Free cash flow remains highly inconsistent, swinging from a positive $14.5 million in 2025Q4 to a negative $33.1 million in 2026Q1, largely driven by working capital friction and $21.5 million in quarterly stock-based compensation.
| 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 |
|---|
| Cash from Operations | 62.58M | 80.86M | 3.39M | -50.1M | -23.01M | -37.75M | -13.76M | -21.86M | -29.07M | -14.91M | -16.65M | -18M | -15.63M | -11.85M |
| Operating CF Margin % | - | 10.82% | 0.57% | -10.17% | -5.6% | -11.69% | -5.19% | -10.19% | -19.74% | -15.04% | -25.99% | -49.82% | -71.85% | -77.1% |
| Operating CF Growth % | -18.51% | 2285.34% | 106.77% | -117.72% | 39.05% | -174.39% | 37.07% | 24.79% | -94.94% | 10.45% | 7.52% | -15.22% | -31.88% | - |
| Net Income | -27.78M | -44.55M | 0 | -123.41M | -116.16M | -101.36M | -43.83M | -54.57M | -48.28M | -29.42M | -20.9M | -22.8M | -15.83M | -13.59M |
| Depreciation & Amortization | 22.11M | 0 | 0 | 22.14M | 19.61M | 16.59M | 6.9M | 3.44M | 2.27M | 1.6M | 568K | 492K | 242K | 150K |
| Stock-Based Compensation | 65.32M | 0 | 0 | 77.2M | 57.74M | 54.53M | 41.52M | 26.24M | 16.33M | 10.12M | 1.87M | 1.41M | 828K | 772K |
| Deferred Taxes | 0 | 0 | 0 | 0 | 0 | 0 | 31.86M | 23.76M | 17.41M | 9.06M | 4.69M | 10K | 408K | 0 |
| Other Non-Cash Items | 58.33M | 217.11M | 102.51M | 76M | 81.3M | 38.72M | 6.03M | 8.99M | -2.93M | 1.81M | 3.85M | 227K | 402K | 1.53M |
| Working Capital Changes | -55.4M | -91.7M | -99.12M | -102.05M | -65.51M | -46.23M | -56.23M | -29.73M | -13.87M | -8.08M | -6.73M | 2.65M | -1.67M | -712K |
| Change in Receivables | -98.31M | -95.43M | -91.92M | -81.19M | -61.84M | -53.57M | -37.96M | -28.73M | -22.89M | -12.95M | -8.52M | -626K | -2.56M | -1.1M |
| Change in Inventory | -10.55M | -8.51M | -224K | 979K | -5.11M | -4.96M | -1.39M | -1.97M | -380K | -293K | -245K | -327K | -71K | 249K |
| Change in Payables | -9M | 28.04M | -7.41M | -1.97M | -2.99M | 6.13M | -3.88M | 5.6M | -192K | 634K | 305K | 132K | 703K | 0 |
| Cash from Investing | -208.7M | -277.06M | -122.98M | -1.21M | -52.43M | 105.26M | -132.39M | -89.27M | 34.12M | -34.59M | -68.17M | -1.79M | -539K | -452K |
| Capital Expenditures | -43.83M | -46.34M | -33.94M | -40.42M | -29.83M | -28.07M | -13.55M | -20.46M | -5.18M | -3.56M | -2.76M | -1.79M | -539K | -452K |
| CapEx % of Revenue | 5.56% | 6.2% | 5.73% | 8.2% | 7.26% | 8.69% | 5.11% | 9.53% | 3.52% | 3.59% | 4.31% | 4.94% | 2.48% | 2.94% |
| Acquisitions | 0 | 0 | 0 | 0 | 0 | 0 | 118.84M | 68.82M | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 0 | 0 | -89.04M | 0 | 0 | 0 | -118.84M | -68.82M | 39.32M | 91K | -65.4M | 0 | 0 | 0 |
| Cash from Financing | 11.03M | 12.61M | 511.38M | 8.82M | 26.72M | -28.58M | 214.32M | 111.58M | 6.3M | 6.53M | 111.25M | 36.38M | 17.68M | 14.53M |
| Debt Issued (Net) | 0 | 0 | 619.84M | 0 | 13.53M | -11.67M | -1.94M | 0 | 3.5M | 0 | 0 | 24.11M | 405K | 2.15M |
| Equity Issued (Net) | 10.05M | 12.61M | -25M | 0 | 0 | 8.94M | 206.03M | 107.37M | 0 | 6.39M | 114.44M | 0 | 17.23M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | -25M | 0 | 0 | 0 | 0 | 0 | -3.88M | 0 | 0 | 0 | 0 | 0 |
| Other Financing | 974K | 0 | -83.46M | 8.82M | 13.18M | -25.85M | 10.23M | 4.21M | 2.8M | 142K | -3.18M | 12.27M | 50K | 12.39M |
| Net Change in Cash | -135.13M | -183.59M | 391.78M | -42.66M | -48.73M | 38.93M | 68.17M | 439K | 11.35M | -42.97M | 26.43M | 16.59M | 1.52M | 2.23M |
| Free Cash Flow | 18.75M | 34.52M | -30.55M | -90.53M | -52.84M | -65.82M | -27.31M | -42.32M | -34.25M | -18.47M | -19.41M | -19.79M | -16.16M | -12.3M |
| FCF Margin % | 2.38% | 4.62% | -5.16% | -18.37% | -12.86% | -20.39% | -10.3% | -19.72% | -23.25% | -18.64% | -30.3% | -54.76% | -74.33% | -80.04% |
| FCF Growth % | 34.5% | 212.99% | 66.25% | -71.31% | 19.72% | -141.01% | 35.47% | -23.57% | -85.39% | 4.85% | 1.91% | -22.44% | -31.41% | - |
| FCF per Share | 0.58 | 1.08 | -0.98 | -2.97 | -1.77 | -2.24 | -0.98 | -1.67 | -1.43 | -0.82 | -3.67 | -1.34 | -1.09 | -9.67 |
| FCF Conversion (FCF/Net Income) | -0.67x | -1.82x | -0.03x | 0.41x | 0.20x | 0.37x | 0.31x | 0.40x | 0.58x | 0.50x | 0.80x | 0.79x | 0.99x | 0.87x |
| Interest Paid | 4.96M | 0 | 6.39M | 2.96M | 3.32M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 546K | 0 | 923K | 1.13M | 287K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
CMS reimbursement rate sensitivity
As evidenced by the company's financial statements, the relationship between net income and operating cash flow remains highly volatile, with the 2026Q1 OCF/NI ratio of 1.88 highlighting a persistent inability to translate accounting losses into consistent cash generation due to significant non-cash stock-based compensation expenses.
The recurring reliance on stock-based compensation, which totaled $21.5 million in 2026Q1, masks the underlying cash burn inherent in the current operating model. Investors should monitor whether the company can achieve positive operating cash flow without relying on these non-cash adjustments to bridge the gap between GAAP losses and actual liquidity.
Based on reported figures, IRTC's free cash flow trajectory remains inconsistent, swinging from a positive $14.5 million in 2025Q4 to a negative $33.1 million in 2026Q1, suggesting that the business has yet to establish a reliable mechanism for self-funding its ongoing operational and capital requirements.
The sharp reversal in FCF margins during the most recent quarter indicates that seasonal revenue patterns and high fixed costs continue to exert significant pressure on liquidity. This volatility warrants further investigation into whether the company's growth initiatives are creating sustainable cash flow or merely deferring the need for external financing.
According to recent SEC filings, IRTC maintains a capital-intensive profile with CapEx/Revenue ratios frequently exceeding 5%, peaking at 10.2% in 2023Q4, which reflects the ongoing necessity of investing in diagnostic infrastructure and next-generation monitoring technology to maintain its competitive moat in the ambulatory cardiac space.
The consistent level of capital expenditure suggests that the company is in a perpetual cycle of upgrading its proprietary AI-based diagnostic platform and hardware. This ongoing investment is essential for maintaining clinical efficacy but acts as a persistent drag on the company's ability to reach sustained free cash flow positivity.
As reported in financial statements, working capital fluctuations are a primary driver of cash flow instability, exemplified by the $27.4 million cash outflow in 2025Q4, which suggests significant friction in the billing and collection cycle for the Zio service model across various insurance reimbursement channels.
The erratic nature of working capital changes implies that the company faces challenges in managing its unbilled receivables and the timing of insurance payments. Investors should monitor whether internal billing efficiencies can be improved to reduce the reliance on working capital swings to support quarterly cash positions.
Based on an analysis of the cash flow statement, stock-based compensation consistently exceeds $20 million per quarter, effectively obscuring the true extent of the company's operational cash burn and complicating the assessment of its long-term ability to sustain growth without dilutive financing or external capital injections.
By treating stock-based compensation as a non-cash add-back, the company presents a more favorable operating cash flow picture than the underlying business performance might otherwise suggest. This accounting treatment warrants further investigation to determine the true economic cost of talent acquisition and retention relative to the company's cash-generating capacity.
Quick answers to the most common questions about buying IRTC stock.
iRhythm Technologies, Inc. (IRTC) generated $80.9M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
iRhythm Technologies, Inc. (IRTC) generated $34.5M 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.
iRhythm Technologies, Inc. (IRTC) spent $46.3M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.