Paysign Q3 Revenue Jumps 42.6% to $30.8 Million on Patient Affordability

Paysign (NASDAQ:PAYS) grew third-quarter revenue 42.6% year over year to $30.8 million, posting record revenue, operating income and adjusted EBITDA (earnings before interest, taxes, depreciation and amortization) as its patient affordability business more than offset slower plasma payment processing growth.

Net income climbed to $6.7 million, or $0.11 per diluted share, from $2.2 million, or $0.04 per share, a year earlier. Gross margin expanded to 64.7% from 56.3%, driven by a greater revenue share from the higher-margin patient affordability segment. Against that backdrop, the company still raised full-year margin and profitability expectations — even as it prepares to lose processing business at 113 plasma centers in the fourth quarter.

For finance teams, the quarter is a case study in mix-shift economics: growth is concentrating in a business with materially better margins, while the legacy plasma unit absorbs a customer loss with limited offsetting cost relief.

What drove the patient affordability surge?

Patient affordability revenue rose 109.8% year over year to $16.6 million. Paysign processed approximately 55% more claims than a year earlier as existing programs matured and new ones launched.

Key operating metrics from the quarter:

• 19 new programs added, bringing active programs to 167 at the end of September.
• Average quarterly revenue per program of $99,524, up from $75,435 a year earlier.
• A target of 190 to 195 active programs by the end of 2026.

CFO Jeff Baker attributed the per-program revenue increase to fees for program management, setup, claims processing, customer service and other billable services.

President and CEO Mark Newcomer said the platform delivered approximately $367 million in financial assistance to patients during the quarter and more than $1.4 billion in the first nine months of the year. He also said the company's dynamic business rules technology saved pharmaceutical clients roughly $82.5 million in the quarter — and more than $553 million year to date — by protecting them from costs tied to copay maximizer and accumulator programs (payer tactics that shift more drug cost onto manufacturers' assistance funds).

Matt Turner, president of patient affordability, cautioned during the question-and-answer session that program counts can mask seasonality. Claims typically run strong early in the year when benefits reset and decline later, but programs added in the third and fourth quarters can lift overall platform utilization.

How much will the plasma transition cost?

Plasma revenue rose 7.5% to $13.8 million in the quarter. Average monthly revenue per center increased to $8,187 from $7,122 a year earlier, primarily on stronger utilization, and Paysign served 562 centers at quarter-end.

One customer plans to move payment processing for 113 centers to another provider by year-end. Newcomer said the customer is consolidating the business with an existing banking partner and told Paysign the decision was not related to its service. Paysign will keep processing for some of the customer's other centers.

Baker quantified the hit: the transition should reduce fourth-quarter revenue by $1.5 million and gross profit by $700,000. Over the 12 months ended September 2026, the affected centers generated approximately $11.3 million in revenue and $5.15 million in gross profit.

Paysign expects to end the year serving 445 to 450 plasma centers. Newcomer said the company expects to offset the loss over the next couple of quarters with new centers from existing clients and is in discussions with prospective customers. Baker added a caveat that matters for margin modeling: plasma processing has a highly variable cost structure, leaving limited expenses to remove as a result of the transition.

Why did guidance go up?

Operating margin rose to 23.8% from 7.3% a year earlier, with operating expenses up just 19.2% — far below revenue growth. Adjusted EBITDA rose 118% to $11 million, and its margin expanded to 35.7% from 23.3%.

The balance sheet carries no bank debt. Paysign ended the quarter with $34.5 million in unrestricted cash and $201.8 million in restricted cash, an increase Baker attributed primarily to customer program deposits and higher balances loaded onto cards but not yet spent.

For full-year 2026, Paysign expects revenue within its existing outlook of $114 million to $117 million. The raised profitability guidance now includes:

• Gross margin of 63.5% to 64.5%.
• Net income of $23 million to $24 million, or $0.37 to $0.38 per diluted share.
• Adjusted EBITDA of $38.5 million to $40 million.

Baker said those margin and profitability expectations exceed the company's prior outlook. Newcomer added that margins should continue expanding as patient affordability accounts for more of total revenue.

What is the status of Apherion?

The Apherion donor management system remains under regulatory review. Newcomer said the company recently completed in-center testing and submitted the results as part of the process, while Turner said Paysign does not have a timeline for a regulatory decision.

Interest continues in both the U.S. and the European Union, and Paysign is building a European base in Dublin through its subsidiary Apherion Technologies Limited. Newcomer said ongoing discussions with potential customers could help the platform ramp more quickly once approved.