Natera, Inc.

Per-test billing provides no explicit backlog, but clinical necessity drives repeat ordering: Signatera MRD monitoring requires serial testing for years post-diagnosis, and Panorama is ordered for effectively every qualifying pregnancy. Revenue grew every fiscal year from FY2020 through Q1 2026, including through the COVID period, without a single year of decline.

Three distinct product lines span women's health (Panorama NIPT and Horizon carrier screening), oncology (Signatera MRD), and organ health (Prospera transplant monitoring). Women's Health accounts for the majority of total test volume and an estimated majority of revenue, with Oncology growing rapidly (800,800 oncology tests in FY2025 of 3.53 million total) but not yet balancing the mix.

Revenue is generated almost entirely from U.S. payers and patients; the central laboratory is U.S.-based and all three product lines derive the substantial majority of revenue from U.S. Medicare and commercial payer coverage. International licensing exists for Panorama but contributes a minor and undisclosed share of total revenue.

Gross margin expanded from the mid-30s in FY2021 to approximately 65% in FY2025 as incremental tests run on shared lab infrastructure and bioinformatics platforms at near-zero marginal cost. Operating expense growth is guided at 9.5% for FY2026 against approximately 25% revenue growth at the midpoint, reflecting structural cost leverage from the laboratory-software hybrid model sustained across four consecutive fiscal years.

Tests across all three product lines are clinically mission-critical: MRD monitoring informs cancer treatment decisions, NIPT screens for chromosomal conditions in pregnancy, and Prospera detects transplant rejection before clinical symptoms appear. The per-test billing model lacks contractual lock-in, but the high clinical stakes and serial nature of MRD monitoring create strong repeat-order dynamics that distinguish Natera's revenue from discretionary or transactional diagnostics.