American Shared Hospital Services (ASHS) reported a total revenue of $28.1 million for the fiscal year ending December 31, 2025, reflecting a slight decrease of 0.9% compared to $28.3 million in 2024. The decline in revenue was primarily attributed to a decrease in the leasing segment, which saw a drop of $3.1 million due to the expiration of several Gamma Knife contracts and a reduction in proton beam radiation therapy (PBRT) volumes. Conversely, the direct patient services segment experienced an increase of $3 million, driven by the commencement of operations at a new radiation therapy facility in Puebla, Mexico, and the acquisition of three facilities in Rhode Island.
The company’s operational metrics showed a mixed performance. The total number of Gamma Knife procedures decreased by 13.6% to 937 in 2025, while PBRT procedures fell by 21.1% to 4,056. However, the number of LINAC procedures surged by 92% to 28,147, largely due to the newly acquired facilities. The average revenue per Gamma Knife procedure increased by 9.4% to $9,803, indicating improved reimbursement rates despite the overall decline in procedure volume.
Strategically, ASHS made significant moves in 2024, including the acquisition of a 60% interest in three radiation therapy facilities in Rhode Island, which began contributing to revenue in 2025. The company also launched a new LINAC facility in Puebla, Mexico, which started treating patients in July 2024. These expansions are part of ASHS's strategy to diversify its service offerings and enhance its market presence in the radiation therapy sector.
Financially, ASHS faced challenges with its debt obligations. As of December 31, 2025, the company reported long-term debt of $17.3 million, down from $20.2 million in the previous year. However, it also noted significant covenant breaches related to its credit agreements, raising concerns about its liquidity and ability to continue as a going concern. The company is currently in discussions with its lender, Fifth Third Bank, regarding potential waivers and extensions of its credit facilities, which are set to mature in April 2026.
Looking ahead, ASHS anticipates that its ongoing efforts to enhance operational efficiency and expand its service offerings will support revenue growth. However, the company remains cautious due to the potential impact of regulatory changes in healthcare reimbursement and the competitive landscape in the radiation therapy market. The management's focus will be on stabilizing its financial position while navigating the challenges posed by its current debt situation and market conditions.
About AMERICAN SHARED HOSPITAL SERVICES
American Shared Hospital Services (ASHS) specializes in providing advanced radiation therapy solutions, including stereotactic radiosurgery and proton beam therapy. With a focus on medical equipment leasing and direct patient services, ASHS targets cancer treatment centers and health systems. The company is expanding its footprint through acquisitions and new facilities in the U.S. and Latin America, addressing a growing market for innovative cancer care technologies.
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