GeneDx (WGS) Q2 2025: Exome and Genome Revenue Jumps 69% as Pediatric Expansion Accelerates

July 29, 2025 | By EarningsIQ Research

GeneDx delivered a breakout second quarter, crossing $100 million in revenue for the first time, powered by a 69% surge in exome and genome sales and record reimbursement rates. The company’s core pediatric neurology segment remains a growth engine, while early traction in the neonatal intensive care unit (NICU) and new specialist channels sets up multiple future catalysts. With a robust data advantage and expanding payer coverage, GeneDx is positioning itself as the genomic testing leader for both rare disease diagnosis and broader pediatric adoption.

Summary

• Core Pediatric Strength: GeneDx’s leadership in pediatric neurology drove most of this quarter’s growth, with continued specialist trust and market share gains.
• Commercial and Medicaid Payer Momentum: Sustained reimbursement improvements and broadening state coverage underpin margin and revenue durability.
• Multi-Pronged Expansion Ahead: New NICU, immunology, and general pediatrics initiatives are building a wider runway for long-term growth.

Performance Analysis

GeneDx crossed the $100 million quarterly revenue mark for the first time, with total revenue reaching $102.7 million and exome and genome revenue up 69% year over year. The core exome and genome testing business accounted for $85.9 million, reflecting both volume growth and a step-function increase in average reimbursement rates. The company reported average reimbursement per test above $3,700, a substantial sequential lift from the prior quarter’s $3,400, attributed to ongoing payer process optimization and expanding Medicaid coverage.

Volume growth remained robust, with 23,102 exome and genome tests performed—up 28% from the prior year—driven by both existing and new ordering clinicians. Gross margin expanded to a record 71%, supported by a favorable mix shift, improved pricing, and cost reductions from process and technology integration. Operating leverage improved as operating expenses fell to 56% of revenue (down from 65% last year), even as the company invested in future growth and the Fabric Genomics acquisition. The company generated $15 million in adjusted net income, marking a fourth consecutive quarter of profitability.

• Reimbursement Rate Upside: Enhanced revenue cycle management and payer wins drove higher average reimbursement, with Medicaid coverage now at 35 states for outpatient and 17 for inpatient rapid genome testing.
• Core Indications Drive Volume: Most test growth came from pediatric neurologists, with new indications like cerebral palsy and immunology just beginning to contribute.
• Margin Expansion: Gross margin improvement was fueled by mix, pricing, and lower cost of goods, with further efficiency expected from Fabric Genomics integration.

Management raised full-year revenue and margin guidance on the back of these results, signaling confidence in both near-term execution and long-term market expansion.

Executive Commentary

Strategic Positioning

1. Pediatric Neurology and Specialist Market Leadership

GeneDx maintains a dominant 80% market share among geneticists and is the clear referral choice for pediatric neurologists, which remain the company’s core growth engine. This specialist trust is reinforced by GeneDx’s unmatched rare disease data set and proprietary interpretation platform, which leverage over 850,000 exomes/genomes and 7 million phenotypic datapoints.

2. New Channel and Indication Expansion

Growth is broadening beyond neurology, with early adoption among pediatric immunologists and new indications like cerebral palsy. The company has reached 14% of its target patient pool, and expects the NICU segment—where only 5% of infants currently get genetic testing—to become a billion-dollar opportunity. Integration with Epic Aura, electronic medical record (EMR) software, is accelerating hospital onboarding, with three health systems live and a dozen expected by year-end.

3. General Pediatrician Market and First-Tier Testing Shift

Recent American Academy of Pediatrics (AAP) guidelines recommend exome/genome sequencing as a first-tier test for developmental delays, opening a $2.5 billion opportunity among 25,000 primary pediatricians serving 600,000 children. GeneDx is taking a phased, education-focused approach to this channel, aiming for broader adoption over the next 18 to 24 months while maintaining focus on its specialist base in the near term.

4. Data Monetization and Pharma Partnerships

GeneDx’s rich genomic database is increasingly valuable to pharmaceutical partners, supporting patient matching, drug discovery, and future collaborations. The company’s GDX Discover data visualization product is gaining traction, and management sees this as a long-term revenue diversification lever.

5. Fabric Genomics Integration and International Opportunity

The Fabric Genomics acquisition is on track, enhancing AI-driven interpretation and dry lab process efficiency. The integration is expected to lower costs, boost diagnostic accuracy, and unlock international markets, with new sales hires targeting global expansion and standardized newborn screening solutions.

Key Considerations

This quarter marks a strategic inflection point for GeneDx, as it cements profitability, achieves new reimbursement highs, and lays the groundwork for multi-segment expansion.

Key Considerations:

• Reimbursement and Coverage Expansion: The company’s ability to secure new Medicaid state coverage and improve commercial payer processes is a critical driver of margin sustainability and pricing power.
• Execution in New Indications: Volume growth from new indications and channels (NICU, immunology, general pediatrics) will determine the pace and durability of future top-line expansion.
• Operational Leverage: Margin expansion is being achieved alongside increased investment, with OPEX as a percentage of revenue improving even as the company scales.
• Data Advantage as Moat: The proprietary, rare disease-enriched genomic data set underpins both clinical differentiation and long-term pharma partnership potential.
• Integration and Scalability: Successful integration of Fabric Genomics and EMR solutions like Epic Aura are pivotal for cost efficiency and scaling hospital-based volume.

Risks

GeneDx faces execution risk as it expands into less-penetrated markets (NICU, general pediatrics), where payer coverage and clinician education may lag. The company’s growth also depends on continued reimbursement gains, successful integration of acquisitions, and operational scalability. Macro headwinds such as Medicaid policy shifts and competitive entry from larger diagnostics players remain ongoing watchpoints, though management is proactively addressing these through advocacy and data-driven health economics.

Forward Outlook

For Q3 and Q4 2025, GeneDx guided to:

• Continued exome and genome volume growth, with back-half acceleration from new indications and hospital channel ramp.
• Further margin expansion as Fabric Genomics integration and payer process improvements take hold.

For full-year 2025, management raised guidance:

• Total revenue of $400 to $415 million (up from prior guide), with exome and genome revenue growth of 48% to 52%.
• Adjusted gross margin of 68% to 71% (raised from prior range).
• At least 30% exome and genome volume growth and continued profitability each quarter.

Management highlighted several factors that support guidance:

• Volume ramp from new indications and Epic Aura hospital integrations expected to be most visible in Q4.
• Conservative guide assumptions for new payer coverage and denial rates, with upside if reimbursement trends persist.

Takeaways

GeneDx’s Q2 results confirm its leadership in pediatric genomic testing while setting the stage for multi-channel expansion and deeper data monetization.

• Margin and Coverage Momentum: Durable reimbursement and payer wins are translating into higher ASPs, improved paid rates, and expanded gross margin, underpinning sustainable profitability.
• Strategic Channel Expansion: The phased approach to general pediatrics, alongside NICU and new specialist channels, gives the company a broad and diversified growth runway while mitigating execution risk.
• Future Watchpoint: Investors should monitor the pace of NICU and hospital channel onboarding, payer adoption for new indications, and the scaling of pharma partnerships as key levers for 2026 and beyond.

Conclusion

GeneDx’s second quarter marks a decisive shift from core specialist dominance to multi-channel genomic leadership, with robust financial execution and expanding strategic optionality. The company’s data advantage, payer momentum, and disciplined channel expansion position it to capitalize on the next era of genomics-driven healthcare.

Industry Read-Through

GeneDx’s record reimbursement rates and rapid volume growth highlight the accelerating mainstreaming of exome and genome testing in pediatric care, signaling a broader shift toward proactive, data-driven medicine. The success of EMR integration and payer engagement offers a roadmap for diagnostics peers seeking to scale hospital and specialist channels. Emerging AAP guidelines and expanding Medicaid coverage are likely to catalyze similar adoption trends across pediatric and rare disease testing, with implications for both diagnostics providers and biopharma partners seeking access to real-world genomic data. As competitive intensity rises, data scale, payer relationships, and workflow integration will increasingly separate winners from laggards in the genomic diagnostics space.

WGS Healthcare Diagnostics Genomics Pediatrics Medicaid Data Monetization NICU