Castle Biosciences Inc. reported a net revenue of $344.2 million for the fiscal year ending December 31, 2025, marking a 3.7% increase from $332.1 million in 2024. The growth was primarily driven by a significant 86.2% increase in test report volumes for its TissueCypher test, which contributed to a $52.8 million rise in revenue from non-dermatologic tests. However, this was offset by a $40.6 million decline in revenue from dermatologic tests, largely due to the loss of Medicare coverage for the DecisionDx-SCC test, which became effective on April 24, 2025. The company reported a net loss of $24.2 million for 2025, compared to a net income of $18.2 million in the previous year.
In terms of operational metrics, Castle Biosciences delivered a total of 105,053 test reports in 2025, an increase from 96,071 in 2024. The DecisionDx-Melanoma test accounted for 39,083 reports, while the DecisionDx-SCC test generated 17,294 reports. The company also launched the AdvanceAD-Tx test in November 2025, with plans for phased expansion throughout 2026. As of December 31, 2025, Castle Biosciences employed 883 full-time staff, reflecting a 16% increase from the previous year.
Strategically, Castle Biosciences made significant moves in 2025, including the acquisition of Previse, which is expected to enhance its gastrointestinal diagnostic offerings. The company also entered into a collaboration with SciBase to develop a non-invasive diagnostic test for atopic dermatitis. These initiatives align with Castle's goal to expand its product portfolio and market reach. However, the company faces challenges, including reliance on a limited number of third-party payors for revenue, with 44% of its revenue coming from Medicare.
Looking ahead, Castle Biosciences anticipates continued investment in research and development, particularly in clinical studies to support its product offerings. The company is also focused on expanding its sales and marketing efforts to increase adoption of its tests. However, uncertainties related to reimbursement policies, market conditions, and regulatory changes could impact its financial performance. The company believes its existing cash and cash equivalents, along with anticipated revenue, will be sufficient to fund operations for at least the next 12 months, but it may need to raise additional capital for future growth initiatives.
About CASTLE BIOSCIENCES INC
Castle Biosciences, Inc. is a molecular diagnostics company specializing in genomic and proteomic tests that aid clinicians in diagnosing and managing dermatologic cancers, Barrett’s esophagus, uveal melanoma, and mental health conditions. Its proprietary multi-analyte assays with algorithmic analysis provide personalized risk stratification to inform treatment decisions. The company serves primarily U.S. healthcare providers and relies on reimbursement from government and commercial payors to deliver clinically validated, evidence-based diagnostic solutions.
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