Cash flow conversion remains volatile, evidenced by an OCF/NI ratio that swung from -6.67 in 2025Q1 to 64.69 in 2023Q4, complicating the assessment of operational cash generation.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 |
|---|
| Cash from Operations | 23.6M | 24.41M | 20.46M | 11.22M | 17.52M | 18.32M | 20.28M | 13.88M | 11.39M | 7.58M | 7.91M | 7.05M | 7.25M | 7.46M | 5.45M | 7.17M | 10.81M | 9.71M | 10.9M | 4.38M | -912.35K | 0 |
| Operating CF Margin % | - | 17.02% | 15.17% | 8.92% | 15.94% | 17.89% | 20.82% | 17.11% | 16.97% | 10.67% | 11.22% | 9.78% | 10.91% | 11.98% | 9.27% | 13.13% | 22.89% | 24.92% | 30.77% | 66.5% | - | - |
| Operating CF Growth % | 134.19% | 19.3% | 82.3% | -35.93% | -4.36% | -9.68% | 46.16% | 21.81% | 50.22% | -4.12% | 12.12% | -2.77% | -2.79% | 36.89% | -23.98% | -33.67% | 11.37% | -10.91% | 148.96% | 579.75% | - | - |
| Net Income | 7.91M | 6.63M | 2.35M | 872K | 18K | 1.42M | 17.33M | 1.36M | -1.09M | -20.71M | -222K | 3.74M | 3.36M | 1.67M | -1.49M | -45.44M | -1.85M | 774K | 9.96M | -2.8M | -7.86M | -24.78K |
| Depreciation & Amortization | 13.25M | 13.29M | 12.5M | 12.51M | 13.36M | 14.63M | 14.03M | 12.34M | 11.31M | 12.52M | 10.74M | 8.24M | 6.14M | 8.03M | 8.4M | 9.05M | 8.6M | 6.44M | 6.4M | 862K | 6.66M | 0 |
| Stock-Based Compensation | 3.25M | 4.36M | 4.46M | 4.07M | 3.83M | 6.4M | 2.61M | 997K | 957K | 682K | 462K | 996K | 576K | 1.12M | 964K | 1.19M | 3.86M | 753K | 1.55M | 1.75M | 6.66T | 0 |
| Deferred Taxes | 1.76M | 2.73M | 1.92M | 633K | 19K | -153K | -10.07M | 104K | -62K | 15.39M | -240K | 1.76M | 2.59M | 1.18M | -906K | -23.42M | -1.24M | 2.25M | 935K | 335K | -6.66T | 0 |
| Other Non-Cash Items | 81K | -2.51M | -1.42M | -1.3M | -90K | -1.29M | -2.35M | -741K | 5.23M | 5.07M | 5.07M | 5.11M | 4.5M | 5.08M | 4.42M | 76.07M | 4.18M | 4.43M | -6.08M | 5.92M | 14.3M | 24.41K |
| Working Capital Changes | -2.66M | -94K | 652K | -5.56M | 385K | -2.69M | -1.26M | -188K | -4.95M | -5.38M | -7.91M | -12.8M | -9.91M | -9.62M | -5.94M | -10.27M | -2.74M | -4.94M | -1.88M | -1.7M | -26.65K | 300 |
| Change in Receivables | 108K | 263K | -701K | -2.36M | -1.15M | 829K | -2.63M | -1.56M | -4.41M | -5.45M | -4.59M | -9.14M | -5.38M | -8.72M | -6.49M | -4.87M | -3.95M | -1.83M | -1.83M | -698K | 0 | 0 |
| Change in Inventory | 504K | 1.14M | -126K | -1.58M | -882K | -864K | -102K | -645K | -490K | 402K | -250K | -158K | -524K | 105K | -30K | -1.7M | -506K | -6.17M | -2.98M | 6.27M | 0 | 0 |
| Change in Payables | -2.06M | -708K | -676K | 2.42M | 2.94M | -2.36M | 2.39M | 2.44M | 183K | -352K | -3.15M | -2.78M | -4.03M | -1.08M | -335K | -3.97M | 2.25M | -601K | -566K | -1.75M | 102.89B | 0 |
| Cash from Investing | -5.39M | -6.79M | -13.24M | -6.73M | -11.48M | -21.32M | -12.16M | -19.64M | -4.98M | 1.05M | -5.34M | -11.91M | -2.84M | -2.16M | -2.56M | -5.55M | -19.06M | -4.61M | -1.04M | 22.02M | -96.96M | 0 |
| Capital Expenditures | -3.3M | -560K | -1.09M | -11.12M | -15.08M | -16.66M | -16.91M | -22.59M | -8.3M | -3.6M | -8.79M | -10.24M | -9.71M | -5.96M | -6.54M | -5.55M | -2.44M | -4.61M | -1.73M | -553K | 0 | 0 |
| CapEx % of Revenue | 2.31% | 0.39% | 0.81% | 8.84% | 13.72% | 16.27% | 17.37% | 27.86% | 12.37% | 5.06% | 12.48% | 14.2% | 14.6% | 9.57% | 11.12% | 10.16% | 5.17% | 11.84% | 4.89% | 8.4% | - | - |
| Acquisitions | 993K | -1.41M | 0 | 0 | 3.6M | -7.98M | 4.75M | 2.95M | 3.32M | 3.87M | -370K | -6.16M | 0 | 0 | 0 | 0 | -16.62M | 784K | 784K | -8.69M | -741.66K | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -1.03M | -4.82M | -12.15M | 4.38M | 3.6M | 3.32M | 0 | 0 | 3.32M | 4.65M | 3.82M | 4.49M | 6.87M | 3.8M | 3.98M | -1.4M | 0 | -783K | -95K | 31.26M | -741.66B | 0 |
| Cash from Financing | -17.61M | -14.96M | -6.92M | -4.42M | -6.06M | -6.46M | -1.12M | 4.1M | -5.56M | -8.56M | 15K | 5.16M | -5.04M | -6.49M | -1.37M | -5.83M | 5.51M | -8.86M | -2.3M | -22.86M | 98.28M | 13.67K |
| Debt Issued (Net) | -9.13M | -4.32M | -5.32M | -3.95M | -13K | -5.47M | 407K | 4.57M | 4.84M | -8.6M | -107K | 5.23M | -4.84M | -6.41M | -1.22M | -5.37M | 6.55M | -8.72M | -2.1M | -409K | -85K | 60K |
| Equity Issued (Net) | -8.46M | -10.64M | -2M | -1.31M | -6.65M | -1.73M | -1.71M | -717K | -10.46M | -58K | -75K | -179K | -204K | -79K | -144K | -465K | -235K | -135K | 0 | 513K | 101.69M | 25K |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -8.82M | -10.97M | -2M | -1.31M | -6.65M | -1.73M | -1.71M | -717K | -10.46M | -58K | -75K | -179K | -204K | -79K | -144K | -465K | -235K | -195K | 0 | 0 | 0 | 0 |
| Other Financing | -12K | 0 | 387K | 835K | 605K | 738K | 190K | 246K | 64K | 93K | 197K | 108K | 0 | 0 | 0 | 0 | -808K | 0 | -195K | -22.97M | -3.32M | -71.33K |
| Net Change in Cash | 600K | 2.66M | 296K | 66K | -21K | -9.46M | 7M | -1.67M | 849K | 71K | 2.58M | 303K | -623K | -1.19M | 1.53M | -4.21M | -2.74M | -3.76M | 7.55M | 3.53M | 413.78K | 13.59K |
| Free Cash Flow | 20.3M | 23.85M | 2.63M | 106K | 2.44M | 1.66M | 3.37M | -8.72M | 3.09M | 3.99M | -886K | -3.19M | -2.45M | 1.5M | -1.09M | 1.62M | 8.37M | 5.1M | 9.16M | 3.82M | -912.35K | 0 |
| FCF Margin % | 14.26% | 16.63% | 1.95% | 0.08% | 2.22% | 1.62% | 3.46% | -10.75% | 4.6% | 5.61% | -1.26% | -4.42% | -3.68% | 2.41% | -1.85% | 2.96% | 17.72% | 13.08% | 25.88% | 58.1% | - | - |
| FCF Growth % | 57.67% | 808.15% | 2377.36% | -95.66% | 47.05% | -50.68% | 138.6% | -382.38% | -22.57% | 550.11% | 72.23% | -30.24% | -263.22% | 237.71% | -167.33% | -80.65% | 64.21% | -44.39% | 139.64% | 519.14% | - | - |
| FCF per Share | 0.97 | 1.13 | 0.12 | 0.00 | 0.11 | 0.08 | 0.15 | -0.42 | 0.14 | 0.18 | -0.04 | -0.14 | -0.11 | 0.07 | -0.05 | 0.08 | 0.42 | 0.27 | 0.49 | 0.21 | -0.07 | - |
| FCF Conversion (FCF/Net Income) | 2.57x | 3.68x | 8.72x | 12.87x | 973.17x | 12.90x | 1.17x | 10.19x | -10.40x | -0.37x | -35.63x | 1.88x | 2.16x | 4.47x | -3.66x | -0.16x | -5.84x | 12.54x | 1.09x | -1.57x | 0.12x | - |
| Interest Paid | 0 | 0 | 1.75M | 2.05M | 1.31M | 1.11M | 1.21M | 1.71M | 1.38M | 1.2M | 1.23M | 1.51M | 2.35M | 2.67M | 3.11M | 1.93M | 2.37M | 2.93M | 3.12M | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 753K | 213K | 153K | 171K | 102K | 111K | 159K | 139K | 105K | 146K | 298K | 549K | 79K | 249K | 21K | 18K | 533K | 0 | 0 | 0 |
CMS reimbursement rate volatility
According to quarterly financial data, InfuSystem's OCF/NI ratio exhibits extreme volatility, ranging from -6.67 in 2025Q1 to 64.69 in 2023Q4, which suggests that reported net income is a poor proxy for the company's actual ability to generate cash from its core oncology and equipment rental operations.
The significant divergence between net income and operating cash flow appears to be driven by heavy non-cash depreciation charges and erratic working capital swings. Investors should interpret this disconnect as a signal that accounting earnings are heavily influenced by non-operational adjustments rather than consistent cash generation.
As reported in recent financial statements, InfuSystem's free cash flow margins have fluctuated wildly, peaking at 23.1% in 2025Q3 before turning negative at -2.6% in 2026Q1, indicating that the company's ability to self-fund its growth initiatives remains highly inconsistent and sensitive to operational timing.
The inability to maintain positive free cash flow suggests that the company's capital-intensive business model requires constant, unpredictable cash injections. This trajectory warrants further investigation into whether the current service-heavy model can achieve the scale necessary to stabilize cash flows over the long term.
Based on InfuSystem's reported figures, working capital changes have been a major source of cash flow instability, with a $5.3 million outflow in 2026Q1 following a $2.0 million inflow in 2024Q4, highlighting the difficulty in managing collections within the complex third-party payer billing environment.
These sharp reversals in working capital suggest that the company's cash position is highly vulnerable to the timing of insurance reimbursements and clinic payments. Such volatility may indicate that the company's billing infrastructure is not yet optimized to provide a predictable cash conversion cycle.
Data from recent filings shows that InfuSystem has consistently prioritized share repurchases, totaling $3.7 million in 2025Q2, even during periods where free cash flow was under pressure, which may indicate a management preference for returning capital over reinvesting in the core pump fleet infrastructure.
The decision to allocate cash toward buybacks while operating cash flow remains erratic appears to be a strategic choice that limits the company's financial buffer. Investors should monitor whether this capital allocation strategy is sustainable if the core oncology business faces further reimbursement headwinds.
Quick answers to the most common questions about buying INFU stock.
InfuSystem Holdings, Inc. (INFU) generated $24.4M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
InfuSystem Holdings, Inc. (INFU) generated $23.8M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
InfuSystem Holdings, Inc. (INFU) spent $0.6M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, InfuSystem Holdings, Inc. (INFU) spent $11.0M on share repurchases. This shows the company's commitment to returning capital to its equity investors.