Castle Biosciences, Inc. reported a net revenue of $83.7 million for the first quarter of 2026, a decrease of 4.9% from $88.0 million in the same period of 2025. The decline was primarily attributed to a $21.9 million drop in revenues from dermatologic tests, particularly following the loss of Medicare coverage for the DecisionDx-SCC test. This was partially offset by a $17.5 million increase in revenues from non-dermatologic tests, driven by a 58% increase in test report volumes for the TissueCypher test. The company recorded a net loss of $14.5 million, a significant improvement compared to the $25.8 million loss reported in the prior year.
Operating expenses for the quarter totaled $102.1 million, down 11.9% from $115.9 million in the previous year. The reduction was largely due to a significant decrease in amortization of acquired intangible assets, which fell from $28.3 million to $2.2 million, following the discontinuation of the IDgenetix test. However, costs associated with sales, general, and administrative expenses rose by 10.7% to $64.9 million, reflecting increased personnel costs and sales-related travel expenses as the company expanded its sales force.
Castle Biosciences has seen operational growth, with a total of 26,933 test reports delivered in the first quarter of 2026, marking a 10% increase from 24,402 reports in the same quarter of 2025. The company’s dermatologic test report volume increased by 6%, while the TissueCypher test volume surged by 58%. The company also reported a headcount of 942 employees as of March 31, 2026, up from 784 a year earlier, indicating ongoing investment in its workforce to support growth.
Looking ahead, Castle Biosciences anticipates that its existing cash and cash equivalents, along with marketable investment securities totaling $197.9 million, will be sufficient to fund operations for at least the next 12 months. The company is focused on expanding its product offerings and maintaining Medicare coverage for its tests, which are critical for revenue generation. However, it acknowledges the potential impact of macroeconomic conditions on its operations and financial performance, including inflation and changes in reimbursement policies.
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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