expiration dates and scrapped inventory. Any write-down of inventory to net realizable value establishes a new cost basis and will be maintained even if certain circumstances suggest the inventory is recoverable in subsequent periods. Costs associated with the write-down of inventory are recorded to cost of revenue on our consolidated statements of operations. Inventory reserves as of March 31, 2026 and December 31, 2025 were not material.
Goodwill and Intangible Assets
Goodwill and Intangible Assets

The excess of the fair value of consideration transferred over the fair value of the net assets acquired in a business combination is recorded as goodwill. Goodwill is not amortized and is tested for impairment, at least annually, at the reporting unit level. The test for impairment is conducted annually each October 1, or more frequently if events occur or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. The Company has one reporting unit, as described within Note 15, Segment Reporting. During the goodwill impairment review, the Company assesses qualitative factors to determine whether it is more likely than not that the fair value of its reporting unit is less than its carrying amount, including goodwill. The Company considers qualitative factors such as macroeconomic conditions, industry and market considerations, and overall financial performance of the Company. A quantitative assessment is performed if the qualitative assessment results in a more-likely-than-not determination or if a qualitative assessment is not performed. The quantitative assessment considers whether the carrying amount of the Company’s reporting unit exceeds its fair value, in which case an impairment loss is recognized to the extent that the reporting unit’s carrying value exceeds its fair value, limited to the total amount of goodwill.

Finite-lived intangible assets are recorded at cost, net of accumulated amortization, and, if applicable, impairment charges. Amortization of finite-lived intangible assets is recorded over the assets’ estimated useful lives on a straight-line basis or based on the pattern in which economic benefits are consumed, if reliably determinable. Amortization expense related to intangible assets acquired via business combinations are recorded in amortization of acquired intangible assets expense in the consolidated statements of operations and comprehensive loss. Amortization expense related to all other intangible assets was recorded to the functional category to which it primarily relates in the consolidated statements of operations and comprehensive loss. The Company assesses the impairment of long-lived intangible assets whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. The Company has not recorded
impairment charges on its finite-lived intangible assets or goodwill for the periods presented in these condensed consolidated financial statements.
Accumulated Other Comprehensive Income (Loss)
Accumulated Other Comprehensive Income (Loss)

Comprehensive loss and its components encompass all changes in equity other than those with stockholders, and include net loss, unrealized gains and losses on available-for-sale marketable securities and foreign currency translation adjustments.
Three months ended
March 31,
20262025
(in thousands)
Beginning balance$(258)$(344)
Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment56 147 
Ending balance$(202)$(197)
The change in net unrealized loss on available-for-sale securities is due to the impact of changes in interest rates on the value of fixed-rate investments and not due to any credit deterioration. Further, due to the short-term nature of these investments, the Company has the ability and intention to hold any such investments until maturity and does not expect to realize any material investment losses. Since the Company did not hold any investments at March 31, 2026 or December 31, 2025, an allowance for credit loss was not necessary.
Revenue Recognition
Revenue Recognition

The Company recognizes revenue under, ASC 606, using the following five step process:
•Identification of a contract, or contracts, with a customer;
•Identification of the performance obligations in the contract;
•Determination of the transaction price;
•Allocation of the transaction price to the performance obligations in the contract; and
•Revenue recognition when, or as, the performance obligations are satisfied.
The Company uses the expected value method of estimating variable consideration. The total consideration which the Company expects to collect in exchange for the Company’s products is an estimate and may be fixed or variable, and is primarily based on historical cash collections for tests delivered, as adjusted for current expectations. Current expectations of cash collections factor in changes in reimbursement rate trends, past events not expected to recur, and future known changes such as anticipated contractual pricing changes or changes to insurance coverage. For insurance carriers and product types with similar reimbursement characteristics, the Company uses a portfolio approach to estimate variable consideration. When assessing the total variable consideration expected to be received from insurance carriers and patients, the Company considers both the magnitude and likelihood of a revenue reversal in the determination of the percentage of revenues to further constrain for estimated refunds.
See Note 4, Revenue Recognition, for detailed discussions of product revenues, licensing and other revenues, and how the five steps described above are applied.
Fair Value
Fair Value
The Company discloses the fair value of financial instruments for financial assets and liabilities for which the value is practicable to estimate. Fair value is defined as the price that would be received upon the sale of an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (exit price).
Risk and Uncertainties
Risk and Uncertainties
Financial instruments that potentially subject the Company to credit risk consist of cash, cash equivalents, and restricted cash, accounts receivable and investments. The Company limits its exposure to credit loss by placing its cash in financial institutions with high credit ratings. The Company’s cash may consist of deposits held with banks that may at times exceed federally insured limits. The Company performs evaluations of the relative credit standing of these financial institutions and limits the amount of credit exposure with any one institution.
Recent Accounting Pronouncements
Recent Accounting Pronouncements
From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (“FASB”) under its accounting standard codifications or other standard setting bodies and adopted by the Company as of the specified effective date.
Recently Adopted Accounting Pronouncements

In July 2025, ASU 2025-05, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses for Accounts Receivable and Contract Assets, was issued, which introduces a practical expedient to calculating current expected credit loss by assuming that the current conditions as of the balance sheet date will not change for the remaining life of the asset. This update is effective for fiscal years beginning after December 15, 2025. Adoption of this standard occurred on January 1, 2026 and did not have a material impact on the Company’s consolidated financial statements.
New Accounting Pronouncements Not Yet Adopted
In November 2024, ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40) was issued, which requires disaggregation of any relevant expense caption presented on the face of the income statement for certain expense categories. The new guidance is effective for fiscal years beginning after December 15, 2026, and interim periods within fiscal years beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.
In May 2025, ASU 2025-03, Business Combinations (Topic 805) and Consolidation (Topic 810), Determining the Accounting Acquirer in the Acquisition of a Variable Interest Entity, was issued, which revised current guidance for determining the accounting acquirer for a transaction effected primarily by exchanging equity interests in which the legal acquiree is a VIE that meets the definition of a business. The amendments require that an entity consider the same factors that are currently required for determining which entity is the accounting acquirer in other acquisition transactions. The amendments in this Update require an entity involved in an acquisition transaction effected primarily by exchanging equity interests when the legal acquiree is a VIE that meets the definition of a business to consider the factors in paragraphs 805-10-55-12 through 55-15 to determine which entity is the accounting acquirer. The amendments in this Update are effective for all entities for annual reporting periods beginning after December 15, 2026, and interim reporting periods within those annual reporting periods. The amendments in this Update require that an entity apply the new guidance prospectively to any acquisition transaction that occurs after the initial application date. Early adoption is permitted as of
the beginning of an interim or annual reporting period. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.

In September 2025, ASU 2025-06, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software was issued, which amends the guidance in ASC 350-40, Intangibles-Goodwill and Other-Internal-Use Software. The amendments modernize the recognition and disclosure framework for internal-use software costs, removing the previous "development stage" model and introducing a more judgment-based approach. This ASU 2025-06 is effective for fiscal years beginning after December 15, 2027, and for interim periods within those annual reporting periods. Early adoption is permitted. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.

In September 2025, ASU 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” was issued. The new guidance excludes non-exchange-traded contracts with underlyings based on operations or activities specific to one of the parties to the contract from derivative accounting. This guidance is effective for fiscal years and interim periods beginning after December 15, 2026, with early adoption permitted. These requirements may be applied prospectively or on a modified retrospective basis through a cumulative-effect adjustment to the opening balance of retained earnings. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.
v3.26.1
Summary of Significant Accounting Policies (Tables)
 3 Months Ended
Mar. 31, 2026
Accounting Policies [Abstract]  
Schedule of Accumulated Other Comprehensive Income (Loss)
Three months ended
March 31,
20262025
(in thousands)
Beginning balance$(258)$(344)
Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment56 147 
Ending balance$(202)$(197)
v3.26.1
Business Combination (Tables)
 3 Months Ended
Mar. 31, 2026
Business Combination, Asset Acquisition, Transaction between Entities under Common Control, and Joint Venture Formation [Abstract]  
Schedule of Consideration Transferred
The following table summarizes the fair value of consideration transferred and the fair values of the assets acquired and liabilities assumed:

(in thousands)
Fair value of common stock issued to Foresight Diagnostics shareholders$273,038 
Pre-combination portion of Natera replacement equity awards12,088 
Fair value of contingent consideration118,360 
Estimated fair value of the adjustment escrow shares2,300 
Stockholder representative allocable expenses1,000 
Foresight Diagnostics’ transaction expenses settled by the Company7,232 
Foresight Diagnostics’ indebtedness settled by the Company5,974 
Settlement of preexisting relationships4,542 
Cash payment for fractional shares2 
Total Foresight Diagnostics consideration$424,536 
Cash and cash equivalents$2,727 
Current assets8,126 
Property and equipment, net7,224 
Goodwill141,070 
Developed technology intangible asset335,300 
Customer relationships intangible asset900 
Trademarks / trade names intangible asset500 
Operating lease right-of-use assets11,261 
Other assets1,291 
Liabilities assumed(22,397)
Deferred tax liability(61,466)
Total purchase price$424,536 
v3.26.1
Revenue Recognition (Tables)
 3 Months Ended
Mar. 31, 2026
Revenue from Contract with Customer [Abstract]  
Schedule of Revenue by Payer Type
The following table shows disaggregation of revenues by payer types:
Three months ended
March 31,
20262025
(in thousands)
Insurance carriers$658,089 $472,647 
Laboratory partners28,817 20,832 
Patients9,738 8,351 
Total revenues$696,644 $501,830 
Schedule of Total Revenue by Geographic Area
The following table presents total revenues by geographic area based on the location of the Company’s payers:
Three months ended
March 31,
20262025
(in thousands)
United States$685,598 $492,305 
Americas, excluding U.S.2,402 1,692 
Europe, Middle East, India, Africa6,425 6,049 
Asia Pacific and Other2,219 1,784 
Total revenues$696,644 $501,830 
Schedule of Changes in the Balance of Deferred Revenues
The following table summarizes the changes in the balance of deferred revenues during the three months ended March 31, 2026 and 2025:
Balance at
March 31,
20262025
(in thousands)
Beginning balance$41,969 $36,592 
Increase in deferred revenues28,431 10,163 
Revenue recognized during the period included in deferred revenues at the beginning of the period(11,305)(9,418)
Revenue recognized from performance obligations satisfied within the same period(5,234)(75)
Ending balance$53,861 $37,262 
v3.26.1
Fair Value Measurements (Tables)
 3 Months Ended
Mar. 31, 2026
Fair Value Disclosures [Abstract]  
Summary of Financial Assets and Liabilities Measured on Recurring Basis
The following table represents the fair value hierarchy for the Company’s financial assets and financial liabilities measured at fair value on a recurring basis:
March 31, 2026December 31, 2025
Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
(in thousands)
Financial Assets:
Cash, cash equivalents and restricted cash (1)
$1,087,932 $— $— $1,087,932 $1,076,140 $— $— $1,076,140 
Warrants— — 19,987 19,987 — — 12,659 12,659 
Total financial assets$1,087,932 $— $19,987 $1,107,919 $1,076,140 $— $12,659 $1,088,799 
Financial Liabilities:
Contingent consideration(2)
$— $— $125,554 $125,554 $118,360 $118,360 
Total financial liabilities$— $— $125,554 $125,554 $— $— $118,360 $118,360 
(1)Cash equivalents includes money market deposits and liquid demand deposits.
(2)As of March 31, 2026, contingent consideration includes $22.4 million classified as current and $103.2 million classified as non-current. As of December 31, 2025, contingent consideration includes $21.6 million classified as current and $96.8 million classified as non-current.
v3.26.1
Goodwill and Intangible Assets (Tables)
 3 Months Ended
Mar. 31, 2026
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of Intangible Assets
Intangible assets are comprised of the following:

March 31,December 31,
    Useful Life20262025
(in thousands)
Developed technology15 years$335,300 $335,300 
Customer-relationships
3-10 years
12,795 12,795 
License and trademarks 
6-10 years
 31,274  30,500 
Total 379,369  378,595 
Less: Accumulated amortization  (12,007) (4,882)
Total Intangible Assets, net$367,362 $373,713 
Schedule of Estimated Future Aggregate Amortization Expense
The estimated future aggregate amortization expense as of March 31, 2026 is as follows:

(in thousands)
Year ending December 31:
2026 (remaining 9 months)$21,477 
202728,636 
202828,613 
202928,336 
203028,336 
2031 and thereafter231,964 
Total$367,362 
v3.26.1
Financial Instruments (Tables)
 3 Months Ended
Mar. 31, 2026
Investments, Debt and Equity Securities [Abstract]  
Schedule of Available-for-Sale Securities Cash, cash equivalents, and restricted cash consisted of the following:
March 31, 2026December 31, 2025
Amortized
Cost		Gross
Unrealized
Gain		Gross
Unrealized
Loss		Estimated Fair ValueAmortized
Cost		Gross
Unrealized
Gain		Gross
Unrealized
Loss		Estimated Fair Value
(in thousands)
Cash, cash equivalents and restricted cash (1)
$1,087,932 $— $— $1,087,932 $1,076,140 $— $— $1,076,140 
Total$1,087,932 $— $— $1,087,932 $1,076,140 $— $— $1,076,140 
(1)Cash equivalents includes liquid demand deposits and money market funds.
v3.26.1
Balance Sheet Components (Tables)
 3 Months Ended
Mar. 31, 2026
Balance Sheet Related Disclosures [Abstract]  
Schedule of Allowance for Doubtful Accounts
The following is a roll-forward of the allowances for expected credit losses related to trade accounts receivable for the three months ended March 31, 2026 and 2025:
Three Months Ended
March 31,
20262025
(in thousands)
Beginning balance$8,018 $7,259 
Provision for (Reversal of) expected credit losses222 195 
Write-offs(313)(20)
Total$7,927 $7,434 
Schedule of Property and Equipment, Net
The Company’s property and equipment consists of the following:
Useful LifeMarch 31,
2026		December 31,
2025
(in thousands)
Machinery and equipment
3-5 years
$183,050 $171,270 
Computer equipment3 years3,993 3,629 
Purchased and capitalized software held for internal use3 years20,117 21,195 
Leasehold improvementsLesser of useful life or lease term62,455 62,152 
Construction-in-process120,176 94,016 
389,791 352,262 
Less: Accumulated depreciation and amortization(120,412)(111,078)
Total property and equipment, net$269,379 $241,184 
Schedule of Other Accrued Liabilities
The Company’s other accrued liabilities consisted of the following:
March 31,
2026		December 31,
2025
(in thousands)
Reserves for refunds to insurance carriers$9,651 $9,507 
Accrued charges for third-party testing3,446 20,874 
Testing and laboratory materials from suppliers21,090 12,353 
Marketing and corporate affairs27,617 20,215 
Legal, audit and consulting fees58,976 56,077 
Accrued shipping charges2,043 3,419 
Sales and income tax payable9,390 8,365 
Accrued third-party service fees20,484 9,758 
Clinical trials and studies19,605 14,467 
Operating lease liabilities, current portion14,823 15,581 
Property and equipment purchases22,390 11,270 
Other accrued expenses3,028 6,773 
Total other accrued liabilities$212,543 $188,659 
v3.26.1
Leases (Tables)
 3 Months Ended
Mar. 31, 2026
Leases [Abstract]  
Schedule of Operating Lease Liabilities
The operating lease right-of-use assets are classified as noncurrent assets in the consolidated balance sheets. The corresponding lease liabilities are separated into current and long-term portions as follows:
March 31,
2026		December 31,
2025
(in thousands)
Operating lease liabilities, current portion included in other accrued liabilities$14,823 $15,581 
Operating lease liabilities, long-term portion144,953 118,473 
Total operating lease liabilities$159,776 $134,054 
Schedule of Future Minimum Lease Payments
The present value of the future minimum lease payments under all non-cancellable operating leases as of March 31, 2026 are as follows:
Operating Leases
(in thousands)
As of March 31, 2026
2026 (remaining 9 months)$18,619 
202724,570 
202827,463 
202927,627 
203028,031 
2031 and thereafter78,182 
Total future minimum lease payments204,492 
Less: imputed interest(44,716)
Operating lease liabilities$159,776 
v3.26.1
Commitments and Contingencies (Tables)
 3 Months Ended
Mar. 31, 2026
Commitments and Contingencies Disclosure [Abstract]  
Schedule of Material Contractual Commitments
The following table sets forth the Company’s material contractual commitments as of March 31, 2026:
PartyCommitmentsExpiry Date
(in thousands)
Laboratory instruments supplier$16,232 December 2027
Material suppliers136,147 November 2030
Application service providers16,397 February 2034
Cloud platform service provider20,211 March 2029
Other material suppliers72,417 Various
Total$261,404 
v3.26.1
Stock-Based Compensation (Tables)
 3 Months Ended
Mar. 31, 2026
Share-Based Payment Arrangement [Abstract]  
Summary of Stock-Based Compensation Expenses
The following table presents stock-based compensation expense recorded in the three months ended March 31, 2026 and 2025.
Three months ended March 31,
20262025
(in thousands)
Cost of revenues$6,625 $5,270 
Research and development33,409 26,511 
Selling, general and administrative55,073 46,046 
Total$95,107 $77,827 
Summary of Stock Option Activity
The following table summarizes option activity for the three months ended March 31, 2026:
Number of
Shares
Outstanding
Weighted-
Average
Exercise
Price
(in thousands, except for per share data)
December 31, 20253,591 $27.03 
Options exercised(346)$10.96 
Options forfeited/cancelled(3)$33.12 
March 31, 20263,242 $28.77 
Schedule of RSU and Performance-Based Award Activity
The following table summarizes unvested RSU and PSU activity during the three months ended March 31, 2026:
Shares
Weighted-
Average
Grant Date
Fair Value
(in thousands, except for per share data)
Balance at December 31, 20258,323 $100.44 
Awards granted2,457 $215.12 
Awards vested(2,686)$81.18 
Awards forfeited/cancelled(145)$103.52 
Balance at March 31, 20267,949 $128.11 
v3.26.1
Net Loss per Share (Tables)
 3 Months Ended
Mar. 31, 2026
Earnings Per Share [Abstract]  
Schedule of Total Outstanding Potentially Dilutive Shares
The following table shows total outstanding potentially dilutive shares excluded from the computation of diluted loss per share as their effect would be anti-dilutive, as of March 31, 2026 and 2025:
March 31,
20262025
(in thousands)
Options to purchase common stock3,242 3,822 
Performance-based awards and restricted stock units7,949 9,974 
Employee stock purchase plan79 98 
Contingent consideration628 — 
Total11,898 13,894 
v3.26.1
Segment Reporting (Tables)
 3 Months Ended
Mar. 31, 2026
Segment Reporting [Abstract]  
Schedule of Segment Reporting Additionally, gross margin is regularly provided to the CODM and is derived based on the consolidated statements of operations and comprehensive loss as follows:
Three months ended March 31,
20262025
(in thousands except percentages)
Revenue$696,644 $501,830 
Cost of product revenues245,203 184,613 
Cost of licensing and other revenues608 452 
Gross margin$450,833 $316,765 
Gross margin percentage64.7%63.1%
v3.26.1
Description of Business (Details)
 3 Months Ended
Mar. 31, 2026
segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Number of operating segments 1
v3.26.1
Summary of Significant Accounting Policies - Liquidity Matters (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Dec. 31, 2024
Policies        
Net loss $ 85,091 $ 66,936    
Accumulated deficit 2,861,113   $ 2,776,022  
Cash, cash equivalents and restricted cash 1,087,932 $ 973,768 1,076,140 $ 945,587
Outstanding balance 80,305   $ 80,323  
Collateral amount 150,000      
Remaining borrowing capacity 20,000      
UBS Credit Line        
Policies        
Outstanding balance $ 80,300      
v3.26.1
Summary of Significant Accounting Policies - Goodwill and Intangible Assets (Details)
 3 Months Ended
Mar. 31, 2026
segment
Accounting Policies [Abstract]  
Number of reporting segments 1
v3.26.1
Summary of Significant Accounting Policies - Schedule of Other Comprehensive Income (Loss) (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance $ 1,712,413 $ 1,195,420
Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment 56 147
Ending balance 1,774,018 1,239,675
Accumulated Other Comprehensive Loss    
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance (258) (344)
Ending balance $ (202) $ (197)
v3.26.1
Summary of Significant Accounting Policies - Related Party Transactions (Details) - USD ($)
$ / shares in Units, $ in Millions
 1 Months Ended 3 Months Ended
Feb. 29, 2024
Mar. 31, 2026
Mar. 31, 2025
Jan. 31, 2026
Dec. 31, 2025
Sep. 30, 2024
Aug. 31, 2024
Dec. 06, 2021
Preferred Stock                
Related Party Transaction [Line Items]                
Investment in equity securities without readily determinable fair value               $ 2.2
Warrant                
Related Party Transaction [Line Items]                
Investment in equity securities without readily determinable fair value               1.8
MyOme, Inc.                
Related Party Transaction [Line Items]                
Investment in equity securities without readily determinable fair value             $ 2.7 $ 4.0
Warrants term 10 years              
Number of common stock shares called by warrants (in shares) 3,058,485              
Warrants exercise price (in dollars per share) $ 0.25              
MyOme, Inc. | Matthew Rabinowitz                
Related Party Transaction [Line Items]                
Ownership percentage               19.40%
MyOme, Inc. | Series B Preferred Stock                
Related Party Transaction [Line Items]                
Number of common stock shares called by warrants (in shares) 2,080,565     1,977,769   2,080,565    
Warrants exercise price (in dollars per share) $ 0.01              
Investment commitments       $ 10.0        
MyOme, Inc. | Preferred Stock                
Related Party Transaction [Line Items]                
Carrying amount of investments   $ 16.7     $ 6.7      
MyOme, Inc. | Warrant                
Related Party Transaction [Line Items]                
Amortization of non-cash liability   0.6 $ 0.4          
Carrying amount of investments   $ 20.0     $ 12.7      
v3.26.1
Summary of Significant Accounting Policies - Risks and Uncertainties (Details) - Customer Concentration Risk - Medicare
 3 Months Ended 12 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Revenue Benchmark      
Concentration Risk [Line Items]      
Concentration risk (as a percent) 14.80% 14.00%  
Accounts Receivable      
Concentration Risk [Line Items]      
Concentration risk (as a percent) 14.60%   14.10%
v3.26.1
Business Combination - Narrative (Details)
$ / shares in Units, $ in Thousands
 3 Months Ended
May 07, 2026
shares
Dec. 04, 2025
USD ($)
shares
$ / shares
Mar. 31, 2026
USD ($)
$ / shares
Mar. 31, 2025
USD ($)
Dec. 31, 2025
USD ($)
$ / shares
Business Combination, Separately Recognized Transaction [Line Items]          
Common stock, par value (in dollars per share) | $ / shares     $ 0.0001   $ 0.0001
Fair value of contingent consideration     $ 125,554   $ 118,360
Contingent consideration payable, current portion     22,350   21,580
Contingent consideration payable, long-term portion     103,204   96,780
Revaluation of contingent consideration     6,120 $ 0  
Foresight Diagnostics, Inc.          
Business Combination, Separately Recognized Transaction [Line Items]          
Total Foresight Diagnostics consideration   $ 424,536      
Issuance of common stock pursuant to asset acquisition, net (in shares) | shares   1,127,982      
Common stock, par value (in dollars per share) | $ / shares   $ 0.0001      
Share price (in dollars per shares) | $ / shares   $ 242.06      
Shares conversion ratio (in shares) | shares   0.0280      
Fair value of contingent consideration   $ 118,360 125,600   118,400
Foresight Diagnostics’ indebtedness settled by the Company   5,974      
Foresight Diagnostics’ transaction expenses settled by the Company   7,232      
Potential future milestone obligations   175,000      
Contingent consideration payable, current portion   21,600 22,400    
Contingent consideration payable, long-term portion   $ 96,800     $ 103,200
Revaluation of contingent consideration     7,200    
Number of shares deposited in escrow (in shares) | shares   9,505      
Estimated fair value of the adjustment escrow shares   $ 2,300      
Stockholder representative allocable expenses   1,000      
Acquisition related costs   3,900      
Acquisition related costs recorded   $ 100      
Goodwill, measurement period adjustment     200    
Adjustment, consideration transferred     $ 200    
Foresight Diagnostics, Inc. | Subsequent Event          
Business Combination, Separately Recognized Transaction [Line Items]          
Shares deposited in escrow account for purchase price adjustments, returned (in shares) | shares 1,087        
Foresight Diagnostics, Inc. | Developed Technology          
Business Combination, Separately Recognized Transaction [Line Items]          
Discount rate used   12.00%      
v3.26.1
Business Combination - Schedule of Consideration (Details) - USD ($)
$ in Thousands
Dec. 04, 2025
Mar. 31, 2026
Dec. 31, 2025
Business Combination, Separately Recognized Transaction [Line Items]      
Fair value of contingent consideration   $ 125,554 $ 118,360
Goodwill $ 141,100    
Foresight Diagnostics, Inc.      
Business Combination, Separately Recognized Transaction [Line Items]      
Fair value of common stock issued to Foresight Diagnostics shareholders 273,038    
Pre-combination portion of Natera replacement equity awards 12,088    
Fair value of contingent consideration 118,360 $ 125,600 $ 118,400
Estimated fair value of the adjustment escrow shares 2,300    
Stockholder representative allocable expenses 1,000    
Foresight Diagnostics’ transaction expenses settled by the Company 7,232    
Foresight Diagnostics’ indebtedness settled by the Company 5,974    
Settlement of preexisting relationships 4,542    
Cash payment for fractional shares 2    
Total Foresight Diagnostics consideration 424,536    
Cash and cash equivalents 2,727    
Current assets 8,126    
Property and equipment, net 7,224    
Goodwill 141,070    
Developed technology intangible asset 335,300    
Customer relationships intangible asset 900    
Trademarks / trade names intangible asset 500    
Operating lease right-of-use assets 11,261    
Other assets 1,291    
Liabilities assumed (22,397)    
Deferred tax liability $ (61,466)    
v3.26.1
Revenue Recognition - Narrative (Details) - USD ($)
$ / shares in Units, $ in Thousands
 1 Months Ended 3 Months Ended
Feb. 28, 2019
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Dec. 31, 2024
Disaggregation of Revenue [Line Items]          
Deferred revenue   $ 53,861 $ 37,262 $ 41,969 $ 36,592
Product revenues          
Disaggregation of Revenue [Line Items]          
Approximate percentage of revenue collected within 9 months   90.00%      
Billing collection period (in months)   9 months      
Extended billing collection period (in months)   6 months      
Test Revenue          
Disaggregation of Revenue [Line Items]          
Increased revenue   $ 61,000 $ 34,300    
Decrease in net loss per share ( in dollars per share)   $ 0.43 $ 0.25    
BGI Genomics          
Disaggregation of Revenue [Line Items]          
Agreement term 10 years        
Deferred revenue   $ 16,700   $ 16,800  
BGI Genomics | Oncology          
Disaggregation of Revenue [Line Items]          
Revenue, remaining performance obligation         $ 20,000
Revenue recognized   $ 100 $ 100    
v3.26.1
Revenue Recognition - Disaggregation (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Disaggregation of Revenue [Line Items]    
Total revenues $ 696,644 $ 501,830
United States    
Disaggregation of Revenue [Line Items]    
Total revenues 685,598 492,305
Americas, excluding U.S.    
Disaggregation of Revenue [Line Items]    
Total revenues 2,402 1,692
Europe, Middle East, India, Africa    
Disaggregation of Revenue [Line Items]    
Total revenues 6,425 6,049
Asia Pacific and Other    
Disaggregation of Revenue [Line Items]    
Total revenues 2,219 1,784
Insurance carriers    
Disaggregation of Revenue [Line Items]    
Total revenues 658,089 472,647
Laboratory partners    
Disaggregation of Revenue [Line Items]    
Total revenues 28,817 20,832
Patients    
Disaggregation of Revenue [Line Items]    
Total revenues $ 9,738 $ 8,351
v3.26.1
Revenue Recognition - Changes in Balance of Deferred Revenues (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Movement in Contract With Customer Liability [Roll Forward]    
Beginning balance $ 41,969 $ 36,592
Increase in deferred revenues 28,431 10,163
Revenue recognized during the period included in deferred revenues at the beginning of the period (11,305) (9,418)
Revenue recognized from performance obligations satisfied within the same period (5,234) (75)
Ending balance $ 53,861 $ 37,262
v3.26.1
Fair Value Measurements - Schedule of Assets and Liabilities Measured at Fair Value (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Financial Assets:    
Cash, cash equivalents and restricted cash $ 1,087,932 $ 1,076,140
Warrants 19,987 12,659
Total financial assets 1,107,919 1,088,799
Financial Liabilities:    
Fair value of contingent consideration 125,554 118,360
Total financial liabilities 125,554 118,360
Contingent consideration payable, current portion 22,350 21,580
Contingent consideration payable, long-term portion 103,204 96,780
Level 1    
Financial Assets:    
Cash, cash equivalents and restricted cash 1,087,932 1,076,140
Warrants 0 0
Total financial assets 1,087,932 1,076,140
Financial Liabilities:    
Fair value of contingent consideration 0
Total financial liabilities 0 0
Level 2    
Financial Assets:    
Cash, cash equivalents and restricted cash 0 0
Warrants 0 0
Total financial assets 0 0
Financial Liabilities:    
Fair value of contingent consideration 0
Total financial liabilities 0 0
Level 3    
Financial Assets:    
Cash, cash equivalents and restricted cash 0 0
Warrants 19,987 12,659
Total financial assets 19,987 12,659
Financial Liabilities:    
Fair value of contingent consideration 125,554 118,360
Total financial liabilities $ 125,554 $ 118,360
v3.26.1
Fair Value Measurements - Narrative (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]      
Revaluation of contingent consideration $ 6,120 $ 0  
Foresight Diagnostics, Inc.      
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]      
Revaluation of contingent consideration $ 7,200    
UBS Credit Line      
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]      
Spread on interest rate (as a percent) 0.50%    
UBS Credit Line | Level 2      
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]      
Fair value of total principal outstanding and accrued interest $ 80,300   $ 80,300
v3.26.1
Goodwill and Intangible Assets - Narrative (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 04, 2025
Goodwill [Line Items]      
Goodwill     $ 141,100
Amortization of acquired intangible assets $ 7,100 $ 300  
Minimum      
Goodwill [Line Items]      
Estimated useful life (in years) 3 years    
Maximum      
Goodwill [Line Items]      
Estimated useful life (in years) 15 years    
Foresight Diagnostics, Inc.      
Goodwill [Line Items]      
Goodwill     $ 141,070
Goodwill, measurement period adjustment $ 200    
Adjustment, consideration transferred 200    
Amortization of acquired intangible assets $ 5,709 $ 0  
v3.26.1
Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Finite-Lived Intangible Assets [Line Items]    
Total $ 379,369 $ 378,595
Less: Accumulated amortization (12,007) (4,882)
Total Intangible Assets, net $ 367,362 373,713
Minimum    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life (in years) 3 years  
Maximum    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life (in years) 15 years  
Developed technology    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life (in years) 15 years  
Total $ 335,300 335,300
Customer-relationships    
Finite-Lived Intangible Assets [Line Items]    
Total $ 12,795 12,795
Customer-relationships | Minimum    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life (in years) 3 years  
Customer-relationships | Maximum    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life (in years) 10 years  
License and trademarks    
Finite-Lived Intangible Assets [Line Items]    
Total $ 31,274 $ 30,500
License and trademarks | Minimum    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life (in years) 6 years  
License and trademarks | Maximum    
Finite-Lived Intangible Assets [Line Items]    
Estimated useful life (in years) 10 years  
v3.26.1
Goodwill and Intangible Assets - Schedule of Future Amortization Expense (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Year ending December 31:    
2026 (remaining 9 months) $ 21,477  
2027 28,636  
2028 28,613  
2029 28,336  
2030 28,336  
2031 and thereafter 231,964  
Total Intangible Assets, net $ 367,362 $ 373,713
v3.26.1
Financial Instruments - Schedule of Available-for-Sale Securities (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Available-for-sale Securities    
Amortized Cost $ 1,087,932 $ 1,076,140
Gross Unrealized Gain 0 0
Gross Unrealized Loss 0 0
Estimated Fair Value 1,087,932 1,076,140
Cash, cash equivalents, and restricted cash    
Available-for-sale Securities    
Amortized Cost 1,087,932 1,076,140
Gross Unrealized Gain 0 0
Gross Unrealized Loss 0 0
Estimated Fair Value $ 1,087,932 $ 1,076,140
v3.26.1
Financial Instruments - Narrative (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Investments, Debt and Equity Securities [Abstract]    
Credit loss reserve $ 0 $ 0
v3.26.1
Balance Sheet Components - Schedule of Allowance for Doubtful Accounts (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Financing Receivable, Allowance for Credit Loss [Roll Forward]    
Beginning balance $ 8,018 $ 7,259
Provision for (Reversal of) expected credit losses 222 195
Write-offs (313) (20)
Total $ 7,927 $ 7,434
v3.26.1
Balance Sheet Components - Schedule of Property and Equipment, Net (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Property and Equipment, net    
Property and equipment, gross $ 389,791 $ 352,262
Less: Accumulated depreciation and amortization (120,412) (111,078)
Total property and equipment, net 269,379 241,184
Machinery and equipment    
Property and Equipment, net    
Property and equipment, gross $ 183,050 171,270
Computer equipment    
Property and Equipment, net    
Useful Life 3 years  
Property and equipment, gross $ 3,993 3,629
Purchased and capitalized software held for internal use    
Property and Equipment, net    
Useful Life 3 years  
Property and equipment, gross $ 20,117 21,195
Leasehold improvements    
Property and Equipment, net    
Property and equipment, gross 62,455 62,152
Construction-in-process    
Property and Equipment, net    
Property and equipment, gross $ 120,176 $ 94,016
Minimum | Machinery and equipment    
Property and Equipment, net    
Useful Life 3 years  
Maximum | Machinery and equipment    
Property and Equipment, net    
Useful Life 5 years  
v3.26.1
Balance Sheet Components - Narrative (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Balance Sheet Related Disclosures [Abstract]    
Impairment charge $ 0.0 $ 0.0
Depreciation expense $ 12.6 $ 8.2
v3.26.1
Balance Sheet Components - Schedule of Other Accrued Liabilities (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Balance Sheet Related Disclosures [Abstract]    
Reserves for refunds to insurance carriers $ 9,651 $ 9,507
Accrued charges for third-party testing 3,446 20,874
Testing and laboratory materials from suppliers 21,090 12,353
Marketing and corporate affairs 27,617 20,215
Legal, audit and consulting fees 58,976 56,077
Accrued shipping charges 2,043 3,419
Sales and income tax payable 9,390 8,365
Accrued third-party service fees 20,484 9,758
Clinical trials and studies 19,605 14,467
Operating lease liabilities, current portion 14,823 15,581
Property and equipment purchases 22,390 11,270
Other accrued expenses 3,028 6,773
Total other accrued liabilities $ 212,543 $ 188,659
v3.26.1
Leases - Narrative (Details)
$ in Millions
 1 Months Ended 3 Months Ended
Jan. 31, 2026
USD ($)
ft²
Dec. 31, 2025
USD ($)
ft²
Aug. 31, 2025
USD ($)
ft²
Mar. 31, 2025
USD ($)
ft²
Jan. 31, 2025
USD ($)
ft²
Sep. 30, 2023
USD ($)
ft²
Dec. 31, 2021
lease
Nov. 30, 2020
USD ($)
ft²
Oct. 31, 2016
ft²
lease
Mar. 31, 2026
USD ($)
Mar. 31, 2025
USD ($)
ft²
Jul. 31, 2024
Jan. 31, 2023
Sep. 30, 2022
ft²
Feb. 28, 2022
ft²
Jan. 31, 2021
Sep. 30, 2015
ft²
Lessee, Lease, Description [Line Items]                                  
Noncash operating activities related to right-of-use assets                   $ 29.2 $ 10.9            
Weighted average remaining lease term                   7 years 2 months 23 days              
Weighted average discount rate (as a percent)                   6.50%              
Lease expense                   $ 5.9 4.4            
Operating lease payments                   $ 5.9 $ 4.5            
Laboratory and Office Spaces                                  
Lessee, Lease, Description [Line Items]                                  
Lease space (area) | ft²   15,485 45,800 57,100   16,319   11,395 136,000   57,100     65,222 32,500   94,000
Number of office space locations | lease             2   2                
Annual lease payment     $ 0.7 $ 0.9 $ 9.7 $ 0.9   $ 0.9                  
Term of lease           60 months   36 months                 132 months
Renewal term of lease                       60 months 3 years     48 months  
Laboratory and Office Spaces | First Space San Carlos, California                                  
Lessee, Lease, Description [Line Items]                                  
Lease space (area) | ft²                 88,000                
Laboratory and Office Spaces | Second Space San Carlos, California                                  
Lessee, Lease, Description [Line Items]                                  
Lease space (area) | ft²                 48,000                
Laboratory and Office Spaces | Additional Space San Carlos, California                                  
Lessee, Lease, Description [Line Items]                                  
Lease space (area) | ft² 63,000       40,700                        
Annual lease payment $ 4.4       $ 1.5                        
Term of lease 10 years                                
Laboratory and Office Spaces | Minimum                                  
Lessee, Lease, Description [Line Items]                                  
Term of lease                   1 year              
Laboratory and Office Spaces | Maximum                                  
Lessee, Lease, Description [Line Items]                                  
Term of lease                   5 years              
Austin, TX Additional Premises Lease                                  
Lessee, Lease, Description [Line Items]                                  
Lease space (area) | ft²   28,468                              
Annual lease payment   $ 0.4                              
Boulder, CO Lease                                  
Lessee, Lease, Description [Line Items]                                  
Lease space (area) | ft²   25,718                              
Annual lease payment   $ 1.5                              
v3.26.1
Leases - Schedule of Operating Lease Liabilities (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Leases [Abstract]    
Operating lease liabilities, current portion included in other accrued liabilities $ 14,823 $ 15,581
Operating lease liabilities, long-term portion 144,953 118,473
Total operating lease liabilities $ 159,776 $ 134,054
v3.26.1
Leases - Schedule of Future Minimum Lease Payments (Details) - USD ($)
$ in Thousands
Mar. 31, 2026
Dec. 31, 2025
Operating Leases    
2026 (remaining 9 months) $ 18,619  
2027 24,570  
2028 27,463  
2029 27,627  
2030 28,031  
2031 and thereafter 78,182  
Total future minimum lease payments 204,492  
Less: imputed interest (44,716)  
Total operating lease liabilities $ 159,776 $ 134,054
v3.26.1
Commitments and Contingencies - Narrative (Details)
$ in Thousands
 1 Months Ended 2 Months Ended 3 Months Ended
Apr. 30, 2026
USD ($)
Nov. 30, 2024
USD ($)
Jan. 31, 2024
USD ($)
patent
Jul. 31, 2023
patent
Mar. 31, 2022
USD ($)
Nov. 30, 2021
patent
Sep. 30, 2021
patent
Jan. 31, 2021
patent
Oct. 31, 2020
patent
Jun. 30, 2020
patent
Mar. 31, 2020
patent
Jun. 30, 2023
USD ($)
patent
Mar. 31, 2026
USD ($)
Dec. 31, 2025
USD ($)
Dec. 04, 2025
USD ($)
Dec. 31, 2023
lawsuit
Feb. 28, 2022
lawsuit
May 31, 2021
lawsuit
Loss Contingencies [Line Items]                                    
Accrued settlement liability                         $ 33,000 $ 32,600        
Fair value of contingent consideration                         125,554 118,360        
Acquired clinical samples and data for oncology development                         15,000          
Clinical samples payable                         3,700          
Total commitments                         261,404          
Potential payments to third party vendor                         50,000          
Foresight Diagnostics, Inc.                                    
Loss Contingencies [Line Items]                                    
Potential future milestone obligations                             $ 175,000      
Fair value of contingent consideration                         125,600 $ 118,400 $ 118,360      
Assets Acquired From Invitae                                    
Loss Contingencies [Line Items]                                    
Asset acquisition, consideration transferred     $ 10,500                              
Asset acquisition upfront consideration transferred     10,000                              
Asset acquisition, consideration transferred, transaction cost     $ 500                              
Estimated useful life (in years)     10 years                              
Asset acquisition, consideration transferred, contingent consideration     $ 42,500                              
Clinical samples and data for oncology development                                    
Loss Contingencies [Line Items]                                    
Total commitments                         $ 1,300          
CareDX Patent Case                                    
Loss Contingencies [Line Items]                                    
Number of patent litigations | patent                     2              
Loss contingency, number of patents allegedly infringed | patent                     3              
Number of patents found infringed | patent     1       3                      
Amount awarded to other party         $ 44,900                          
Amount awarded from other party     $ 96,300                              
ArcherDX Case                                    
Loss Contingencies [Line Items]                                    
Gain contingency, number of patents allegedly infringed | patent               3                    
Gain contingency, number of patents found infringed | patent                       3            
Amount awarded from other party                       $ 19,400            
ArcherDX Case | Subsequent Event                                    
Loss Contingencies [Line Items]                                    
Amount awarded from other party $ 1,230                                  
Decrease in amount awarded from other party $ 10,000                                  
Ongoing royalty percentage 0.30                                  
Ravgen Patent Case                                    
Loss Contingencies [Line Items]                                    
Loss contingency, number of patents allegedly infringed | patent                   2                
Amount awarded to other party     $ 57,000                              
Genosity Inc. Patent Case                                    
Loss Contingencies [Line Items]                                    
Gain contingency, number of patents allegedly infringed | patent                 1                  
Inivitae Patent Case                                    
Loss Contingencies [Line Items]                                    
Loss contingency, number of patents allegedly infringed | patent           3                        
Inivata Patent Case                                    
Loss Contingencies [Line Items]                                    
Number of lawsuits consolidated | lawsuit                               2    
NeoGenomics Patent Case                                    
Loss Contingencies [Line Items]                                    
Gain contingency, number of patents allegedly infringed | patent       2                            
Guardant Case                                    
Loss Contingencies [Line Items]                                    
Amount awarded to other party   $ 292,500                                
Number of lawsuits | lawsuit                                   2
Class action                                    
Loss Contingencies [Line Items]                                    
Number of lawsuits | lawsuit                                 2  
v3.26.1
Commitments and Contingencies - Schedule of Contractual Commitments (Details)
$ in Thousands
Mar. 31, 2026
USD ($)
Long-Term Purchase Commitment [Line Items]  
Total commitments $ 261,404
Laboratory instruments supplier  
Long-Term Purchase Commitment [Line Items]  
Total commitments 16,232
Material suppliers  
Long-Term Purchase Commitment [Line Items]  
Total commitments 136,147
Application service providers  
Long-Term Purchase Commitment [Line Items]  
Total commitments 16,397
Cloud platform service provider  
Long-Term Purchase Commitment [Line Items]  
Total commitments 20,211
Other material suppliers  
Long-Term Purchase Commitment [Line Items]  
Total commitments $ 72,417
v3.26.1
Stock-Based Compensation - Compensation Expense (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Stock based compensation expense    
Stock-based compensation expense $ 95,107 $ 77,827
Cost of revenues    
Stock based compensation expense    
Stock-based compensation expense 6,625 5,270
Research and development    
Stock based compensation expense    
Stock-based compensation expense 33,409 26,511
Selling, general and administrative    
Stock based compensation expense    
Stock-based compensation expense $ 55,073 $ 46,046
v3.26.1
Stock-Based Compensation - Narrative (Details) - USD ($)
$ in Thousands, shares in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Stock Based Compensation      
Stock-based compensation expense $ 95,107 $ 77,827  
PSU's      
Stock Based Compensation      
Stock-based compensation expense $ 21,900 $ 18,700  
Target (percentage) 100.00%    
Awards granted (in shares) 0.2 0.4  
Aggregate grant date fair value, target vesting percentage 1    
Aggregate grant date fair value $ 42,400 $ 64,900  
Stock-based compensation, milestones as a percentage of grant value 100.00%   200.00%
PSU's | Minimum      
Stock Based Compensation      
Vesting percentage 0.00%    
PSU's | Maximum      
Stock Based Compensation      
Vesting percentage 200.00%    
Liability-Classified Awards      
Stock Based Compensation      
Stock-based compensation expense $ 1,400 $ 0  
Liability-Classified Awards | Foresight Diagnostics, Inc.      
Stock Based Compensation      
Stock-based compensation expense $ 1,100    
v3.26.1
Stock-Based Compensation - Stock Options (Details)
shares in Thousands
 3 Months Ended
Mar. 31, 2026
$ / shares
shares
Number of Shares Outstanding  
Outstanding, beginning balance (in shares) | shares 3,591
Options exercised (in shares) | shares (346)
Options forfeited/cancelled (in shares) | shares (3)
Outstanding, end balance (in shares) | shares 3,242
Weighted- Average Exercise Price  
Outstanding, beginning balance (in dollars per share) | $ / shares $ 27.03
Exercised (in dollars per share) | $ / shares 10.96
Forfeited/cancelled (in dollars per share) | $ / shares 33.12
Outstanding, end balance (in dollars per share) | $ / shares $ 28.77
v3.26.1
Stock-Based Compensation - Schedule of Restricted Stock Units and Performance-Based Awards Activity (Details) - RSU and performance-based awards
shares in Thousands
 3 Months Ended
Mar. 31, 2026
$ / shares
shares
Shares  
Balance (in shares) | shares 8,323
Awards granted (in shares) | shares 2,457
Awards vested (in shares) | shares (2,686)
Awards forfeited/cancelled (in shares) | shares (145)
Balance (in shares) | shares 7,949
Weighted- Average Grant Date Fair Value  
Balance (in dollars per share) | $ / shares $ 100.44
Awards granted (in dollars per share) | $ / shares 215.12
Awards vested (in dollars per share) | $ / shares 81.18
Awards forfeited/cancelled (in dollars per share) | $ / shares 103.52
Balance (in dollars per share) | $ / shares $ 128.11
v3.26.1
Debt (Details) - USD ($)
$ in Millions
 1 Months Ended 3 Months Ended
Oct. 31, 2023
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Jun. 30, 2023
Dec. 31, 2019
Sep. 30, 2015
Debt Instrument [Line Items]              
Collateral amount   $ 150.0          
Remaining borrowing capacity   $ 20.0          
UBS Credit Line              
Debt Instrument [Line Items]              
Spread on interest rate (as a percent)   0.50%          
UBS Credit Line | Line of Credit | Revolving Credit Facility              
Debt Instrument [Line Items]              
Maximum borrowing capacity         $ 100.0 $ 50.0 $ 50.0
Collateral amount   $ 150.0          
Spread on interest rate (as a percent) 0.50%            
Total drawn down   80.0          
Remaining borrowing capacity   20.0          
Interest expense   0.9 $ 1.0        
Outstanding balance   $ 80.3   $ 80.3      
v3.26.1
Income Taxes (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Dec. 31, 2025
Income Tax Disclosure [Abstract]      
Income tax expense $ 283 $ 173  
Interest and penalties accrued $ 0   $ 0
v3.26.1
Net Loss per Share (Details) - shares
shares in Thousands
 3 Months Ended
Mar. 31, 2026
Mar. 31, 2025
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Potentially dilutive shares not included in diluted per share calculation (in shares) 11,898 13,894
Options to purchase common stock    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Potentially dilutive shares not included in diluted per share calculation (in shares) 3,242 3,822
Performance-based awards and restricted stock units    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Potentially dilutive shares not included in diluted per share calculation (in shares) 7,949 9,974
Employee stock purchase plan    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Potentially dilutive shares not included in diluted per share calculation (in shares) 79 98
Contingent consideration    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Potentially dilutive shares not included in diluted per share calculation (in shares) 628 0
v3.26.1
Segment Reporting (Details)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
USD ($)
segment
Mar. 31, 2025
USD ($)
Segment Reporting Information [Line Items]    
Number of reporting segments | segment 1  
Number of operating segments | segment 1  
Revenue $ 696,644 $ 501,830
Product revenues    
Segment Reporting Information [Line Items]    
Revenue 693,868 500,036
Cost of revenues 245,203 184,613
Licensing and other revenues    
Segment Reporting Information [Line Items]    
Revenue 2,776 1,794
Cost of revenues 608 452
Reportable Segment    
Segment Reporting Information [Line Items]    
Revenue 696,644 501,830
Gross margin $ 450,833 $ 316,765
Gross margin percentage 64.70% 63.10%
Reportable Segment | Product revenues    
Segment Reporting Information [Line Items]    
Cost of revenues $ 245,203 $ 184,613
Reportable Segment | Licensing and other revenues    
Segment Reporting Information [Line Items]    
Cost of revenues $ 608 $ 452