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I would now like to turn the conference over to Bruce Voss of Alliance Advisors. Please go ahead.

Thank you, good afternoon, everybody. This is Bruce Voss with Alliance Advisors IR. Welcome to the Myomo first quarter 2026 financial results conference call. With me on today's call are Myomo's Chief Executive Officer, Paul Gudonis, and Chief Financial Officer, Dave Henry. Before we begin, I'd like to caution listeners that statements made during this call by management other than historical facts are forward-looking statements. The words anticipate, believe, estimate, expect, intend, guidance, outlook, confidence, target, project, and other similar expressions are typically used to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and may involve and are subject to risks, uncertainties, and other factors that may affect Myomo's business, financial condition, and operating results. These risks, uncertainties, and other factors are discussed in Myomo's filings with the Securities and Exchange Commission.

Actual outcomes and results may differ materially from what's expressed in or implied by these forward-looking statements. Except as required by law, Myomo undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this call today, May 7, 2026. It's now my pleasure to turn the call over to Myomo's CEO, Paul Gudonis. Paul, please go ahead.

Thanks, Bruce. Good afternoon, and thank you all for joining us today. We remain very excited about the opportunity in front of us to improve lives and grow our company. Chronic arm upper limb paralysis is an underserved medical condition. Each year, stroke leaves hundreds of thousands of Americans with lasting arm impairment. When you add in spinal cord injury, traumatic brain injury, and brachial plexus injuries, the addressable U.S. population reaches into the millions. Globally, millions more. For most of these patients, the standard of care has been a passive brace, ongoing physical therapy with diminishing returns or resignation to permanent loss of function.

Our MyoPro is the only commercially available powered arm orthosis in the U.S. that uses non-invasive EMG sensors to detect the patient's own muscle signals and amplify them into functional movement, thereby permitting paralyzed individuals to feed themselves, carry objects, return to work, and reclaim independence at home. That's not an incremental improvement on existing care. It's really an entirely different category of device, and Myomo owns it. Let me start with a quick real-life story. Our staff just helped Mike, who lost the use of his right arm due to a brachial plexus injury from a motorcycle accident when he was just 17 years old. Now, some 50 years later, he's using both arms again with the help of a MyoPro. He's carrying objects safely around his home, and he's doing household tasks such as mowing his lawn.

Our MyoPro has improved the quality of life for Mike and for his wife, reducing the burden of care from his impairment, and that's what this is all about. Several positive factors are converging right now to drive Myomo's success. Reimbursement, distribution, and technology. Reimbursement by CMS in a new Medicare Part B benefit category with HCPCS codes for the MyoPro has opened access to a Medicare population of tens of millions and removed the single largest historical barrier to adoption. New clinical studies and in-network contracts with a growing number of commercial payers has significantly increased market access for patients covered by these plans. We're transitioning our go-to-market strategy with a distribution system based on recurring patient sources from rehab hospitals and O&P providers to reduce our customer acquisition costs and to build the foundation for accelerated growth going forward.

Our investments in technology are increasing the value to patients and clinicians while reducing our operating costs as we scale the business to sustain profitability. Earlier this year, we established 4 success pillars for 2026: recurring revenue, market access, operating leverage, and innovation. With strong progress against each, first quarter revenue and profitability exceeded our targets. We measure our progress against these 4 success pillars, let's review each of them. Number 1, the shift to recurring patient sources. We launched the MyoConnect program in mid-2025 to encourage therapists and physicians at rehab hospitals, stroke clinics, and other healthcare facilities to refer prospective MyoPro patients to us or to a local O&P partner. These channels not only provide recurring referrals, they also carry lower acquisition costs and higher conversion rates versus direct-to-patient marketing.

With Medicare coverage in place and the new MyoPro 2x introduced last year, it was the right time to bring the benefits of the MyoPro to the incidence population of patients who are currently in outpatient therapy, expanding our target market beyond the individuals with chronic arm paralysis and the large prevalence population. We reoriented our field clinical team, added sales specialists, and conducted numerous in-service educational sessions at these rehab locations. I'm pleased to report that now more than 150 rehab facilities are now referring candidates to us. The O&P channel is another source of recurring referrals, and our O&P revenue grew 79% year-over-year as we trained and certified additional CPOs and jointly implemented outreach programs.

Earlier this week, we announced that we've been working with Ottobock's U.S. clinical operations to certify them as MyoPro Centers of Excellence, and we recently conducted training for over 20 clinical specialists from around the country as part of their national rollout. Ottobock is the world's largest provider of O&P products and clinical services, and we're very pleased to be working so closely with them. In Germany, we have more than 100 O&P practices working with us to provide the MyoPro to their patients. The insurance environment in Germany is highly favorable, and our international revenues reached a Q1 record of approximately $2 million. We continue to expand our sales and clinical staff in Germany, and later this month, we'll be attending the OTWorld Conference in Leipzig to engage with additional O&P clinics. This conference is the largest O&P event in Europe.

As a result of these efforts, we're tracking extremely well against our targets of consistently increasing revenue from recurring patient sources. Pillar number 2, that's the second success pillar, is to increase market access for patients by signing additional payer contracts. As discussed in March, we signed a national arrangement with Elevance, which manages a number of Anthem Blue Cross Blue Shield plans in 27 states, including large ones like Texas, Ohio, Virginia, and California. We've been entering into these payer contracts to secure Myomo as an in-network provider with case-by-case coverage determinations and agreed upon price for the MyoPro. As a result, we're now seeing a significantly higher authorization rate from these payers' Medicare Advantage and commercial plans. Over the next several months, I expect we'll sign additional state contracts under the Elevance national arrangements.

Since we secured Medicare coverage in April of 2024 and added various commercial and Medicare Advantage contracts, we've gone from just 9 million covered lives to 158 million lives currently. Pillar 3 is to demonstrate operating leverage and the path to profitability. We demonstrated early operating leverage in the first quarter, with revenue up 3%, while OpEx was down 1% year-over-year. We also expanded gross margin by 100 basis points, and the combination of these accomplishments resulted in a 20% improvement in adjusted EBITDA. Pillar 4 is to continue to invest in product development and clinical research.

At the end of March, we launched a new mobile app, which allows clinicians, patients, and caregivers to use their smartphones to adjust the MyoPro device settings, display their muscle movements and EMG signals, and collect usage data that can be used by therapists and physicians. The app also eliminates the need to ship a laptop with our proprietary software to each user, reducing our MyoPro material cost by about 10%. You'll see this benefit flowing through to gross margin beginning in the second quarter. Another R&D investment is a randomized control trial being conducted by the University of Utah Rehabilitation Hospital. After a successful pilot last year, the university's IRB approved a study which will compare the outcomes of users with the MyoPro against those who received the current standard of care of occupational therapy.

We've enrolled 18 of the 50 subjects to date, and when completed, and assuming similar results to our pilot last year, this clinical evidence is expected to support increased reimbursement of the MyoPro. Finally, development of the MyoPro 3 next-generation platform is progressing. We're focused on enhanced functionality and increased processing power to support future software driven innovations. The progress on each of our 4 success pillars is tracking with our targets, and we're excited to keep on delivering. On the marketing front, we added a new marketing executive and engaged a new digital ad agency in Q1. As a result, we've also refined our marketing strategy with a new approach to digital channels and data-driven targeting. We're also expanding the use of social media to engage directly with healthcare providers and to introduce the MyoPro in geographies with payer contracts.

These initiatives are already improving lead quality, which is resulting in more pipeline adds per lead generated and reducing patient acquisition costs. We expect further efficiency gains as these programs scale throughout 2026. With that overview, I'll turn the call over to our CFO, Dave Henry, to walk through the financial results in more detail.

Thank you, Paul, and good afternoon, everyone. As Paul just discussed, we've been busy executing against the success pillars we introduced earlier this year, and I'm pleased to report on the progress we've made. Our revenue for the first quarter of 2026 was $10.1 million, up 3% versus the prior year period. The increase was driven by a higher average selling price, or ASP, partially offset by a slightly lower number of revenue units. ASP in the first quarter was $58,800, up 9% versus the prior year due to a higher Medicare Part B and Medicare Advantage reimbursement amounts reflecting beginning of year fee updates, as well as a positive channel mix, including higher international and Medicare Advantage revenues. We delivered 172 MyoPro revenue units during the quarter.

Looking at payer mix, Medicare Part B patients in our direct billing channel represented 51% of revenue in the first quarter, which was down 12% in dollar terms compared with the prior year. Medicare Advantage patients on our direct billing channel represented 19% of first quarter revenue, and in dollar terms was up 11% compared with the prior year quarter. As many healthcare providers are seeing, the macro environment for Medicare Advantage plans continues to be challenging. To mitigate the impact, we are focusing on in-network patients obtained through our contracting efforts, where early results are showing higher authorization rates compared with non-contracted payers. The direct billing channel represented 71% of revenue in the first quarter, compared with 79% in the prior year quarter. Direct billing revenue declined as we continued transitioning our business toward recurring patient sources.

Revenue from recurring patient sources represented 49% of first quarter revenue, up from 25% in the prior year. As you can see, we have made significant progress in shifting toward recurring patient sources at a lower patient acquisition cost compared with advertising-driven direct patient revenues, which carry a much higher cost to acquire. Breaking down the recurring patient sources, approximately 20% of first quarter revenue was generated by direct billing referrals. Another 20% was generated by the international channel, 8% from the U.S. O&P channel, and the rest was from VA payers. International revenue was up 53% year over year, and the U.S. O&P channel was up 79% year over year. As of March 31, 2026, the pipeline stood at 1,680 patients, an increase of 10% sequentially and 13% year over year.

During the first quarter, we added 723 patients to the pipeline, which is up 7% sequentially and 3% year-over-year. 11% of first quarter pipeline adds were generated from direct billing referrals, demonstrating the traction so far with the MyoConnect program. 62% of first quarter revenue units were from intra-fill revenue units, which is up from 45% of revenue units a year ago and demonstrates our increased velocity in fulfilling orders. 16% of first quarter orders came from direct billing referrals. We exited the quarter with a backlog of 226 patients.

Gross margin for the first quarter of 2026 was 68.2%, up from 67.2% a year ago, driven by a higher ASP and material cost reductions, partially offset by higher labor and travel costs needed to fit patients on site. Operating expenses for the first quarter of 2026 were $10.1 million, down 1% over the prior year quarter. Decrease was driven primarily by lower R&D and G&A expenses, partially offset by higher sales, clinical and marketing expenses. Operating loss for the first quarter of 2026 was $3.2 million, which narrowed from an operating loss of $3.5 million in the prior year quarter. Adjusted EBITDA for the first quarter of 2026 was a negative $2.3 million, compared with a negative $2.8 million in the prior year quarter.

The improvement was driven by a lower operating loss I just mentioned and higher add backs for depreciation expense and stock-based compensation. First quarter non-operating income includes a mark-to-market gain from the change in fair value of derivative liabilities, partially offset by cash and non-cash interest expense under the Avenue Capital term loan. Net loss for the first quarter of 2026 was $3 million, or $0.07 per share. This compares with a net loss of $3.5 million, or $0.08 per share in the prior year quarter. Turning now to our balance sheet and cash flow. As of March 31st, 2026, cash equivalents and short-term investments were $15.7 million.

Reflective of the improvement in adjusted EBITDA, our use of cash was $2.7 million in the first quarter, compared with $3.2 million used in the first quarter of 2025. Let me conclude my remarks with our forward-looking guidance. As you just heard, we are making tremendous progress on our 2026 objectives. In the first quarter, we achieved higher year-over-year revenue, improved gross margin and lower operating expenses, resulting in improved adjusted EBITDA. Our transition of the business toward recurring patient sources is running ahead of plan. In addition, the marketing changes we initiated are beginning to take effect. As a result, we expect second quarter revenue to be in the range of $10.3 million-$10.8 million, which is up 7%-12% year-over-year and up 2%-7% sequentially.

We expect gross margin in the second quarter to be higher year-over-year, but lower sequentially due primarily to channel mix. We expect operating expenses to increase slightly versus the first quarter, reflecting a modest increase in advertising spending. For the full year, we are reiterating our revenue guidance in the range of $43 million to $46 million, we affirm our full year operating leverage expectation to limit the growth of operating expenses in 2026 to about one half the growth of revenue. With that financial overview, I'll turn the call back to Paul.

Thanks, Dave. Well, to summarize, we're keenly focused on implementing our four success pillars to grow MyoPro volume and revenues while improving key financial metrics, including gross margin, adjusted EBITDA and cash usage. Our technology is making a dramatic difference in the lives of patients who are suffering with this chronic arm paralysis. Now Dave and I are ready to take your questions. Operator?

Thank you. We will now begin the question and answer session. To join the question queue, please press star then one on your touch tone phone.If you are using a speakerphone, please pick up your handset before pressing any keys. If at any time your question has been addressed and you'd like to withdraw your question, please press star then two. At this time, we will pause momentarily to assemble our roster.

While we're waiting for the first question, I'd like to mention that in May, we'll be participating in the Sidoti Virtual Investor Conference and A.G.P.'s annual healthcare company showcase. On June 23rd and 24th, we'll be presenting at the iAccess Alpha Select Virtual Conference and holding one-on-one meetings with investors. Okay, operator, let's take the first question whenever you're ready.

Our first question comes from Chase Knickerbocker of Craig-Hallum. Please go ahead.

Good afternoon. Thanks for taking the questions. Maybe just first on the ASP increase, could you just go into a little bit more detail as far as what drove that, as far as kind of the mix specifically that you were referring to and kind of the drivers within that mix, you know, higher or lower within ASP? I guess the next question is just how sustainable is that? How should we be thinking about kinda ASP sequentially through the year? Thanks.

Yeah, sure. The ASP was, you know, $58,800. The increase was due in part to the fee increase, like, happens at the beginning of every year with CMS. That also affected the Medicare Advantage payers as well. Both Medicare and Medicare Advantage, those were about 70% of revenues in the first quarter, and those were all subject to that fee increase. Also, you know, international revenues, we get some foreign currency benefit from that. International is our second-largest channel in terms of both revenues and ASP, and they were 20% of revenue. Those are the reasons why.

In terms of sustainability, I do expect that the ASP will come down a bit due to channel mix in the second quarter. I think, you know, I think it's still prudent to assume maybe around a, you know, a $55,000 or so ASP on a more longer term basis.

Understood. Maybe just on the advertising efficiency side, can you just kinda break down, you know, what the percentage kinda benefit was in the quarter from MyoConnect? Was the majority of kinda that decrease in cost per pipeline ad driven by MyoConnect, or was there, some improvements that you are seeing on the digital marketing side?

Just in terms of the metrics, you know, the 11% of the pipeline ads in the quarter were MyoConnect, and those come at a, you know, a low cost per pipeline ad. We're not advertising to get those. That's a, you know, that's a big part of it. You know, just some of the efficiencies we're seeing, as Paul mentioned, we are seeing sort of a lower cost or more pipeline ads per lead that we're generating through some of these efforts that we're making.

We're finding that the quality of the leads, you know, which was an issue a year ago, Chase, has really turned around. Now we're getting more of the leads that are generating. We're engaging with those patients, and they're medically qualified, so they're moving into the pipeline. We redid our TV advertising as well with a new 120-second slot. That's paid off really well. A good cost per call, and the patients that see that or their caregivers are really engaged. Those couple factors have reduced our cost per pipeline ad.

You had kind of mentioned ramping some of the marketing spend as we go through the year here into Q2. Is that kind of driven by seeing some improvement on that side of things? Or maybe just talk me through kind of the drivers behind that kind of reinvestment.

Yeah. I would say that is the case, it's also something that we do typically every year. You know, second and third quarters are typically our highest spending for advertising. It comes back down again in the fourth quarter just because of the, you know, the efficiencies that happen during the fourth quarter, or the inefficiencies, I should say, that happen in the fourth quarter.

Well, also due to the revenue cycle, which could be 4 to 6 months or longer, depending on, you know, the patient's insurance, advertising now builds a good pipeline and backlog for Q3 and Q4 revenue.

Just last from me, guidance assumes a step up in growth in the second half. You know, guidance has reiterated, the mix on a per quarter basis was a little bit different than what we kind of expected. Can you just kinda walk us through what the top end of your guidance assumes and the bottom end as far as kind of the moving pieces and the assumptions in there? Thank you.

I think the, you know, the top end of the guidance, I think would reflect, you know, more from the direct billing channel, particularly as it relates to more success on the referrals side of things. You know, MyoConnect, I think, is probably the biggest swing factor in terms of our guidance. You know, like, you know, good news and good traction with that, which so far we're seeing, would lead us to trend towards the higher end of our guidance. If some, for some reason that were to, you know, some of those results would begin to flatten out or going down, that would, you know, drive us toward the lower end of our guided range.

Understood. Thank you.

Our next question comes from Edward Woo of Ascendiant Capital. Please go ahead.

Yeah. Congratulations on the quarter. My question is on international. Once again, you had another very strong quarter, very good growth, record revenue. How much potential can the German market have, and is there ability to accelerate the growth on near term?

Well, you look at the German market, over 80 million population compared to, let's say, 330 here in the U.S. It's, you know, about 25%-30% of the total size of the U.S. market. You can see that there is definitely upside potential there. Also, as we've seen, because of the statutory health insurance, social court rulings over there, we're getting good traction with the insurance companies there. That's why we're continuing to add resources, which is the way to grow that German business. I'll be there later this month in Leipzig, Germany for the OTWorld Conference to recruit more O&P providers. We'll also start looking at some other international markets.

That sounds good. You mentioned other international markets. I know you previously have said that the German market was kinda unique. Other European markets or would it be possibly markets in other areas? Any updates on the Chinese market?

Well, probably the other European markets where we can get the reimbursement relatively quickly. We'll be talking to some O&P providers in these other countries to see what they feel about the reimbursement environment so that you know, we always look at where I'm going to invest another euro, where is the best place to put in. So far, the best return has been in Germany. Also staying in Europe would help us leverage the infrastructure we have over there. In China, we continue conversations with Chinaleaf, which was one of the major investors in the joint venture.

We've had regular conversations to introduce new potential partners, medical device manufacturers and investment partners into the JV, but nothing's been finalized over there as far as the next step with the JV.

Great. Well, thanks for answering my questions. I wish you guys good luck. Thank you.

Thank you, Ed.

Our next question comes from Jeremy Pearlman of Maxim Group. Please go ahead.

Yeah. Thank you for taking my question. Firstly, I wanted to talk about the MyoConnect. You've mentioned that you had roughly 150 rehab facilities that are referring patients currently. You know, how extensive do you think that runway is? How many more rehab clinics, you know, is in the pipeline to convert to this MyoConnect?

Well, you know, we've had tremendous results in just the first 9 months, Jeremy, you know, since we started that in mid 2025. I expect we're gonna add, you know, new clinics every month. You know, I'd love to get to the point where we have several hundred by the end of this year. There are about 1,500 stroke clinics in the U.S., plus many other major hospitals that treat stroke patients. On top of that, you know, we're finding a lot of success with these smaller private rehab clinics. You know, there are therapists out there who have their own clinic, and they are referring MyoPro patients to us. Our goal is to grow the number of rehab facilities to a couple hundred by the end of the year.

Also see what I call same store sales growth, where after referring that first patient, they'll refer a couple of others, and that should grow not only this year, but well into next year. That's why I see we're laying the foundation for accelerated growth next year. You can imagine hundreds of these clinics, you know, then growing the number of patients they refer next year, plus new clinics that come online next year as MyoConnect partners. Plus, you have more and more O&P providers coming on. We just announced Ottobock. They've got over 50 locations in the U.S. We just trained 20 some of their clinicians around the country. They're gonna be spreading the word within their territories. We've got other major national accounts, you know, lined up for similar type of training going on.

Okay, that's great. To just, you know, to follow up, you mentioned that you hope this is laying the foundation for accelerated growth. The, you know, hopefully, they'll refer these clinics. Once they refer the first patient, they'll refer more. Is it too early to tell? Have you seen that play out with the rehab clinics that are already using the MyoConnect program? Does that give you confidence that in 2027 we could see a big uptick?

You know, we are starting to see those sort of green shoots. You know, remember that, you know, most of these have just come online. They made their first referral in December or January, then the patient has to go through the insurance process, has to get fit with the device, then goes to that clinic for therapy services, then they see the outcome. It may be 6 months from the time they make their first referral till we make the second. I'm confident that in the way our device performs for these patients, that we'll get these ongoing referrals.

Okay. Understood. Also just related to the last question related to the MyoConnect. Do a higher percentage of the patients that are referred through this program convert eventually to the backlog into a paying customer, or is it similar to, you know, that's your legacy advertising direct to consumer marketing that pulls into patients where, you know, this certain percentage drops off and then whatever percentage goes to the final MyoPro?

Oh, yeah. That's a good observation. That's a very good observation because these patients are better in two respects. One, we've trained the clinicians that are referring to pre-qualify these patients for us. They are sending us better quality patients, meaning they are more likely to benefit from MyoPro in terms of their medical qualifications. That's a plus. They're a higher quality patient than what comes in from the general advertising. Number two, because these clinicians know that Medicare will cover this, they're sending us a higher % of Medicare than in the general population. It's almost like a double win from these referrals from the MyoConnect program.

Okay. That's great. Understood. Just last question. I know you mentioned on the last, you know, last year, your Investor Day, a big part of-- there was a section about adjudicating denied claims. I just wonder any follow-up, maybe how is that, the success rate of that? Is that steady? Has it been improving? Maybe anything you could talk about that would be great.

Yeah. We are continuing to do these ALJ hearings. Still running about that same success rate. However, as we mentioned, where we have contracts with these various plans, we have a much higher authorization rate right up front, and so we don't even have to go to the hearings.

Okay. That's great. All right. Thank you for taking my questions. I'll hop back in queue.

Yeah. Thank you.

Once again, if you have a question, please press star then one. This concludes our question and answer session. I would like to turn the conference back over to Paul for any closing remarks.

Well, thanks, operator. Thank you all for joining us today and for your questions. We look forward to seeing and hearing from you in the coming months. Thanks again. Have a good evening.

This concludes today's conference call. You may now disconnect your lines. Thank you for participating and have a pleasant day.

Good day, welcome to the Myomo fourth 1/4 and full year 2025 financial results. All participants will be in a Listen-Only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by 0.

After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then 1 on your Touch-Tone phone. To withdraw your question, please press star then 2. Please note this event is being recorded. I would now like to turn the conference over to Mr. Tirth Patel with Alliance Advisors IR. Please go ahead, sir.

Thank you, operator. Good afternoon, everyone. This is Tirth Patel with Alliance Advisors IR. Welcome to the Myomo fourth 1/4 and full year 2025 financial results conference call. With me on today's call are Myomo's Chief Executive Officer, Paul Gudonis, and Chief Financial Officer, David Henry.

Before we begin, I'd like to caution listeners that statements made during this call by management other than historical facts are Forward-Looking statements. The words anticipate, believe, estimate, expect, intend, guidance, outlook, confidence, target, project, and other similar expressions are typically used to identify such forward-looking statements.

These forward-looking statements are not guarantees of future performance and may involve and are subject to risks, uncertainties, and other factors that may affect Myomo's business, financial condition, and operating results. These risks, uncertainties, and other factors are discussed in Myomo's filings with the Securities and Exchange Commission.

Actual outcomes and results may differ materially from what's expressed in or implied by these forward-looking statements. Except as required by law, Myomo undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this call today, March 9, 2026. It's now my pleasure to turn the call over to Myomo CEO, Paul Gudonis. Paul, please go ahead.

Thanks, Tirth. Good afternoon, and thank you all for joining us today. During our last quarterly call, I outlined four major objectives for the company. One, continue to grow revenue through our direct-to-patient marketing, as well expand the number of orders from recurring sources, namely the Orthotics and Prosthetics channel and the MyoConnect referral program.

Number 2, increase market access for patients by signing additional payer contracts and engaging with Medicare Advantage and commercial plans for coverage. Number 3, manage our cost structure and enhance our manufacturing processes to demonstrate operating leverage as we scale. Number four, continue to innovate in product development to maintain our market leadership position.

I'm pleased to report that we made progress on all four of these objectives. Fourth 1/4 of 2025 was our strongest revenue 1/4 of the year, with $11.4 million in revenue.

This brought our full year revenue to $40.9 million, representing 26% growth over 2024. We also recorded the highest number of orders in the company's history, with 241 MyoPros ordered during the 1/4, up 5% sequentially from the 1/3 1/4.

This growth was driven by expanded penetration of the O&P channel, the early success of our MyoConnect clinical referral program, and stronger international revenues. Over the past year, we launched the MyoPro Center of Excellence program to educate domestic O&P practices on the new MyoPro 2X product and the improved reimbursement environment.

O&P providers from national and regional chains to local independent practices ordered approximately 100 MyoPros last year.

In addition, quarterly revenue from the U.S. O&P channel exceeded $1 million for the first time, and our revenue from the O&P channel was up 81% for the 1/4 and doubled for the year. To capitalize on the clinical relationships we've developed with therapists at rehab hospitals across the country, we established the MyoConnect program to engage therapists and physicians in referring medically qualified patients to Myomo and our O&P partners.

In just the first 6 months of this program, we've had over 100 qualified candidates enter our patient pipeline, and referrals were nearly 10% of total pipeline adds in the fourth 1/4. We'll continue to lean into the MyoConnect program in 2026 as we focus on growing revenues from recurring patient sources.

MyoConnect makes sense for clinicians since they want better outcomes for their patients, and these rehab hospitals will continue to provide therapy and training support based on the MyoPro protocol. This strategic pivot to recurring patient sources is already evident in our results. Back in the fourth 1/4 of 2024, 26% of our revenue came from recurring sources.

By the fourth 1/4 of 2025, that figure had increased to 42%, representing 52% Year-Over-Year growth. Supporting the above revenue initiatives is a revised marketing plan that's raising awareness of our products to healthcare professionals and further optimizing our digital marketing to patients.

We believe these initiatives, along with better insurance coverage, will reduce our acquisition costs per customer. Our international operations delivered quarterly revenues in excess of $2 million for the first time, growing 46% for the 1/4 and 48% for the year.

The increase was due to growth in the patient pipeline, more O&P clinics and medical professionals sourcing patients for MyoPro, favorable reimbursement policies from statutory health insurers, and some foreign exchange tailwinds. We're adding more business development and clinical staff to our team in Germany, and we expect continued growth in that market in 2026.

Over in China, we became aware toward the end of the year that the majority shareholder in the joint venture, Ryzur Medical, ran into financial problems in its core rehab hospital business and declared bankruptcy. As a result, operations of the JV company are on hold at this time.

As you may recall, we received $2.7 million in upfront license payments a few years ago, and we're now working with China Lead Ventures, a major investor in the JV, to see if the venture can be recapitalized and restructured so they can address that very large market opportunity in that country. Our market access strategy here in the U.S. continues to gain traction, and we've signed in-network contracts with additional Medicare Advantage and commercial payers in the past several months.

Most notably, we recently reached a multi-state agreement with Elevance Health, which allows us to begin executing State-By-State in-network contracts across their network, which covers 45 million lives. This represents our first such extensive payer arrangement, which provides for case-by-case authorization. This is significant since we are seeing an increasing number of authorizations from plans where we have a contract.

Since we have these agreements on pricing, we don't have to go through a lengthy single case agreement process, and that speeds up the patient's access to MyoPro and our revenue cycle. Our 1/3 major initiative is to manage our cost structure. We've taken steps to increase our organizational efficiency, reduce the cost of outside services, and continue to drive down material costs for manufacturing the MyoPro units.

We're becoming more efficient while investing in critical R&D projects to build on our market leadership. In Q2 of this year, we plan to activate the Myomo mobile app for patients and clinicians, which is now available as a free download in the Apple and Google App Stores.

The app provides enhanced capabilities and data collection for users, while allowing us to reduce the cost of goods sold by eliminating the need to ship a laptop, including our proprietary software, to each MyoPro user. Meanwhile, we expect to roll out other enhancements this year while developing the next generation MyoPro 3.

Another R&D investment we're making is in a randomized controlled trial that's being conducted by the Craig H. Neilsen Rehabilitation Hospital, and this is expected to add to the growing body of research publications, including the 2 that were released last year. In summary, we're making significant progress in our strategic pivot to recurring patient sources, an increased number of insurance authorizations and O&P channel orders, and a lower cost structure as we intend to cut the cash burn in 1/2 in 2026.

With that overview of our results and actions, I'll turn the call over to our CFO, David Henry, to provide more of the financials and details.

Thank you, Paul, and good afternoon, everyone. As Paul mentioned, we saw full-year revenue growth of 26%, driven by growth across all of our sales channels, led by the U.S. O&P channel and international, which both had record 1/4s. Revenue for the fourth 1/4 of 2025 was $11.4 million, which was our highest revenue 1/4 this year, up 13% from the 1/3 1/4 of 2025, but down slightly versus the prior year period.

The Year-Over-Year decrease was driven by a lower number of revenue units and a slightly lower average selling price, or ASP. In addition, in the fourth 1/4 of 2024, we experienced stronger Medicare Advantage revenue and filled demand from Medicare patients after beginning to cover the MyoPro earlier that year.

We delivered 208 MyoPro revenue units during the 1/4, down 5% Year-Over-Year, but up 12% sequentially. 62% of fourth 1/4 revenue units were generated from authorizations received during the 1/4. In addition, our ASP decreased less than 1% versus the prior year to approximately $54,600, due primarily to channel mix.

Medicare Part B patients represented 49% of revenue in the fourth 1/4. Medicare Advantage patients represented 20% of fourth 1/4 revenue and in dollar terms was down 11% compared to the prior year 1/4.

As I'm sure you have seen with other companies, it's been a challenging year dealing with Medicare Advantage payers who have constrained this by issuing a high number of pre-authorization denials, necessitating an appeals process in order to serve these patients.

We have and will continue to fight these denials to make our product available to patients who are in need. As we enter into more payer contracts, we are seeing more authorizations under those agreements. Not enough so far to replace the volume from payers that previously authorized more routinely.

We continue to work to secure more payer contracts and are encouraged by our first multi-state payer arrangement with Elevance. 69% of revenue in the fourth 1/4 came from the direct billing channel, compared with 81% in the prior year 1/4.

Direct billing revenue was down 20% Year-Over-Year due to lower Medicare and Medicare Advantage authorizations and challenges with social media lead generation we faced in the first 1/2 of 2025. Partially offsetting lower direct billing revenue were solid results in our other sales channels.

International revenue was a record $2.2 million, up 46% Year-Over-Year, and representing 19% of total revenue, primarily from Germany. The U.S. O&P channel also achieved a milestone, reaching a record $1 million in quarterly revenue, up 81% Year-Over-Year and representing 9% of total revenue. Recurring patient sources, including referrals under our MyoConnect program, international, U.S. O&P, and the VA, represented 42% of fourth 1/4 revenue.

As of December 31st, 2025, the pipeline stood at 1,528 patients, an increase of 10% Year-Over-Year. During the fourth 1/4, we added 676 patients to the pipeline, which is up 3% from the prior year 1/4. We exited the 1/4 with a backlog of 199 patients.

A record 241 orders in the 1/4, combined with the smooth-running operations, resulted in a record 62% of fourth 1/4 revenue units coming from intra-1/4 fill units, up from 35% of revenue units a year ago. Gross margin for the fourth 1/4 of 2025 was 68.6%, down from 71.4% a year ago and up from 63.8% in the 1/3 1/4.

The Year-Over-Year decrease was due to a lower amount of overhead capitalized inventory compared to the prior year period and higher warranty expenses. Operating expenses for the fourth 1/4 of 2025 were $10.6 million, up 19% over the prior year 1/4. This increase was driven primarily by higher sales, clinical and marketing expenses, particularly advertising expense, which was up approximately $1.2 million Year-Over-Year.

Advertising spending in the fourth 1/4 was down 4% sequentially. Operating loss for the fourth 1/4 of 2025 was $2.8 million, compared with an operating loss of about $200,000 in the prior year 1/4.

Fourth 1/4 Non-Operating expenses include a One-Time Write-Off of debt issuance costs, cash interest expense under the Avenue term loan, Non-Cash interest expense for the amortization of discounts on the debt, and a loss on the change in fair value of derivative liabilities bifurcated from the debt on the issuance date and recorded as separate liabilities which must be marked to market to fair value each 1/4. Net loss for the fourth 1/4 of 2025 was $3.8 million, or $0.09 per share. This compares with a net loss of $300,000 or $0.01 per share for the fourth 1/4 of 2025.

Adjusted EBITDA for the fourth 1/4 of 2025 was a negative $1.9 million, compared with a positive $200,000 for the fourth 1/4 of 2024. Before I move to the balance sheet, let me give you a quick summary of some selected full year results. As I mentioned, revenue was $40.9 million, up 26%. Gross margin for the year was 65.7%, compared with 71.2% for 2024.

The decrease was due to higher overhead costs, primarily due to our facility move earlier this year. Investments in R&D, which resulted in the launch of the MyoPro 2X, our Mark 2 unit, and progress on the MyoPro 3 in 2025, as well as higher sales and marketing expense, drove the increase in operating expenses to $41.3 million in 2025, compared with $29.4 million in 2024.

Turning now to our balance sheet and cash flow. As of December 31st, 2025, cash equivalents and short-term investments were $18.4 million. Cash burn, which we define as free cash flow, was $1.5 million in the fourth 1/4, excluding the net proceeds from the Avenue term loan, repayment of the debt to Silicon Valley Bank, and issuance fees and expenses.

Operating cash flow was a negative $1.1 million in the 1/4, compared to a positive $3.4 million in the fourth 1/4 a year ago. Let me conclude my remarks with financial guidance. As Paul mentioned, we are approaching 2026 as a year where we orient our business more towards stroke patients in the incidence population and recurring patient sources through our MyoConnect referral program, increasing engagement with the U.S. O&P channel, as well as continued international growth.

Our near-term objective to generate a majority of revenue from recurring sources is expected to make the business easier to scale. To fund this transition, we will continue to advertise direct to patients, but limit the growth in advertising spending while building out our MyoConnect program and adding direct sales resources to support the O&P and international channels.

As a reminder, first 1/4 revenue tends to be seasonally lower and expenses higher, with payroll taxes and employee benefits resetting. In line with this historical seasonality, first 1/4 revenue is expected to be in the range of $9 million-$9.5 million. With sequentially lower revenue and operating expenses expected to be slightly higher sequentially, we expect first 1/4 operating loss to be higher than fourth 1/4 2025. For 2026, we expect revenue to be in the range of $43 million-$46 million.

We expect gross margin to benefit from higher volume and lower cost of goods sold per unit, as well as a 2% Medicare price increase effective January 1, 2026. In addition, we expect to generate operating leverage and limit the growth of other operating expenses. We expect to limit the growth of OpEx to 1/2 the growth of revenue in 2026.

With gross margin expected to increase in 2026 and operating cost management, we expect a lower operating loss in 2026, and that cash burn or free cash flow will be reduced by roughly 1/2 in 2026 compared with 2025, driven by the higher revenue and gross margin, partially offset by investment in R&D and sales and marketing, as well as interest expense on our debt. We are committed to growing the top line while prudently investing in the business.

With that overview, I'll turn the call back to Paul.

Thanks, David. Well, to summarize, in 2025, we saw a 26% revenue growth. We launched the MyoPro 2X. We invested in developing the next-gen MyoPro 3. We generated several million dollars in orders from the new O&P channel. We Re-Grew the recurring revenue portion of our business by over 50%. We also expanded our addressable market by engaging patients right after their stroke while they're still in the rehab centers, in addition to the large prevalence population with chronic arm paralysis.

For example, we just provided a MyoPro to a 36-Year-Old male who had a stroke last year and was referred to us by his therapist. With our contract with his Blue Cross Blue Shield plan, he was quickly approved for the device and received it within a year of the incidence of his stroke.

As we look ahead to this year, we plan to continue this go-to-market transition, reduce our customer acquisition costs, and demonstrate that operating leverage with a lower cost structure. While the untapped market for our product remains vast, with hundreds of thousands of potential patient candidates representing a large long-term opportunity.

Given our sales and marketing transition and the uncertainty around the behavior of the Medicare Advantage payers, we believe it's prudent to be conservative and guide to approximately 10% revenue growth with improvement in adjusted EBITDA. We're looking forward to updating you on our progress as the year unfolds. We're now ready to take your questions. Operator?

Thank you. We will now begin the question-and-answer session. To ask a question, you may press Star then one on your touch tone phone. If you are using a speakerphone, please pick up your handset before pressing the keys. If at any time your question has been addressed and you would like to withdraw your question, please press Star then 2. At this time, we'll pause momentarily to assemble our roster.

While we're waiting for the first question.

The first question. Go ahead, sir. I'm sorry.

Well, yeah. Chuck, I was gonna say, while we're waiting for the first question, I do wanna mention that we're planning to host another investor analyst day for an update on the business, and we'll provide details on this event at a later date. We hope to speak with many of you there. Okay, operator, let's go with the first question.

The first question will come from Chase Knickerbocker with Craig-Hallum. Please go ahead.

Good afternoon. Thanks for taking the questions. Maybe just first, you noted progress on MyoConnect, though cost per pipeline ad, you know, increased in the 1/4. Can you just detail what maybe drove that up in the 1/4? Then can you talk about kind of the plan on the direct side of the business to kind of get that acquisition cost down? Thanks.

Thanks, Chase. The MyoConnect program is gaining traction. We're getting these referrals, there's no advertising cost around that. Fourth 1/4, as we've mentioned in the past, tends to have a higher advertising cost because you were competing with holiday advertising. There may be election cycles in some cases.

Our pipeline ads, when you divide by the, you know, into the advertising costs were higher than we like. What we've done is, we brought on a new head of marketing. She started at the end of last year. We brought on a new digital marketing agency in January. They've gotten started revamping our digital marketing approach and social media. We've introduced new TV creative for that advertising, and we've seen the cost per call go down.

You know, we expect that all these different actions should take down that cost per pipeline ad over time, especially with more referrals where there's a 0 advertising cost associated with it.

Have you seen any of that improvement so far as we've kinda came into Q1?

Well, we're not really discussing Q1 at this time. I will say, though, it is kind of a little bit early. I mean, the ad agency just really started, I would say, within the last 6 to 8 weeks, you know, really starting to, you know, do their work. It's a little bit too early to talk about results at this time. I think we'll give you a better update when we report in May the first 1/4 results.

Got it. Maybe just a couple more details on the O&P channel, if you would. Can you give any sort of, any sort of kind of KPIs around kind of ordering number, like number of clinics that ordered in the 1/4, you know, some sort of active account number? Can you just give us the number of units through the O&P channel in Q4? Was ASP kinda solid there, Q3 to Q4? Thanks.

We've got a couple of dozen O&P providers that have been trained, certified, and are ordering the MyoPros, and we had over $1 million of revenue in the 1/4. On an average price there, some 30 some units. Dave?

It was about 36 O&P units in the fourth 1/4.

Got it. Maybe just, the last one for me, just on 2026 guidance, can you just, kind of detail what your assumptions are there for that U.S. O&P business as far as what it'll co-contribute to that 2026 guidance?

Well, we're expecting growth in the O&P channel and in international. That's what's going to drive the growth this year. I think direct billing is gonna be relatively flat if you, if you look at it. That's because it's just we're too soon into these marketing changes to really, you know, have some conviction that and to say that direct billing is going to grow.

You know, we're trying to limit the amount of spending on advertising because we are trying to, we've seen the results, you know, in the last 1/2 of 2025, and the cost per pipeline ad is unacceptably high.

We have to, you know, we need to see that being addressed before we'll decide to spend, you know, more money on advertising beyond what we're already spending. The MyoConnect program is kind of really ramping up.

You know, there's some, you know, just uncertainties some uncertainty as we wait to see how these marketing changes will flow through to get some, you know, better visibility on what that channel might look like for 2026. We're working really hard to grow those recurring patient sources because as Paul mentioned, you know, the cost per pipeline ad there is minimal, and we're all about trying to increase operating leverage, reduce cash burn while at the same time growing revenue in 2026.

Understood. Thank you.

The next question will come from Scott Henry with AGP. Please go ahead.

Thank you. Good afternoon. Starting from the top of the funnel pipeline ads, 676 is a little lower than it's been in the past couple quarters. Do you see that as an aberration? Are you getting higher quality ads? You know, alternatively, should we see that bounce back towards some of the higher levels we saw in the middle of the year? Thank you.

Yeah. I think, a key will be the, you know, the success of MyoConnect to generate some pipeline ads. You know, we're not going to spend more on advertising. We're gonna try to keep that spending relatively flat Year-Over-Year. That's where the sources are going to come from.

We did have, you're right, 676. It was a little bit lower. I will say, though, that we did shut down for about in the last 9 days or so of 2025. That did have a little bit of effect on pipeline ad generation. We had about 2 less weeks in the fourth 1/4 compared to the 1/3.

Like I said, I think it's, you know, we're really looking to see the MyoConnect program gain some traction and try to bring more pipeline ads at a much reduced cost per pipeline ad here in 2026.

Okay. We'll continue to track that. Also the dropout rate, I think by my calculations, was around 40%. I guess that could change a little bit depending how you calculated it. A little bit higher, not dramatically higher than past 1/4s, but any comments on that rate?

This is the backlog drop rate, correct?

Yes.

Yeah. It was about, by my calculations, it was a little over 20%.

Okay. The trend should be the same, depending... I'm just backing it out of the reimbursement pipeline. If you add all the ads and you subtract the units placed, you come up with a number.

Yeah. I would say you're talking about a pipeline drop rate then.

Yes.

Okay. Yeah. I was referring to backlog. Sorry.

Oh.

I haven't calculated the pipeline drop rate. I'll take your word for it was around that. I mean, there's.

It's a little bit higher than...

Yeah, the overall pipeline, you know, the pipeline did decrease, and a lot of that was probably because of drops. There's been a lot of Medicare Advantage patients that have been accumulating in the pipeline that we're having, you know, they're making it hard on us to get authorized. And as a result, a lot of them, you know, we're seeing a lot of drop-offs as a result of that.

Okay.

On the other hand, Scott, what we are seeing is, especially from the referring therapist, because we've encouraged them to, you know, check insurance and so on, we're seeing more Medicare-qualified patients coming to us from their referral channel, which means, there's a, you know, a higher probability that they will get approved for their MyoPro.

Okay. Thank you for the color. The final question, gross margins were very strong in the 1/4, and you mentioned they could get even stronger, at least in the press release. From that kind of 68%-69% level, do you think that could be a new baseline? Kinda how high can that go? Because it's obviously a pretty good number for the 1/4.

Yeah. It will fluctuate with volume, I would expect first 1/4 gross margin will be lower than fourth 1/4 just because of the, you know, less units absorbing overhead. As we go through the year, you know, the, you know, the guidance implies increasing revenues as we go through the 1/4s of 2026.

That will help the gross margin in addition to, you know, we're, you know, we're working on about, as we mentioned actually last Analyst Day, around 200 basis points of gross margin improvement from various activities. Paul mentioned the mobile app that will be, we expect that to be released here in the coming weeks.

That will help, you know, take out about $400-$500 of cost out of the MyoPro because we're not providing a laptop anymore. There's other cost reduction projects that we're working on as well. We, you know, so I think that, we're trying to get that gross margin back up into the, into the 70% range here, by the time we exit 2026.

Okay, great. Thank you for taking the questions.

Mm-hmm.

The next question will come from Anthony Vendetti with Maxim Group. Please go ahead.

Thank you for taking my question. First one was related to the O&P clinics. I think if I recall correctly, you mentioned in last year's investor day that you were planning on having roughly 200 clinics trained, certified, and to be able to deliver the MyoPro in 2028. Is that still, you know, a goal that's on track? You know, how fast is this O&P ne2rk expanding?

You know, that is still a goal of ours. You know, we have a number of clinics that, you know, they're earlier stage, you know, where they're just getting trained. They're building their patient pipelines. They're getting the reimbursement, and so then they will turn into orders.

We also have a very robust national account programs because there's been consolidation in the industry where there's been a number of players that own 40 to 50, 80 or so clinics, and we've been doing national account planning with these entities where they're starting out with a couple of their regions, piloting it, getting some good results, and then we'll see greater rollout. I think, look, this is the most powerful new product opportunity to be address a big unmet need.

I'm very bullish about the O&P channel adopting the MyoPro into their clinical treatment plans.

Okay, great. Then, you know, switching maybe to reimbursement cycle times. I think, again, in the past, you've mentioned numerous times, it's roughly 6 months, I think, from, you know, when a patient reaches out until you actually get payment. Now that you're signing up more of these payers, does that reimbursement, you know, cycle time, are you seeing improvements or it's still roughly that 6-month timeframe?

Well, I think the, the bigger improvement is coming from the fact that we're, you know, Medicare is now, you know, roughly 1/2 of our revenues. Medicare reimburses pretty quickly. You know, we can generally get, we can get paid in, you know, 3 weeks, and we're recording revenue on delivery.

The, you know, the most, I would say the majority of our revenues are occurring at delivery, though I will say, that, one of the things that we see with the backlog here is that as we have more contracts and the payer base broadens, not only are we seeing, you know, contracted payers, you know, authorized, but also non-contracted payers.

We're actually seeing a bit of an increase in the non-contracted payers, authorizing the MyoPro, which means we're waiting till payment to get revenue. We're starting to see a little bit of that. It's sort of good news that there are, you know, a broader base of payers now reimbursing for the device.

Okay, great. Just last question from us. You know, what I might have missed this earlier in the call, but what % of the pipeline add was from this new recurring referral sources as opposed to, you know, maybe some of the direct in the past? Also, do you have a target goal % of, you know, how you wanna see that breakdown in the future?

The pipeline adds were about 10% of the pipeline adds and about 10% of the orders were from referrals in the fourth 1/4. In terms of the way we're thinking about what that, what success might look like here in the near term is we're looking to get the revenues from recurring sources to approach 1/2 of our revenues here by the end of 2026. I think that's the near term objective that we're focused on.

Okay. Thank you very much for taking my questions. I'll hop back into queue.

The next question will come from Swayampakula Ramakanth with H.C. Wainwright. Please go ahead.

Hey, good afternoon, guys, and thanks for taking our questions. First on the German market, it's great to see that it grew really well since the end of last year. I was just wondering if you could provide some color on what were the main drivers behind this growth and how do you expect that market to go in 2026.

I'm sorry, you cut out a little bit. Which market were you referring to? International?

Germany market, yes.

Well, Germany is a large market, you know, with over 80 million population, 1% prevalence. You're talking about 800,000 prevalence population plus, again, all these incidences. Our team has done a good job recruiting a number of O&P practices around the country there. We've gotten very good social court rulings.

Many statutory health insurance companies will pay for the MyoPro, so we don't face the same reimbursement issues there in Germany as we do in the U.S. That's why it's a very good market, grew over 40% and we're continuing to invest in scaling that operation.

Great. Thanks for that. My second question is on the randomized controlled trial that's going on in University of Utah. If this study is successful, how will you use this data, in your commercial efforts, and where do you think it will help the most?

The good news is that the IRB was just approved for this trial. It's an RCT, patients with MyoPro versus those that don't get a MyoPro as a control group. We should start seeing the first readouts by the end of this year. Our plan is to use that, like we've used the other research, to basically convince more payers that they should be covering the cost of the MyoPro because it's not experimental, it's not investigational, and it is medically reasonable and necessary.

That's our plan is that will just reinforce The research that's already been published, that's been accepted by CMS and many other payers, just like this new Elevance agreement we entered into and announced today.

Fantastic. That's very helpful. Our last question is on the R&D efforts for MyoPro 3. Could you provide some timeline for the 3.0 model? What are the primary clinical manufacturing advantages of the 3.0 versus the 2X?

This will be a next generation platform. We are revamping everything about the MyoPro from the chip that's in the device, the software that's out there, the sensing systems, the orthotic materials, the hand grasp capability, elbow motor, harness. It's a total redo of the MyoPro to provide more functional benefit for the patients. It'll be customizable like the current one is, but just provide more function, comfort, and hopefully get even greater market adoption because of it.

Excellent. Thank you for, again, for taking our questions. That's all we have.

The next question will come from Edward Woo with Ascendiant Capital. Please go ahead.

Yeah, thanks for taking my question, and congratulations. I was questioning, in terms of As you guys continue to grow international, what's the gross margin % in international compared to domestic, and what is your operating leverage opportunity? Thank you.

I've often said that in terms of the ASPs, the international business has the second highest ASP compared to the, you know, compared to the, like, the Medicare allowable here in the U.S. The gross margin will be a little bit lower on international. If we're at about a 68% gross margin in the fourth 1/4, international will be a little bit lower than that.

How much leverage do you have in the model to increase it as your sales grow?

I think, you know, all the manufacturing is here in the U.S. As we put more volume into the facility here, you know, the gross margin in Germany will benefit just as the, you know, the overall company gross margin benefits.

Great. Well, thanks for answering my questions, and I wish you guys good luck. Thank you.

Thank you, Ed.

Again, if you have a question, please press star then one. This will conclude our question and answer session. I would like to turn the conference back over to Mr. Paul Gudonis for any closing remarks. Please go ahead.

Well, thanks, operator. Well, the actions we've taken over the last 6 to nine months have already demonstrated progress for achieving our goals of creating a growing profitable company, addressing this large unmet need of chronic arm paralysis.

We're planning for a record number of MyoPro orders this year with a growing contribution from these recurring patient sources. We expect to lower our customer acquisition costs with the new approach to digital and TV advertising and the shift to the new O&P and rehab hospital channels.

Our lowered cost structure and these projects to reduce our manufacturing costs should result in improvements in our gross margin. We continue to innovate in product development to maintain our market leadership position. Thank you all for your questions and your interest in Myomo. Have a nice evening.

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

Good day, and welcome to the Myomo Third Quarter 2025 Financial Results Conference Call. All participants will be in listen-only mode. After today's presentation, there will be an opportunity to ask questions. Please note this event is being recorded. I would now like to turn the conference over to Tirth Patel, with Alliance Advisors IR. Please go ahead.

Thank you, operator, and good afternoon, everyone. This is Tirth Patel with Alliance Advisors IR. Welcome to the Myomo Third Quarter 2025 Financial Results Conference Call. Joining me on today's call are Myomo's Chief Executive Officer, Paul Gudonis, and Chief Financial Officer, Dave Henry. Before we begin, I'd like to caution listeners that statements made during this call by management other than historical facts are forward-looking statements. The words anticipate, believe, estimate, expect, intend, guidance, outlook, confidence, target, project, and other similar expressions are typically used to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and may involve and are subject to risks, uncertainties, and other factors that may affect Myomo's business, financial condition, and operating results. These risks, uncertainties, and other factors are discussed in Myomo's filings with the Securities and Exchange Commission. Actual outcomes and results may differ materially from what's expressed in or implied by these forward-looking statements. Furthermore, except as required by law, Myomo undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this call today, 11/10/2025. It's now my pleasure to turn the call over to Myomo's CEO, Paul Gudonis. Paul, please go ahead.

Thanks, Tirth. Good afternoon, and thank you all for joining us today. I'm pleased to announce that Myomo had another strong quarter with revenue of $10.1 million, coming in at the high end of our expectations. This was driven by record revenues in our international markets and a growing number of O&P providers. In addition, we saw our pipeline increase, and for the first time this year, our quarterly authorizations and orders increased sequentially. We are seeing more Medicare Advantage payer authorizations and orders from the new in-network contracts we signed earlier this year. Now before turning the call over to Dave to review the financial results in detail, I'd like to touch on the progress we made during the quarter on the key initiatives that we outlined on our last call. These were to: one, improve the identification and qualification of prospective patients; two, expand the MyoConnect program and O&P channel; three, expand insurance coverage; and four, reduce our overall operating costs. First, as mentioned, the core area of focus has been improving the identification and qualification of prospective patients. The number of new patient candidates who qualify for MyoPro is growing, and with the shift in our advertising media mix, the cost per pipeline add is beginning to decrease. In Q3, we shifted more of our advertising spend to TV from social media, which yielded a higher percentage of leads that met our clinical criteria to become a successful patient. These candidates were also more motivated to quickly complete the screening process. Thus, we enhanced the quality of our pipeline adds as well as generating a sequential increase in the number of candidates in the pipeline. We hired a new head of marketing with extensive experience in healthcare direct-to-consumer advertising as well as B2B marketing to support our efforts, particularly in reinforcing our message to physicians, therapists, and O&P practitioners. We will optimize the use of our various media to educate patients, family members, clinicians, and payers about the benefits of the MyoPro. Second, we believe the path to lowering customer acquisition cost is by developing recurring sources of patients that do not depend on a prospective candidate's self-initiating response to a paid advertisement. That is central to our new MyoConnect program and the growing O&P channel. Our MyoConnect clinical referral program is off to a good start, generating high-quality patient referrals by therapists and physicians at rehab clinics around the country. Importantly, there is no advertising expense incurred to educate these clinicians and these patients since we are already engaged with them. In mid-year, we launched MyoConnect, where our field clinical teams engage directly with therapists and physicians across the country to expand the network of clinicians who understand the benefits the MyoPro can produce. These clinical practitioners, who are responsible for the design and delivery of patients' treatment protocols, refer qualified patients to us through our local O&P channel partners. Over the years, we have trained numerous occupational therapists who have seen the improvement in patient functionality from the MyoPro. Their willingness to refer patients was facilitated by CMS's decision to cover the MyoPro for Medicare reimbursement and by the introduction of the new MyoPro 2X model this past spring. The result is we are beginning to see more OTs and physicians sending their patients our way to obtain a MyoPro. While still early in the rollout, we are encouraged by the initial traction and believe this program can develop into a scalable and cost-efficient source of high-quality referrals over time. Another source of recurring orders is the O&P channel. We are continuing to provide clinical and reimbursement education and certification to the O&P practitioners, which is the mechanism to expand adoption in this channel. In September, we attended the American Orthotics and Prosthetics Association National Assembly, which is the major trade show for the O&P industry. We had a productive set of meetings with existing and prospective channel partners, and I am confident that sales to these clinics will continue to grow as we diversify our revenue sources beyond our direct-to-consumer advertising and direct billing business. Revenue from this new O&P channel more than doubled year over year, and their patient pipelines are growing with the training and clinical support we are providing to these certified prosthetists and orthotists. In the past 45 days, I've had meetings with senior managers of the large and small O&P clinical groups in the industry as we work together to bring the MyoPro to their patients. We have good working relationships with these firms, and they are eager to work with MyoPro on programs to help improve the upper extremity impairments this important segment of their patient population has. They already treat stroke patients with various lower extremity assisted devices to enable their mobility. Meanwhile, our own chief channel partners in Germany placed a record number of orders in the quarter, leading to strong growth in revenues from our international operations and a greater number of patients in the pipeline for continued growth. Third, to expand insurance coverage, our Chief Medical Officer and reimbursement team have been following up with the major Medicare Advantage payers to obtain more MyoPro authorizations for their beneficiaries. We saw a sequential increase in authorizations for patients covered by some of these plans and from payers with whom we have contracts. These positive results led to the higher number of authorizations and orders this past quarter. During Q3, we signed an additional contract with a payer to become an in-network provider for our direct billing business, which now brings us to 35 million covered lives among private payers. We have other contracts pending as well to increase access to MyoPro for patients covered by these commercial health insurance plans. There's also a development in the payer industry that could be positive for Myomo. Insurance companies that offer Medicare Advantage plans are withdrawing Medicare Advantage coverage from certain geographic areas, thereby reducing their member count. For example, UnitedHealthcare projects a 1 million member drop, and other payers are making similar announcements. If these patients choose to enroll in standard fee-for-service Medicare, those that are medically qualified for MyoPro may be more likely to obtain our device for their paralyzed arms under Medicare Part B coverage. To support increased reimbursement, we continue to add to the published research on the MyoPro. During Q3, a highly respected Topics in Stroke Rehabilitation Journal published a systematic review of patient outcomes from the use of the myoelectric orthosis. Providing this information to payers, rehab physicians, and therapists, as well as O&P professionals, leads to greater insurance coverage and clinical adoption. Lastly, during the quarter, we implemented manufacturing changes to improve our gross margin and also managed headcount and other cost reductions to lower operating expenses. We are positioning ourselves for improved operating leverage as we grow future revenues based on the larger patient pipeline augmented by the increased number of authorizations and orders we expect from the MyoConnect program and the expanded O&P channel. Based on the backlog going into the fourth quarter and the number of patient cases progressing through reimbursement, we are able to reiterate our full 2025 annual guidance of $40 million to $42 million, which represents an increase of more than 23% over last year. With that overview of our performance and actions, I'll turn the call over to our CFO, Dave Henry, to provide more of the financials and details on our newly executed term loan facility, which is designed to provide us with growth capital to continue scaling the business to sustainable profitability and positive cash flow as our MyoPro volumes and revenue increase.

Thank you, Paul, and good afternoon, everyone. Let me start with a review of our third quarter financial results. Revenue for 2025 was $10.1 million. This represents a 10% increase versus the prior year and was driven by a higher number of revenue units offset by a lower average selling price or ASP. We delivered 186 MyoPro revenue units during the quarter, up 16%, with 57% of those units from authorizations and orders received in the third quarter. Our ASP decreased 5% versus the prior year to approximately $54,300 and was roughly flat sequentially. ASP in the prior year period was unusually high due to the change in revenue recognition for Medicare patients to be upon delivery instead of payment. In that period, we began recording Medicare and some supplemental revenues at delivery in addition to some at payment on deliveries prior to the accounting change. This had about a $4,300 favorable impact on ASP in 2024. Normalized for the accounting change, ASP increased 3% year over year. Medicare Part B patients represented 54% of revenue in the third quarter. Medicare Advantage revenue was 18% of third quarter revenue and in dollar terms was down 18% compared with the prior year. Medicare Advantage revenue remained constrained by the high number of pre-authorization denials, forcing us into an appeals process in order to serve these patients. This is not unique to Myomo. Unfortunately, insurance companies force patients into this process, hoping they will not appeal. And while successful appeal rates vary, we typically see about 45% to 50% overturned on appeal for those that stay engaged with us in the process of trying to receive a MyoPro. 73% of revenue in the third quarter came from the direct billing channel, compared with 81% in the prior year quarter. International revenue was a record $1.8 million in the quarter, up 63% and representing 18% of total revenue, primarily from Germany. Revenue in the O&P channel was also a quarterly record at $900,000, up 154% year over year and representing 9% of total revenue. As Paul mentioned, the O&P channel is emerging as a high-quality, lower-cost source of qualified patients, and we intend to continue to develop this channel. As of 09/30/2025, the pipeline stood at 1,669 patients, an increase of 32% year over year. In the third quarter, we added 826 patients to the pipeline, which is up 28% from the prior year quarter and up 1% sequentially. There were 266 Medicare patients in the pipeline, an increase of 21% year over year and 4% sequentially. We ended the quarter with a backlog of 208 patients, down 34% versus the prior year. As a reminder, backlog represents insurance authorizations and orders received but not yet converted to revenue. In the case of Medicare Part B patients, whom we have collected medical records and deemed qualified for delivery based on our inclusion criteria. The decrease represents reduced Medicare Advantage authorizations and the fact that intra-quarter fill units are making up an increasing percentage of our quarterly revenues. In other words, we were able to convert more of our backlog into revenue faster. Indeed, 57% of third quarter revenue units came from intra-quarter fill units, up from 24% a year ago. We received 229 authorizations and orders during the third quarter, an increase of 11% sequentially and 2% year over year. The higher authorizations and orders helped us to generate record revenue from intra-quarter fill units. Gross margin for 2025 was 63.8%, down from 75.4% for the prior year quarter. Prior year gross margin was favorably impacted by a change in accounting for revenues from Medicare patients that I mentioned earlier, which favorably impacted third quarter 2024 gross margin by approximately 200 basis points. In addition, with our growth, we opened a new facility and hired additional staff, leading to higher payroll and lease expense. Finally, an unfavorable change in the overhead absorbed in inventory in 2025 negatively impacted gross margin, as well as higher material costs. Higher labor and overhead spending and change in absorption impacted gross margin by approximately 800 basis points and represents an opportunity to improve gross margin as activity increases. Total operating expenses for 2025 were $10 million, up 26% over 2024 but down 6% sequentially. This increase was driven primarily by higher payroll and advertising spending and by higher R&D due to development efforts on a mobile app for our MyConfig software, the MyoPro 3, and funding for a pilot of a randomized control trial at the University of Utah. As Paul touched on, we are focused on more efficient customer acquisition, leading to a sequential reduction in cost per pipeline add. We are investing in our MyoConnect platform and expect to gain further leverage with our growth in patients. Operating loss for 2025 was $3.5 million, compared with an operating loss of $1 million in the prior year quarter. Net loss for 2025 was $3.7 million, or $0.09 per share. This compares with a net loss of $1 million, or $0.03 per share, for 2024. During 2025, approximately 600,000 pre-funded warrants were exercised. As of 09/30/2025, approximately 3.8 million pre-funded warrants remain outstanding from our offerings in 2023. These pre-funded warrants are considered common stock equivalents under GAAP accounting and are included in our weighted average shares outstanding. Adjusted EBITDA for 2025 was a negative $2.7 million, compared with a negative $600,000 for 2024. Turning now to our balance sheet and cash flow. As of 09/30/2025, cash, cash equivalents, and short-term investments were $12.6 million. Cash burn was $2.9 million in the third quarter, including $1.8 million from operating activities and $1 million from capital expenditures related to the setup of the additional manufacturing space we took over in the third quarter, along with capitalized software costs for one of our product development projects and demo unit builds. On 11/04/2025, we entered into a loan and security agreement with Avenue Capital, which provides for a committed term loan facility of $17.5 million, of which $12.5 million was funded at closing. The remaining $5 million is available to borrow at our discretion from November 2026 through May 2027, assuming certain conditions are met. We will make interest-only payments for the next eighteen months, after which we will repay principal in 24 equal monthly installments. Use of proceeds went to repay the borrowings of our $4 million under our credit facility with Silicon Valley Bank and fees and expenses, with the remaining $7.6 million to be used for general corporate purposes. Pro forma for the funding provided at closing, net of repayment to Silicon Valley Bank and fees and expenses, our cash balance as of 09/30/2025 is $20.1 million. For more details regarding the term loan facility, please refer to our current report on Form 8-K filed today. Let me close with our financial guidance. Given our backlog entering the fourth quarter and anticipated fill units, we continue to expect full-year 2025 revenue to be in the range of $40 million to $42 million. While we are not providing specific 2026 guidance at this time, we want to convey that we are focused on diversifying our revenue streams in 2026, relying less on advertising-driven revenues and generating growth through our MyoConnect platform and further penetration of our O&P channel in international markets. We plan to improve operating leverage and lower the cash burn in 2026. With that financial overview, I'll turn the call back to Paul.

Thanks, Dave. Operator, we're now ready to take our attendees' questions. Thank you.

We will now begin the question and answer session. And while we're waiting for the first question, I'd like to mention that we will be attending the Craig Hallum Alpha Select Conference in person in New York City on November 18. Hope to see some of you there. Okay, operator, whenever you're ready, let's take the first question.

Yes. First question comes from Chase Knickerbocker with Craig Hallum. Please go ahead.

Good afternoon. Thanks for taking the question. So maybe just to start, could you help us quantify the scale of your U.S. O&P business at this point? So just from a domestic O&P perspective, how many units did you ship into that channel in the third quarter just to help us think about how that business is scaling?

It was about $900,000, and I must say it was roughly 30 units, but I'll get you the exact number.

No worries. That's helpful. And then maybe just as far as your new Head of Marketing goes, can you just cue us in on what kind of levers were identified as far as potential avenues for improvement in terms of reducing customer acquisition costs? I respect that you're becoming more focused on MyoConnect here, but just kind of within that direct billing channel, any levers that were initially identified as far as we need to be doing this, need to be doing this better, etcetera?

Yes. During the interview process, Chase, we were looking for people who had experience in various media: social media, television, YouTube, other channels. And so we're looking at that and doing a comprehensive review right now of, okay, how effective is our television advertising? Are we using social media the right way? What else should we be doing to again generate more leads at a lower cost per lead for qualified patients? So that's the review that's underway right now. And she started about two weeks ago.

Got it. Maybe just kind of turning to the pipeline, etcetera. There was a noticeable uptick as far as backlog drops are concerned. Can you just kind of walk us through what might be the driver there, kind of what you saw in the quarter as far as how the backlog progressed?

Yes. I think a lot of the backlog drops, I would say about 40% of them came from Germany as a result of what I think was, I don't think the backlog in terms of some of those trials that did not convert was updated, and I think there was some cleanup that went on in the third quarter. And so I think part of that higher number of backlog drops is due to that. So like I said, about 40% of those drops related to that, with the rest just normal activity.

Got it. Maybe just last one for me, Dave. Is this the right way to think about OpEx for the foreseeable future? I mean, how should we be thinking about OpEx kind of building off of Q3 levels? And then along those same lines, if you could just talk about how you guys are thinking about the time to return to positive adjusted EBITDA and kind of how you're managing the business with that in mind?

Yes. So I think in terms of the operating expenses, our plan is to, there is going to be some growth in the operating expenses. For example, we do intend to spend more on advertising, though not as much of an increase as in 2025. We are going to spend more on R&D, particularly for that randomized control trial that we're funding that I mentioned earlier. But other than that, our intention is to not grow the operating expenses as much as possible. And we want to be generating and showing that we can generate operating leverage and grow revenues faster than operating expenses. And in terms of when we get back to positive adjusted EBITDA, again, we'll provide more of an update when we give our 2026 guidance.

Understood. Thanks for the questions.

Thank you. The next question comes from Scott Henry with AGP. Please go ahead.

Thank you and good afternoon. A couple of questions on the metrics. I guess first, reimbursement or not reimbursement, but pipeline adds, they were up slightly in Q3 to Q2. Do you think you could still see big gains there, or is it going to be harder at some point, there's a saturation level? Or is it maybe it's just flattening before jumping higher again? How do you think about that pipeline add or that top of the funnel?

Well, Scott, given the size of the market opportunity, of the prevalence and a quarter million new cases just in the U.S. every year, I don't think we're near saturation. I think we've got to find better innovative ways to reach those patients. But also, I think through the O&P channel referral program, I'm expecting we're going to see more of our patient pipeline adds coming through those channels. And so I expect that's what's going to drive more growth not only this quarter but into 2026 because there are so many people coming out of these rehab hospitals and stroke clinics with a paralyzed arm. We want to make sure that they know about the MyoPro because what we found is they are more medically qualified. They pass our screening criteria because they are more recent to their stroke. We also find that they're more motivated because they might have just lost their ability to use that arm a year ago versus twenty-five years ago. So you don't have that sort of patient inertia. That's why we want to capture more patients in the prep in incidence population. I think we'll grow the pipeline, but also improve the quality of the pipeline.

Okay. All right. That's helpful. Thank you. And then when we think about Q4, you're going to have a smaller backlog entering Q4 than you did entering Q3. And typically, the quarter before you use backlog is an indicator for what we should expect in the next quarter. So I know your guidance targets growth, but if you could just kind of walk through sequential growth from Q3 to Q4, if you could just talk about how you're going to do that with a smaller backlog? It may just be other levers that are pulling, but I just want to get a better understanding from your perspective. Thank you.

Yes. Well, it's obviously going to come from fill units and from authorizations and orders that we get inside of the quarter. You're correct that the backlog is lower. But we've also been demonstrating that as we get authorizations and orders, our operations are actually able to turn them into revenue faster. And so that's what we plan on seeing, that growth in the fourth quarter coming from.

Okay. So we should expect that to continue and even accelerate, that day trippers, if you will, people that come and go in the same quarter.

I think as the authorizations and orders go up, I think that we will probably, the number of fill units that we have just in whole numbers will probably also go up as we go through time.

Okay, great. And then I guess final question, and it's somewhat strategic. It's always a little higher risk profile to take on debt when you're losing money. The question is, is this a sign that you think, I mean, obviously, you have eighteen months runway before you have to start paying it back. But do you feel based on your ability to take this debt that eighteen months from now, you could be close to breakeven? Just trying to get a sense of the decision to take debt over equity, even though I know you're not probably happy with the share price, but certainly debt has a degree of risk that comes with it.

Sure. First off, I guess, we would not have done this transaction if we didn't feel like we could pay it back. That was really the first criteria. And so, I think that also sort of says that before in the eighteen months that we, before we started having to pay this back, we would expect that we're not burning cash by the time we get to that point. That's so we're managing the business that way through continuing to grow revenues. And by holding down the growth in operating expenses and generating more incremental operating income from those additional revenues. So we feel like that we could pay it back. Obviously, that was the first criteria. And then it was the best combination of capital that was provided to us with the minimum amount of dilution. And so we've been very consistent that if we were to look for additional, we wanted to do it in a way that was the least dilutive way possible. And we feel that we accomplished that.

Okay. Thank you for that insight into the decision-making. I appreciate that. That should do it for me. Thank you for taking the question.

All right. Thanks, Scott. The next question comes from Anthony Vendetti with Maxim Group. Please go ahead.

Hi, it's Anthony. So Paul and David, in terms of the O&P clinics, how many have been trained so far? Do you have a goal in terms of the number you'd like to have by the end of '25? Or by the end of '26? And then, I was wondering if you could discuss a little more of the details of MyoConnect. What's behind that initiative and what do you hope to accomplish there? Thanks.

Yes. Hi, Anthony. So we've been training a lot of O&P clinicians, but in various stages of their certification process. For example, a couple of hundred have taken the online training program on how to evaluate a patient. And then those that have moved forward to get that patient into an evaluation, we show up in person with our clinical team to do the evaluation with them. So there's that additional training. Then they have to fit up three units in order to become fully certified. That number is growing. The good news is we've got a lot of interest among Hanger clinicians around the country. We've got the other major firms like Ottobock has a number of clinicians, O&P has its four motion clinics, and Equal, there's like 90 clinics. So we continue to do seminars on reimbursement, on clinical training, on how to do the marketing as well. So our goal is to have a couple of dozen, I would say, that are actively placing orders this year, and our goal is to continue to expand that. I think what you'll see is, I've mentioned this in previous calls, someone will do one order, see how it works out for their patients, get good outcomes, make sure they get the reimbursement check, they'll do another one, and that starts to take off from there. As far as MyoConnect, one of the assets we have is we've got a dozen field clinicians, primarily occupational therapists, who are well-versed in the MyoPro. They're in these rehab hospitals all the time, training therapists on how to work with users who get a new MyoPro. We train some 80 to 100 therapists every month, and in the process of doing so, we conduct in-service presentations, and we're seeing a growing number of clinical referrals now. And we think that will be a real source because the strategic shift that I'm looking to execute here is from one-time sort of advertising-driven orders from a patient to recurring sources of patients. So that's O&P providers in the U.S. and Germany and rehab hospitals who will hopefully provide us with a steady flow of new patient candidates. So that's the outline of the MyoConnect program.

Okay. And then just lastly, maybe more for David, but just in terms of getting to breakeven, any update on what that quarterly revenue run rate needs to be or timeline for getting there?

Well, when we did the headcount reduction earlier this year, prior to that, we kind of gave some guidance of about $17 million to $18 million of quarterly revenue was required to breakeven. I think after that headcount reduction in July, you probably shaved about $1 million a quarter off of that. So I would say around $16 million to $17 million.

Okay, great. All right, thanks. I'll hop back in the queue. Appreciate it.

The next question comes from Sean Lee with H.C. Wainwright. Please go ahead.

Hey, good afternoon, guys, and thanks for taking my questions. I just have two quick ones. First, I think you mentioned it's $1.8 million of revenue from Germany this quarter. It seems to be increasing quite well. So I was wondering if you can provide some color on that. What's behind the increase there?

Well, we've got a network of 100 O&P channel partners there that have been developed over the last several years, Sean. And in Germany, we've had very good success with the statutory health insurers so that virtually anyone in Germany who medically qualifies for the MyoPro can get access to it. We don't have to go through the same type of pre-authorization hassles that we sometimes face here by some payers. We have to appeal these and so on. So patients that are medically qualified can get a MyoPro, and that's helped drive the growth there in Germany.

I see. Thanks for that. And my last question is on the advertising spend. So do you think you've reached a new plateau now with the advertising spend following your switch to more focus on TV? Or do you expect that to go up more in Q4? And how does that impact your pipeline? How do you expect that to impact your cost per pipeline add?

Well, as I mentioned a little bit earlier, we are intending to spend more on advertising in 2026 but not at a rate of growth like we did in 2025. So the growth rate in advertising spending will be lower in 2026 versus 2025. But I think the bigger impact might be from MyoConnect and some of the efforts with the O&P channel in terms of growing the pipeline adds. And obviously, I think there's, for dollars that we invest in advertising, more pipeline adds come from that. But we're looking to increase the quality of the pipeline adds because, as Paul mentioned, people that are in the incidence population that the MyoConnect program is really targeting, those people are closer to their pre-stroke life in terms of what they remember what it was like before the stroke. And so we think that they're going to be more motivated. The quality of the pipeline should improve. And so a pipeline add overall, as the mix of patients that come from referrals and from the O&P channel increases, the conversion of those pipeline adds to revenue should increase over time. That's the intent of doing this. And we're doing MyoConnect with the people that we have today. So right now, we're not spending more for it. And so those are the reasons why we're doing it and why we think that the pipeline adds should grow, but not only that, but the quality of the adds should grow in 2026.

Okay. And that does make it a lot clearer. Thanks for that. That's all I have.

All right, Sean. Thank you.

The next question comes from Edward Wu with Ascendiant Capital. Please go ahead.

Yes. Thanks for taking my question. It looks like International Germany continues to do very well. How is the rest of your international business? And any updates on your partnership in China?

Ed, you've always been a proponent and an early spotter that Germany is going to be a really good market for us. I think we validated your thesis on that. So again, Germany is growing with a growing pipeline. We expect continued record revenues next year. Other international markets, we've just decided we're not going to spend a lot of money at this point to try to get reimbursement, which is a couple of year process there. From our last call with the China JV, they're still conducting a clinical trial to get NMPA approval. So not much progress over there, but it doesn't really cost us anything at this point. We're just regularly engaging with management of the JV.

Great. Well, thanks for the update and congratulations on Germany. And I wish you guys good luck.

Thank you, Ed. Thank you. Operator, any more questions?

No. There are no further questions. I would like to turn the conference back over to Paul Gudonis for closing remarks.

Well, thanks. Well, just to summarize our business plan going forward, we expect continued revenue growth through our direct-to-patient marketing as well as expanding O&P channels as we discussed here in the MyoConnect referral program. We're increasing market access for patients by signing additional payer contracts and engaging with the Medicare Advantage and commercial plans for coverage. We're managing our cost structure as Dave described and enhancing our manufacturing processes to demonstrate operating leverage as we scale, and we continue to innovate product development to maintain our market leadership position. Thank you all for your questions and for your interest in Myomo. We look forward to speaking to you again when we report our Q4 and full-year 2025 financial results in about four months. Have a nice evening, everyone.

Thank you. The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.