Persistent operational inefficiency is evidenced by ten consecutive quarters of negative free cash flow, with 2026Q1 free cash flow margins reaching -116.9%.
| Cash from Operations | -17.48M | -15.26M | -12.69M | -11.95M | -19.59M | -15.73M | -5.68M | -5.34M | -5.31M |
| Operating CF Margin % | - | -87.5% | -84.43% | -86.56% | -122.24% | -93.19% | -43.47% | -46.87% | -140.12% |
| Operating CF Growth % | -102% | -20.27% | -6.24% | 39.01% | -24.48% | -177.01% | -6.36% | -0.5% | - |
| Net Income | -25.12M | -21.23M | -11.14M | -13.58M | -23.84M | -20.29M | -12.06M | -10.75M | -8.44M |
| Depreciation & Amortization | 1.59M | 1.31M | 581K | 621K | 669K | 733K | 717.87K | 751.23K | 610.67K |
| Stock-Based Compensation | 495K | 661K | 762K | 924K | 2.4M | 2.66M | 2.17M | 1.99M | 1.28M |
| Deferred Taxes | 0 | 0 | 0 | 0 | 0 | 1.14M | 0 | 60.34K | 0 |
| Other Non-Cash Items | 654K | 0 | 42K | -2.77M | -518K | -9K | 3.92M | 83.07K | 364.34K |
| Working Capital Changes | 4.91M | 4M | -2.94M | 2.86M | 1.71M | 28K | -431.07K | 2.53M | 867.1K |
| Change in Receivables | -117K | -217K | -228K | 255K | 746K | 228K | -559.6K | -276.1K | -530.29K |
| Change in Inventory | 0 | 0 | 0 | 0 | 0 | 168K | 332.59K | 401.01K | 0 |
| Change in Payables | 733K | 524K | -1.05M | 734K | 491K | 139K | -274.21K | 547.62K | 246.53K |
| Cash from Investing | -7.42M | -7.53M | -568K | -853K | -924K | -2.61M | -120.25K | 86.22K | -1.12M |
| Capital Expenditures | -789K | -2.34M | -568K | -853K | -924K | -2.4M | -120.25K | -175.6K | -1.25M |
| CapEx % of Revenue | 4.03% | 13.42% | 3.78% | 6.18% | 5.77% | 14.19% | 0.92% | 1.54% | 32.98% |
| Acquisitions | -50K | -5.18M | 0 | 0 | 0 | -225K | 0 | 250K | 133.34K |
| Investments | - | - | - | - | - | - | - | - | - |
| Other Investing | -6.58M | 0 | 0 | 0 | 0 | 13K | 0 | 11.82K | 0 |
| Cash from Financing | 24.67M | 18.56M | 17.88M | 10.92M | 0 | 24.17M | 23.54M | 4.47M | 5.25M |
| Debt Issued (Net) | 11.63M | 10.64M | 0 | 0 | 0 | -25K | 1.19M | 3.73M | -88.24K |
| Equity Issued (Net) | 13.04M | 7.91M | 7.8M | 10.92M | 0 | 24.19M | 22.59M | 0 | 5.35M |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | -1.5M | -2.15M | -350K | -1M |
| Other Financing | 0 | 0 | 10.08M | 0 | 0 | 0 | -245.14K | 738.61K | -12.46K |
| Net Change in Cash | -232K | -4.23M | 4.62M | -1.88M | -20.51M | 5.82M | 17.74M | -785.37K | -1.18M |
| Free Cash Flow | -18.25M | -17.6M | -13.26M | -12.75M | -20.51M | -18.13M | -5.8M | -5.52M | -6.56M |
| FCF Margin % | -93.25% | -100.92% | -88.21% | -92.38% | -128% | -107.38% | -44.39% | -48.42% | -173.1% |
| FCF Growth % | -29.35% | -32.77% | -4% | 37.84% | -13.13% | -212.57% | -5.16% | 15.97% | - |
| FCF per Share | -1.25 | -1.71 | -2.64 | -10.46 | -22.28 | -21.35 | -7.96 | -11.11 | -14.21 |
| FCF Conversion (FCF/Net Income) | 0.73x | 0.72x | 1.14x | 0.88x | 0.82x | 0.78x | 0.47x | 0.50x | 0.63x |
| Interest Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Imminent liquidity and dilution
According to reported financial statements, VVOS consistently reports negative net income alongside operating cash outflows, with the OCF/NI ratio fluctuating significantly, suggesting that the company's accrual-based losses are being compounded by a failure to generate positive cash flow from its core clinical operations.
The persistent gap between net income and operating cash flow indicates that the company is not merely suffering from non-cash accounting charges, but is actively consuming cash to fund its operations. Investors should monitor the volatility in this ratio, as it suggests that the underlying quality of earnings remains poor and highly dependent on external financing.
As evidenced by the quarterly cash flow data, VVOS has maintained a negative free cash flow trajectory for ten consecutive quarters, with FCF margins frequently exceeding -100%, highlighting a structural inability to cover operational and capital requirements through internal revenue generation.
The consistent negative FCF margin suggests that the company's business model is currently incapable of self-funding its growth initiatives. This trend warrants further investigation into whether the company can achieve a pivot toward positive cash flow before its current liquidity reserves are fully exhausted.
Based on the provided cash flow statements, working capital changes have been highly erratic, swinging from a $2.8 million inflow in 2025Q4 to significant outflows in other periods, which complicates the assessment of the company's true underlying cash burn rate.
These fluctuations in working capital suggest that the company may be relying on aggressive timing of payables or collections to manage its immediate liquidity needs. Such volatility often obscures the true operational cash burn, making it difficult to forecast the company's runway with any degree of certainty.
As reported in recent filings, the company's reliance on stock-based compensation and periodic asset divestitures, such as the $5.1 million acquisition net in 2025Q3, appears to mask the severity of the core operational cash burn that continues to erode shareholder value.
The use of non-cash adjustments and one-time asset sales to manage the cash flow statement suggests that the company is attempting to bridge a widening gap between its operating expenses and revenue. Investors should be wary of these items, as they do not represent sustainable sources of liquidity for the business.
Quick answers to the most common questions about buying VVOS stock.
Vivos Therapeutics, Inc. (VVOS) generated $-15.3M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Vivos Therapeutics, Inc. (VVOS) reported negative free cash flow of $17.6M in 2025, indicating capital requirements exceeded cash from operations.
Vivos Therapeutics, Inc. (VVOS) spent $2.3M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.