LifeStance Health : LFST Q1'26 Earnings Presentation

Published: 2026-05-07 06:37:12 ET LFST

Published on 05/07/2026 at 06:37 am EDT

Reimagining Mental Health

Q 1 2026 Earnings Presentation • May 7, 2026

LifeStance: Reimagining Mental Healthcare

Clinicians 11% Y/Y Growth

Increasing access to trusted, affordable, and personalized mental healthcare

A truly healthy society where mental and physical healthcare are unified to make lives better

Revenue | TTM(1) 16% Y/Y TTM(1) Growth

Visits | TTM(1)

Centers in 33 States

with unmatched scale

Note: Unless otherwise stated, data is as of March 31, 2026; (1) Trailing twelve months

Q1 2026 Highlights

Q1 Revenue of $403.5 million increased 21% year-over-year

Total clinicians of 8,349 increased +11% Y/Y; 309 net clinician adds in Q1

Q1 visit volumes of 2.5 million increased +18% Y/Y

Q1 Center Margin of $135.9 million, or 33.7% as a percentage of revenue

Q1 Adjusted EBITDA of $51.1 million, or 12.7% as a percentage of revenue

Ended Q1 with a Cash position of $194.8 million

Note: See reconciliation of GAAP to non-GAAP measures in the Appendix to this presentation. Amounts are unaudited. 4

Q1 2026 Results

Clinicians

+11%

8,349

7,535

Q1'25

Q1'26

+21%

$403.5

$333.0

Revenue (in $M)

Center Margin (in $M)

Adjusted EBITDA (in $M)

Q1'25 Q1'26

+24%

$135.9

$109.8

Q1'25 Q1'26

Center Margin (% of total revenue) 33.0% 33.7%

+48%

$51.1

$34.6

Q1'25 Q1'26

Adj. EBITDA (% of total revenue) 10.4% 12.7%

Note: See reconciliation of GAAP to non-GAAP measures in the Appendix to this presentation. 5

Amounts are unaudited.

Quarterly Trends

Clinicians

8,349

7,996

8,040

7,535

7,708

Q1'25 Q2'25 Q3'25 Q4'25 Q1'26

Revenue (in $M)

$403.5

Center Margin (in $M)

$135.9

Adjusted EBITDA (in $M)

$51.1

$382.2

$363.8

$333.0

$345.3

$126.3

$116.6

$109.8

$108.4

$48.8

$40.2

$34.6

$34.0

Q1'25 Q2'25 Q3'25 Q4'25 Q1'26

Center Margin (% of total revenue) 33.0% 31.4% 32.0% 33.0% 33.7%

Q1'25 Q2'25 Q3'25 Q4'25 Q1'26

Adj. EBITDA (% of total revenue) 10.4% 9.8% 11.1% 12.8% 12.7%

Note: See reconciliation of GAAP to non-GAAP measures in the Appendix to this presentation. Amounts above may not cross-foot due to 6

rounding. Amounts are unaudited.

Balance Sheet, Cash Flow, and Capital Allocation

Balance Sheet & Cash Flow Capital Allocation

$195M

Cash & Cash Equivalents

$263M

Net Long-term Debt*

$33M

Operating Cash Flow (YTD)

$11M

Capital Expenditures (YTD)

Selective deployment to enable clinician and market growth

Opened 6 new centers in Q1

Disciplined investments

to drive growth

Completed 2 tuck-in acquisitions in Q1

Evolving from purely growth mindset to balanced set of objectives that include operational excellence, profitable growth, and disciplined capital deployment

2026 Guidance

(All $ in M)

FY 2026

Q2 2026

Revenue

$1,640 - $1,680

(Raised from $1,615 - $1,655)

$405 - $425

Center Margin

$547 - $571

(Raised from $526 - $550)

$135 - $147

Adj. EBITDA

$200 - $220

(Raised from $185 - $205)

$50 - $60

Note: Center Margin and Adjusted EBITDA anticipated for second quarter of 2026 and full year 2026 are calculated in a manner consistent with the historical presentation of these measures in the Appendix to this presentation. Reconciliation for the forward-looking second quarter of 2026 and full year 2026 Center Margin and Adjusted EBITDA guidance is not being provided, as LifeStance does not currently have sufficient data to accurately estimate the variables and individual adjustments for such reconciliation. LifeStance management cannot estimate on a forward-looking basis without unreasonable

Planning Assumptions

Assumes 20 to 30 new center openings

Appendix

2026

2025

Q4 Q3 Q2 Q1

Total revenue $403.5 $382.2 $363.8 $345.3 $333.0

($M)

Operating expenses

Center costs, excluding depreciation and amortization 267.5 255.9 247.2 236.9 223.2

General and administrative expenses 100.3 94.8 95.6 97.4 94.4

Depreciation and amortization 13.3 13.4 13.6 14.0 13.8

Income (loss) from operations $22.3 $18.1 $7.4 ($3.0) $1.6

Other expense

Loss on remeasurement of contingent consideration (0.0) - - - -

Transaction costs (0.5) - - - -

Interest expense, net (1.8) (2.9) (2.8) (2.9) (3.1)

Other expense (0.2) (0.0) (0.0) (0.1) (0.0)

Total other expense (2.5) (2.9) (2.8) (3.0) (3.1)

Income tax (provision) benefit

(5.5)

(3.5)

2.2

Earnings (loss) per share

Basic Diluted

Weighted-average shares outstanding

Basic Diluted

0.04

0.03

0.00

(0.01)

0.00

387.3

395.1

387.0

396.0

387.0

388.9

386.7

383.3

390.7

Other comprehensive loss

Unrealized losses on cash flow hedge, net of tax

(0.3)

Comprehensive income (loss) $14.2 $11.7 $0.7 ($4.1) $0.4

Net income (loss) $14.2 $11.7 $1.1 ($3.8) $0.7

Income (loss) before income taxes $19.8 $15.2 $4.6 ($5.9) ($1.5)

2026

2025

($M)

Q4 Q3 Q2 Q1

Income (loss) from operations

$22.3

$18.1

$7.4

($3.0)

$1.6

Adjusted for:

Depreciation and amortization

13.3

13.4

13.6

14.0

13.8

General and administrative expenses (1)

100.3

94.8

95.6

97.4

94.4

Center Margin

$135.9

$126.3

$116.6

$108.4

$109.8

Subtotals in the schedule above may not foot or cross-foot due to rounding. Amounts are unaudited.

(1) Represents salaries, wages and employee benefits for our executive leadership, finance, human resources, marketing, billing and credentialing support and technology infrastructure and stock-based compensation for all employees.

2026

2025

($M)

Q4 Q3 Q2 Q1

Net income (loss)

$14.2

$11.7

$1.1

($3.8)

$0.7

Adjusted for:

Interest expense, net

1.8

2.9

2.8

2.9

3.1

Depreciation and amortization

13.3

13.4

13.6

14.0

13.8

Income tax provision (benefit)

5.5

3.5

(2.2)

Loss on remeasurement of contingent consideration

0.0

Stock-based compensation

15.2

16.7

18.3

21.1

18.6

Loss on disposal of assets

0.2

0.0

0.1

0.0

Transaction costs (1)

0.5

Executive transition costs

0.1

0.6

0.5

0.2

Litigation costs (2)

(0.2)

0.1

(0.1)

1.0

0.2

Strategic initiatives (3)

0.1

Real estate optimization and restructuring charges (4)

(0.0)

(0.1)

(0.0)

Amortization of cloud-based software implementation costs (5)

0.4

Adjusted EBITDA

$51.1

$48.8

$40.2

$34.0

$34.6

Subtotals in the schedule above may not foot or cross-foot due to rounding. Amounts are unaudited.

- Primarily includes capital markets advisory, consulting, accounting and legal expenses related to the underwritten public offering of shares of our common stock by certain selling stockholders completed in the first quarter of 2026.

- Litigation costs, net of insurance recoveries, include only those costs which are considered non-recurring and outside of the ordinary course of business based on the following considerations, which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) the complexity of the case (e.g., complex class action litigation), (iii) the nature of the remedy(ies) sought, including the size of any monetary damages sought, (iv) the counterparty involved, and (v) our overall litigation strategy. During each of the three months ended March 31, 2026 and 2025, litigation costs included cash expenses related to certain litigation matters, including a privacy class action litigation, and for the three months ended March 31, 2025, a compensation model class action litigation.

- Strategic initiatives consist of expenses directly related to evaluating and implementing a critical enterprise-wide scalable electronic health resources system in connection with our significant expansion. Strategic initiatives represents costs, such as third-party consulting costs and one-time costs, that are not part of our ongoing operations related to this enterprise-wide system. We considered the frequency and scale of this enterprise upgrade when determining that the expenses were not normal, recurring operating expenses.

- Real estate optimization and restructuring charges consist of cash expenses and non-cash charges related to our real estate optimization initiative, which included certain asset impairment and disposal costs, certain gains and losses related to early lease terminations, and exit and disposal costs related to our real estate optimization initiative to consolidate our physical footprint during 2023. As the decision to close these centers was part of a significant strategic project driven by a historic shift in behavior, the magnitude of center closures was greater than what would be expected as part of ordinary business operations and did not constitute normal recurring operating activities. During the three months ended March 31, 2025, real estate optimization and restructuring charges consisted of certain gains and losses related to early lease terminations of previously abandoned real estate leases in 2023.

- Represents amortization of capitalized implementation costs related to cloud-based software arrangements that are included within general and administrative expenses included in our unaudited consolidated statements of operations and comprehensive income (loss).

2026

2025

($M)

Q4 Q3 Q2 Q1

Key Metrics

Clinicians

8,349

8,040

7,996

7,708

7,535

Total Revenue

$403.5

$382.2

$363.8

$345.3

$333.0

Center costs, excluding depreciation and amortization

267.5

255.9

247.2

236.9

223.2

Center Margin (Non-GAAP)

$135.9

$126.3

$116.6

$108.4

$109.8

% Margin

33.7%

33.0%

32.0%

31.4%

33.0%

General and administrative expenses

100.3

94.8

95.6

97.4

94.4

Depreciation and amortization

13.3

13.4

13.6

14.0

13.8

Income (loss) from operations

22.3

18.1

7.4

(3.0)

1.6

Other expense

(8.0)

(6.4)

(6.3)

(0.8)

(0.9)

Net income (loss)

$14.2

11.7

1.1

(3.8)

0.7

Other comprehensive (loss) income

Unrealized (losses) gains on cash flow hedge, net of tax

(0.3)

Comprehensive income (loss)

$14.2

$11.7

$0.7

($4.1)

$0.4

Adjusted EBITDA build

Net income (loss)

14.2

11.7

1.1

(3.8)

0.7

Interest expense, net

1.8

2.9

2.8

2.9

3.1

Depreciation and amortization

13.3

13.4

13.6

14.0

13.8

Income tax provision (benefit)

5.5

3.5

(2.2)

Loss on remeasurement of contingent consideration

0.0

Stock-based compensation

15.2

16.7

18.3

21.1

18.6

Loss on disposal of assets

0.2

0.0

0.1

0.0

Transaction costs

0.5

Executive transition costs

0.1

0.6

0.5

0.2

Litigation costs

(0.2)

0.1

(0.1)

1.0

0.2

Strategic initiatives

0.1

Real estate optimization and restructuring charges

(0.0)

(0.1)

(0.0)

Amortization of cloud-based software implementation costs

0.4

Adjusted EBITDA (Non-GAAP)

$51.1

$48.8

$40.2

$34.0

$34.6

% Margin

12.7%

12.8%

11.1%

9.8%

10.4%

Subtotals in the schedule above may not foot or cross-foot due to rounding. Amounts are unaudited. See appendix for reconciliation

2026

2025

Q4 Q3 Q2 Q1

($M)

Current assets

Cash and cash equivalents

194.8

248.6

203.9

188.9

134.3

Patient accounts receivable, net

122.9

95.7

121.1

129.5

140.4

Prepaid expenses and other current assets

38.2

71.8

35.4

40.4

29.9

Total current assets

355.9

416.2

360.4

358.8

304.6

Property and equipment, net

161.5

161.6

162.7

160.6

163.7

Right-of-use assets

151.5

149.7

145.7

143.2

148.1

Intangible assets, net

175.1

177.7

180.8

184.0

187.3

Goodwill

1,297.0

1,293.3

Other noncurrent assets

4.8

5.4

6.1

6.9

7.6

Total noncurrent assets

1,790.0

1,787.7

1,788.6

1,788.0

1,800.0

Total assets

$2,145.9

$2,203.9

$2,149.0

$2,146.8

$2,104.7

Accounts payable

4.3

6.1

12.2

7.8

7.4

Accrued payroll expenses

117.3

143.3

113.8

129.2

99.9

Other accrued expenses

52.4

42.2

42.1

46.9

43.2

Operating lease liabilities, current

47.4

45.5

47.4

47.1

47.3

Other current liabilities

18.4

14.8

13.1

11.3

9.5

Total current liabilities

239.7

252.0

228.6

242.3

207.4

Long-term debt, net

262.5

265.9

269.4

272.9

276.3

Operating lease liabilities, noncurrent

148.8

148.6

144.2

143.4

149.4

Deferred tax liability, net

16.4

14.0

14.1

14.2

Other noncurrent liabilities

1.0

0.1

0.2

0.3

Total noncurrent liabilities

428.7

431.0

427.7

430.6

440.2

Total liabilities

$668.5

$682.9

$656.2

$672.9

$647.6

Common stock

3.9

Additional paid-in capital

2,267.9

2,325.8

2,309.1

2,291.1

2,270.2

Accumulated other comprehensive income

0.3

0.6

Accumulated deficit

(794.4)

(808.6)

(820.3)

(821.4)

(817.6)

Total stockholders' equity

1,477.4

1,521.0

1,492.7

1,473.9

1,457.1

Total liabilities and stockholders' equity $2,145.9

$2,203.9

$2,149.0

$2,146.8

$2,104.7

Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited.

($M)

Q1'26

Q1'25

CASH FLOWS FROM OPERATING ACTIVITIES

Net income

$14.2

0.7

Adjustments to reconcile net income to net cash provided by (used in) operating activities:

Depreciation and amortization

13.3

13.8

Non-cash operating lease costs

10.7

10.2

Stock-based compensation

15.2

18.6

Amortization of discount and debt issue costs

0.3

Other, net

0.1

0.4

Change in operating assets and liabilities, net of businesses acquired:

Patient accounts receivable, net

(27.0)

(8.6)

Prepaid expenses and other current assets

33.8

(4.5)

Accounts payable

(1.0)

(0.1)

Accrued payroll expenses

(26.4)

(17.5)

Operating lease liabilities

(10.0)

(11.9)

Other accrued expenses

9.8

(4.4)

Net cash provided by (used in) operating activities

$33.1

($3.1)

CASH FLOWS FROM INVESTING ACTIVITIES

Purchases of property and equipment

(10.8)

(7.2)

Acquisitions of businesses, net of cash acquired

(3.1)

Net cash used in investing activities

($13.9)

($7.2)

CASH FLOWS FROM FINANCING ACTIVITIES

Payments of long-term debt

(1.8)

Taxes related to net share settlement of equity awards

(23.9)

(8.2)

Repurchases of common stock

(49.1)

Net cash used in financing activities

($73.0)

($10.0)

NET DECREASE IN CASH AND CASH EQUIVALENTS

($53.8)

($20.2)

Cash and cash equivalents - beginning of period

$248.6

$154.6

CASH AND CASH EQUIVALENTS - END OF PERIOD

$194.8

$134.3

Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited.

(FCF)

2026

2025

($M)

Q4 Q3 Q2 Q1

Net cash provided by (used in) operating activities

$33.1

$57.6

$27.3

$64.4

($3.1)

Purchases of property and equipment

($10.8)

($10.9)

($10.3)

($7.8)

($7.2)

Free Cash Flow

$22.3

$46.6

$17.0

$56.6

($10.3)

We define FCF, a non-GAAP performance measure, as net cash provided by (used in) operating activities less purchases of property and equipment. We believe that FCF is a useful indicator of liquidity that provides information to management and investors about the amount of cash generated from our operations that, after investments in property and equipment, can be used for future growth. FCF is presented for supplemental informational purposes only and has limitations as an analytical tool and should not be considered in isolation or as a substitute for analysis of other GAAP financial measures, such as net cash provided by (used in) operating activities. It is important to note that other companies, including companies in our industry, may not use this metric, may calculate metrics differently, or may use other financial measures to evaluate their liquidity, all of which could reduce the usefulness of this non-GAAP metrics as a comparative measure.

The above table presents a reconciliation of net cash provided by (used in) operating activities to FCF, the most directly comparable financial measure calculated in accordance with GAAP. Subtotals in the schedule above may not foot or cross-foot due to rounding. Amounts are unaudited.

2026

2025

Q4 Q3 Q2 Q1

Total Revenue ($M)

$403.5

$382.2

$363.8

$345.3

$333.0

Total Visits (000s)

2,468

2,394

2,299

2,199

2,098

Total Revenue Per Visit (TRPV)

$163.5

$159.6

$158.2

$157.0

$158.7

Subtotals in the schedule above may not foot or cross-foot due to rounding. Amounts are unaudited.

Disclaimer

LifeStance Health Group Inc. published this content on May 07, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on May 07, 2026 at 10:36 UTC.