Free cash flow remains highly volatile, swinging from a positive $692,000 in 2025Q4 to a deep outflow of $17.2 million in 2025Q1, highlighting the firm's inability to maintain predictable cash generation.
| Cash from Operations | -3.38M | -20.37M | -31M | -32.04M | -30.74M | -27.98M | -28.39M | -30.48M | -20.59M | -11.14M | -8.54M |
| Operating CF Margin % | - | -13.66% | -41.39% | -44.9% | -47.14% | -50.59% | -57.65% | -48.65% | -39.02% | -27.56% | -24.95% |
| Operating CF Growth % | 325.55% | 34.27% | 3.25% | -4.23% | -9.85% | 1.43% | 6.86% | -48.04% | -84.77% | -30.48% | - |
| Net Income | -37.11M | -39.13M | -43.73M | -30.19M | -37.16M | -31.19M | -27.45M | -29.04M | -24.1M | -16.06M | -11.23M |
| Depreciation & Amortization | 2.55M | 3.46M | 2.07M | 2.01M | 1.65M | 1.06M | 941K | 1.06M | 882K | 596K | 673K |
| Stock-Based Compensation | 5.4M | 6.85M | 5.6M | 7.32M | 8.75M | 7.87M | 4.4M | 3.43M | 1.74M | 496K | 161K |
| Deferred Taxes | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1.4M | -271K | 108K |
| Other Non-Cash Items | 3.79M | 1.87M | 11.86M | 2.93M | 1.14M | 918K | 1.99M | 976K | 1.07M | 938K | 406K |
| Working Capital Changes | 11.6M | 6.58M | -6.81M | -14.1M | -5.12M | -6.64M | -8.28M | -6.91M | -1.58M | 3.16M | 1.34M |
| Change in Receivables | 6.17M | 3.54M | -3.73M | -8.83M | -6.66M | -3.05M | -597K | -950K | -1.35M | -690K | -123K |
| Change in Inventory | -570K | -395K | 3.15M | -1.1M | -2.59M | -3.44M | -945K | -306K | -435K | -1.07M | -646K |
| Change in Payables | 888K | -1.75M | -1.99M | 2.03M | -1.97M | 276K | -1.08M | 299K | 606K | 788K | 734K |
| Cash from Investing | -581K | -801K | -2.41M | -1.32M | 6.73M | -9.84M | -730K | -813K | -1.01M | -594K | -324K |
| Capital Expenditures | -582K | -801K | -1.47M | -2.37M | -3.27M | -2.35M | -730K | -813K | -1.01M | -594K | -324K |
| CapEx % of Revenue | 0.38% | 0.54% | 1.96% | 3.32% | 5.01% | 4.25% | 1.48% | 1.3% | 1.92% | 1.47% | 0.95% |
| Acquisitions | 25K | 0 | -2.55M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 11K | 31K | 1.61M | 1.05M | 10M | -7.81M | 0 | 2.61M | 0 | 0 | 0 |
| Cash from Financing | 16.87M | 35.85M | -6.81M | 22.7M | 207K | 83.01M | 2.37M | 2.42M | 97.04M | 23.84M | 4.9M |
| Debt Issued (Net) | 4.62M | 9.62M | -2.52M | 23.8M | 0 | 0 | 2.5M | 0 | 0 | 10M | 5M |
| Equity Issued (Net) | 7.85M | 26.82M | 0 | 0 | 0 | 80.97M | 0 | 0 | 100M | 14.82M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | 4.41M | -594K | -4.29M | -1.1M | 207K | 2.03M | -131K | 2.42M | -2.96M | -980K | -104K |
| Net Change in Cash | -2.26M | 14.68M | -40.22M | -10.66M | -23.8M | 45.18M | -26.75M | -28.88M | 75.44M | 12.11M | -3.97M |
| Free Cash Flow | -3.96M | -21.18M | -32.46M | -34.41M | -34.01M | -30.34M | -29.12M | -31.3M | -21.6M | -11.74M | -8.87M |
| FCF Margin % | -2.61% | -14.2% | -43.35% | -48.22% | -52.15% | -54.85% | -59.13% | -49.95% | -40.93% | -29.03% | -25.9% |
| FCF Growth % | 89.37% | 34.77% | 5.65% | -1.17% | -12.1% | -4.18% | 6.95% | -44.87% | -84.03% | -32.41% | - |
| FCF per Share | -0.06 | -0.32 | -1.02 | -1.20 | -1.26 | -1.19 | -1.55 | -1.70 | -2.41 | -1046.17 | -790.11 |
| FCF Conversion (FCF/Net Income) | 0.11x | 0.52x | 0.71x | 1.06x | 0.83x | 0.90x | 1.03x | 1.05x | 0.85x | 0.69x | 0.76x |
| Interest Paid | 0 | 0 | 6.51M | 4.79M | 3.54M | 0 | 3.89M | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Persistent operating cash burn
As reported in financial statements, Neuronetics exhibits a persistent disconnect between net income and operating cash flow, with the OCF/NI ratio frequently exceeding 1.0, suggesting that reported losses are being exacerbated by significant working capital volatility rather than being mitigated by non-cash accounting adjustments or accruals.
The recurring divergence between net losses and operating cash flow suggests that the company's earnings quality is strained by operational inefficiencies. Investors should monitor whether the inability to convert revenue into cash reflects underlying challenges in collecting receivables or managing the cash-intensive nature of the installed base.
Based on recent SEC filings, Neuronetics' free cash flow trajectory is characterized by extreme quarterly swings, ranging from a positive $692,000 in 2025Q4 to a deep outflow of $17.2 million in 2025Q1, indicating that the business lacks the predictable cash generation required for long-term financial stability.
The erratic nature of FCF margins suggests that the company's cash position is highly sensitive to the timing of capital equipment sales and associated working capital fluctuations. This volatility implies that the current business model has yet to achieve the scale necessary to produce consistent, self-sustaining cash flows.
According to the provided quarterly data, working capital changes have been a primary driver of cash flow instability, with swings as large as negative $6.9 million in 2025Q1, highlighting the company's difficulty in maintaining a predictable cash conversion cycle amidst its aggressive commercial expansion efforts.
These significant fluctuations in working capital suggest that the company may be struggling with inventory management or the timing of customer payments for its NeuroStar systems. Such instability warrants further investigation into whether the company is utilizing aggressive credit terms to incentivize sales in a competitive market.
As indicated by the financial data, Neuronetics' capital expenditure intensity has trended downward from 4.3% of revenue in 2023Q4 to negligible levels in 2026Q1, which may suggest a strategic pivot toward capital preservation at the expense of necessary investment in the long-term maintenance of its installed base.
The reduction in capital spending appears to be a defensive measure to conserve cash rather than a sign of operational efficiency. Analysts should consider whether this lower level of investment is sufficient to support the ongoing service requirements of over 1,500 systems currently in the field.
Quick answers to the most common questions about buying STIM stock.
Neuronetics, Inc. (STIM) generated $-20.4M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Neuronetics, Inc. (STIM) reported negative free cash flow of $21.2M in 2025, indicating capital requirements exceeded cash from operations.
Neuronetics, Inc. (STIM) spent $0.8M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.