Neuronetics, Inc. (STIM): Business Model Canvas [Dec-2025 Updated]

Honestly, trying to map out Neuronetics, Inc.'s business after the Greenbrook acquisition can feel like navigating a maze, but after two decades analyzing these plays, I can simplify it for you. We're looking at a hybrid model now: selling the NeuroStar device while also running over 95 owned TMS treatment centers, which drives a significant portion of their expected \$147 million to \$150 million in total worldwide revenue for fiscal 2025. This vertical integration is key, but it pressures margins down to the 47% to 49% range, which is something we need to watch closely. If you want the full, no-nonsense breakdown of how they make money, who their customers are, and where the costs are hitting hardest based on their latest 2025 guidance, dive into the nine blocks below.

Neuronetics, Inc. (STIM) - Canvas Business Model: Key Partnerships

You're looking at how Neuronetics, Inc. (STIM) structures its external relationships to deliver its NeuroStar Advanced Therapy, and the numbers here show a mix of strategic clinical alignment and critical financing support.

The agreement with Elite DNA Behavioral Health is a cornerstone, established as an exclusive three-year deal where Neuronetics, Inc. (STIM) is the sole provider of NeuroStar devices across Elite DNA's 30+ locations in Florida. This partnership, which began with a pilot launch in the fourth quarter of 2025, also leverages the Greenbrook platform to deliver fee-based operational and patient-support services, including PHQ-10 processing and scheduling, with plans for expansion in 2026.

Financially, the relationship with Perceptive Credit Holdings IV, LP is key for immediate liquidity. In August 2025, Neuronetics, Inc. (STIM) drew a Tranche 2A term loan of $10.0 million under an amendment to its credit agreement. This move also secured covenant relief, reducing the minimum cash/liquidity requirement to $2 million through September 30, 2026. As part of this, Perceptive received a warrant for 225,000 common shares.

Coverage from Third-Party Payors is vital for patient access. Following FDA clearance for adolescent use in 2024, coverage for adolescent TMS has expanded. Major insurers like Cigna (via Evernorth Health Services), Humana, and Aetna already provide coverage for patients aged 15+. Furthermore, TRICARE West (TriWest) expanded its coverage to adolescents aged 15+ effective November 12, 2025, immediately impacting beneficiaries in 26 states.

The Better Me Provider (BMP) Practices network is designed to enhance operational efficiency for users of the NeuroStar system. This network is structured around clinics committed to rigorous standards.

Here's a breakdown of the key metrics associated with these relationships:

The expanding payer landscape is best summarized by the specific coverage wins:

• Evernorth Health Services (Cigna) covering adolescents 15+ with MDD.
• Humana and Aetna covering adolescents 15+ with MDD.
• TRICARE West coverage for ages 15+ effective November 12, 2025.
• Estimated 4.3 million U.S. adolescents aged 15-21 affected by major depression.

Neuronetics, Inc. (STIM) - Canvas Business Model: Key Activities

Neuronetics, Inc. focuses its key activities on the technology platform, the clinical expansion, and the integrated delivery network following the Greenbrook TMS acquisition.

Manufacturing and distributing the NeuroStar Advanced Therapy System.

The activity involves producing and shipping the NeuroStar Advanced Therapy System units to customers. The system shipment volumes for the later part of 2024 and through the first three quarters of 2025 reflect this operational focus.

The company also tracks the cumulative patient treatment volume, a key output of system distribution and use. As of the third quarter of 2025, Neuronetics, Inc. achieved a milestone of over 229,429 global patients treated, with 8.2 million treatment sessions delivered.

Operating and managing the Greenbrook TMS clinic network (over 95 locations).

This activity centers on the direct delivery of NeuroStar Advanced Therapy through the acquired clinic footprint. The transaction, effective December 9, 2024, integrated Greenbrook's network of over 95 treatment clinics across the United States. Prior to the acquisition, Greenbrook operated 101 facilities across 18 states.

The financial contribution from this network is a core part of the current operations:

• U.S. Greenbrook clinic revenue for Q1 2025 was $18.7 million.
• U.S. Greenbrook clinic revenue for Q2 2025 was $23.0 million.
• U.S. Greenbrook clinic revenue for Q3 2025 was $21.8 million, representing 25% growth on an adjusted pro forma basis versus Q3 2024.

Driving integration and realizing over $22 million in annualized cost synergies.

A critical activity post-acquisition was realizing operational efficiencies. Neuronetics, Inc. identified over $22 million in expected annualized cost synergies. By March 2025, actions to realize over $21 million of this target were fully executed.

The breakdown of the total expected annualized cost savings of $22.6 million includes:

• NNI RIF/Spend Reductions: $16.2 million (Annualized).
• Greenbrook Clinics Reductions: $5.1 million (Annualized).
• Additional Reductions: $1.3 million (Annualized) expected in the first half of 2025.

Over 90% of the identified synergies were reported as fully implemented as of January 2025.

Clinical research and regulatory clearance for new indications like OCD and adolescent MDD.

Neuronetics, Inc. continues research to expand the use cases for NeuroStar Advanced Therapy. The system is cleared by the U.S. Food and Drug Administration (FDA) for several indications:

• Adults with Major Depressive Disorder (MDD).
• As an adjunct for adults with Obsessive-Compulsive Disorder (OCD).
• As an adjunct for adults with anxious depression.
• As a first line adjunct for the treatment of MDD in adolescent patients aged 15-21.

The adolescent MDD clearance, received in March 2024, increased the total addressable market for MDD by approximately 35% to 29.3 million patients. Real-world data from the TrakStar database supported this clearance, showing 78% of adolescent patients achieved clinically meaningful improvement. Further data published in Q2 2025, drawing from over 1,200 patients aged 12-21, showed nearly 70% experienced clinically meaningful improvement.

Neuronetics, Inc. (STIM) - Canvas Business Model: Key Resources

You're looking at the hard assets that make Neuronetics, Inc. a leader in neuromodulation, and honestly, the numbers here tell a clear story of scale, especially after the Greenbrook TMS Inc. acquisition.

NeuroStar Advanced Therapy System: Patented, FDA-cleared Transcranial Magnetic Stimulation (TMS) technology.

The core technology is the NeuroStar Advanced Therapy System, which is FDA-cleared. You should note its clearance for adolescent Major Depressive Disorder (MDD) in March 2024, covering ages 15-21 as a first-line adjunct therapy. This is a significant regulatory moat. Financially, the system sales themselves contributed $3.5 million in revenue during the third quarter of 2025, with 40 systems shipped in that period. The average selling price (ASP) for the system was strong in Q2 2025, hitting over $85,000, which was the highest ASP in the last five years.

Greenbrook TMS Clinic Network: Physical infrastructure of over 95 owned treatment centers.

The physical footprint, anchored by the Greenbrook acquisition which closed on December 9, 2024, provides immediate scale. At the time of acquisition, the network comprised over 95 treatment clinics across the United States, though Greenbrook previously operated 101 facilities. This network is now a primary revenue driver. Here's a quick look at the clinic revenue contribution through the first three quarters of 2025:

This clinic revenue stream is what drove the massive year-over-year growth, like the 84% total revenue increase in Q1 2025.

Intellectual Property: Patents protecting the core TMS device and treatment protocols.

Neuronetics, Inc. relies on its intellectual property protection for the NeuroStar Advanced Therapy System. While the exact number of active patents isn't explicitly stated in the latest filings, the company explicitly lists maintaining this protection as a key factor in its outlook. The technology is considered to be supported by the largest clinical data set of any competing TMS system, which itself acts as a form of proprietary asset.

Clinical Data Set: Largest TMS data set with over 7.6 million treatments delivered.

The depth of real-world evidence is a massive, non-physical resource. As of the second quarter of 2025, the company had achieved a milestone of 7.6 million treatment sessions delivered. By the end of the third quarter of 2025, this number had grown further to 8.2 million treatment sessions delivered to over 229,429 global patients. This data backs the system's efficacy claims, including an 83% response rate from one real-world outcomes study.

You can see the scale of the treatment volume through these key operational metrics:

• Global Patients Treated (as of Q3 2025): over 229,429
• Total Treatment Sessions (as of Q3 2025): 8.2 million
• Insurance Coverage: Major providers covering adolescents aged 15+ including Cigna's Evernorth, Humana, and Aetna
• NeuroStar is covered by Medicare and Tricare, representing access to 300 million people through over 95 major U.S. private insurers

Finance: draft 13-week cash view by Friday.

Neuronetics, Inc. (STIM) - Canvas Business Model: Value Propositions

Non-Invasive Treatment: A non-drug, non-systemic option for Major Depressive Disorder (MDD).

You are offering a therapy that avoids systemic drug exposure for patients. As of late 2025, Neuronetics, Inc. has supported a massive patient base with this approach. The company achieved a milestone of over 229,429 global patients treated with 8.2 million treatment sessions as of September 30, 2025. To be fair, the NeuroStar Advanced Therapy System for MDD in adults had already delivered more than 6.9 million treatments as of January 2025.

Expanded Indications: FDA-cleared for MDD in adults, OCD, and adolescents aged 15-21.

The clearance for adolescent MDD treatment, received in March 2024, was a significant expansion. This specific clearance increased the total addressable market for MDD by approximately 35%, bringing the total to 29.3 million patients. Furthermore, you secured a major payer win supporting access: New York State Medicaid expanded coverage for TMS Therapy, including NeuroStar Advanced Therapy, to treat MDD, affecting over 5 million members statewide starting October 1, 2025.

The scope of indications covered includes:

• Major Depressive Disorder (MDD) in adults
• Obsessive-Compulsive Disorder (OCD)
• Adolescent MDD (ages 15-21)

Vertically Integrated Model: Combines device technology with direct service delivery through owned clinics.

This integration means Neuronetics, Inc. captures revenue from both the capital equipment sale/leasing side and the recurring treatment service side. Looking at the third quarter of 2025, the combined entity generated total worldwide revenue of $37.3 million. The clinic operations, driven by the Greenbrook acquisition, formed the largest component of this revenue base.

Here's the quick math on the revenue mix for Q3 2025:

The clinic revenue growth of 25% on an adjusted pro forma basis shows the strength of the direct service delivery channel in that quarter. Still, the overall gross margin for Q3 2025 settled at 45.9%, down from 75.6% in Q3 2024, primarily due to the inclusion of the clinic business mix.

Clinical Efficacy: Backed by the largest real-world clinical data set in the TMS space.

The clinical foundation rests on the TrakStar® data set, which is explicitly cited as the largest real-world outcomes database in TMS. This database provides the evidence base for expanding indications and payer acceptance. For instance, data from this TrakStar database supported the FDA clearance for adolescents, showing that 78% of adolescent patients treated with NeuroStar achieved clinically meaningful improvement in their depression severity.

You're building a reputation on data, not just device sales. The company continues to invest in research using this resource, including presenting analyses comparing NeuroStar's Figure-8 coil against competitors' coils.

Finance: draft 13-week cash view by Friday.

Neuronetics, Inc. (STIM) - Canvas Business Model: Customer Relationships

You're looking at how Neuronetics, Inc. manages its connections with the different groups it serves-from the clinics buying the systems to the patients getting the therapy. It's a multi-pronged approach, blending direct sales with service-based partnerships, especially after integrating Greenbrook TMS Inc. in late 2024.

Dedicated Sales and Support

This relationship pillar focuses on the direct sale of the NeuroStar Advanced Therapy System to purchasers, which requires robust clinical hand-holding to ensure proper adoption and utilization. The efficacy of this direct sales channel is reflected in the system shipment volume, though this channel is now strategically balanced against the high-volume clinic partnerships. For the third quarter of 2025, Neuronetics, Inc. shipped 40 systems to customers. This resulted in $3.5 million in U.S. NeuroStar Advanced Therapy System revenue for the quarter. Overall, the company has reached a milestone of over 229,429 global patients treated with 8.2 million treatment sessions delivered as of the end of Q3 2025. For general inquiries or support related to the system, the Customer Service Center number is 877-600-7555.

Better Me Provider Program

The Better Me Provider (BMP) program is designed to offer high-touch support and embed operational best practices directly within partner clinics that purchase the NeuroStar system. This program, which saw its national launch in July 2024, aims to speed up patient onboarding. As of the guidance provided in January 2025, the program had over 350 active sites and over 125 more committed to joining. The reported benefits for participating practices are significant, showing results like up to 3 times faster 24-hour follow-ups and a 2.5x reduction in time from initial patient interest to motor threshold determination. This structure helps Neuronetics, Inc. scale its quality standards across a broader network of independent providers.

Fee-Based Services

Neuronetics, Inc. is actively using its Greenbrook platform to offer fee-based operational and patient-support services, moving beyond just selling the device. A prime example is the exclusive three-year agreement with Elite DNA Behavioral Health, which commenced with a pilot launch in Q4 2025. Under this deal, Neuronetics, Inc. serves as the sole provider of NeuroStar TMS devices across Elite DNA's 30+ locations. The service component involves Neuronetics, Inc. assisting Elite DNA with administrative and clinical functions through a subsidiary, including:

• PHQ-10 assessments
• TMS consultations
• Patient scheduling

This arrangement operationalizes a strategic value derived from the Greenbrook acquisition, creating a scalable model for servicing large partners.

Direct Patient Interaction

The ownership of Greenbrook clinics allows Neuronetics, Inc. to manage patient relationships directly, offering a fully integrated care experience. This segment is a major revenue driver, reflecting direct patient interaction for therapy delivery. For the third quarter of 2025, U.S. Greenbrook clinic revenue reached $21.8 million. This figure represents a 25% growth on an adjusted pro forma basis compared to the third quarter of 2024. As of June 2025 data, the Greenbrook network, which operates across the United States, had provided more than 1.8 million treatments to over 55,000 patients struggling with depression.

Here's a quick look at how the key relationship channels contributed financially and operationally in Q3 2025:

Finance: draft 13-week cash view by Friday.

Neuronetics, Inc. (STIM) - Canvas Business Model: Channels

You're looking at how Neuronetics, Inc. gets its NeuroStar systems and therapy access into the hands of psychiatrists and patients across the US and beyond. It's a multi-pronged approach combining direct sales, owned clinics, and partnerships. Honestly, the integration of Greenbrook TMS has fundamentally changed this part of the model.

Direct Sales Force: Selling NeuroStar systems to psychiatrists and hospitals in the U.S.

Neuronetics, Inc. relies on its commercial organization to place the NeuroStar Advanced Therapy System directly with healthcare providers. This channel focuses on selling the capital equipment itself. For instance, in the second quarter of 2025, the Company shipped a total of 41 systems. The average selling price per system (ASP) in that quarter was over $85,000, which was the highest ASP in the past 5 years. This direct sales effort supports both independent practices and the company's own clinic network.

Here's a look at system sales and associated revenue for context:

Owned Clinic Network: Over 95 Greenbrook TMS treatment centers providing direct patient care.

This channel represents a significant shift, as Neuronetics, Inc. now operates the Greenbrook TMS Inc. network. As of the Greenbrook acquisition effective December 9, 2024, this network includes over 95 company-operated treatment centers across the United States. This provides a direct-to-patient delivery mechanism for both NeuroStar TMS and SPRAVATO® treatments. The revenue generated here is substantial; for the third quarter of 2025, U.S. clinic revenue reached $21.8 million. For the first quarter of 2025, that U.S. clinic revenue was $18.7 million. It's a major component of the overall revenue picture now.

Partnered Clinic Network: The Better Me Provider network across 49 states.

Neuronetics, Inc. is actively executing growth initiatives around its partnered channel, specifically mentioning the rollout of the Better Me Provider Program. This program is designed to enhance patient care and accessibility through external providers. While the exact number of states covered as of late 2025 isn't explicitly confirmed in the latest filings I have access to, the company is focused on the successful roll-out of this program. The company also notes that NeuroStar Advanced Therapy is FDA cleared for use in adolescents aged 15-21 with MDD, expanding the addressable market by an estimated 35%, which benefits all provider networks.

• Better Me Provider Program execution is a key 2025 priority.
• FDA clearance for adolescent MDD expands partner market reach.
• The program aims to institute the buy-and-bill model for providers.

International Distributors: Selling systems and treatment sessions outside the U.S.

The international segment contributes to the overall revenue base, though it is smaller than the U.S. operations. For the third quarter of 2025, international revenue showed strong growth, increasing 73% over the third quarter of 2024. This indicates that the distributor network for selling systems and treatment sessions outside the U.S. is expanding its contribution. For comparison, total U.S. revenue in Q3 2025 increased by 102% over Q3 2024, highlighting the relative scale, but the international growth rate is notable.

Finance: draft 13-week cash view by Friday.

Neuronetics, Inc. (STIM) - Canvas Business Model: Customer Segments

You're looking at the core groups Neuronetics, Inc. (STIM) serves as of late 2025, a picture heavily shaped by the Greenbrook TMS acquisition and new indications. These segments drive both capital equipment sales and recurring treatment revenue.

Psychiatrists and Mental Health Practices: Clinics purchasing the NeuroStar system (capital equipment).

This segment is the direct buyer of the NeuroStar Advanced Therapy System. The purchase decision is driven by the need for a non-invasive, non-drug alternative for patients who haven't responded to standard medication. The average selling price (ASP) for these systems is a key metric here; for the three months ended June 30, 2025, the ASP was over $85,000, which was the highest ASP in the past 5 years. System shipments fluctuate, with 41 systems shipped in Q2 2025 and 40 systems shipped in Q3 2025. This group is also targeted by the Better Me Provider program, which aims to improve site efficiency, with participating practices showing up to 3 times faster 24-hour follow-ups.

Adult Patients with MDD/OCD: Individuals who have failed to achieve satisfactory improvement from prior medication.

These are the end-users of the NeuroStar therapy. The system is indicated for Major Depressive Disorder (MDD) adults who failed prior medication, and as an adjunct for Obsessive-Compulsive Disorder (OCD). The sheer volume of use underscores this segment's importance; NeuroStar Advanced Therapy has seen more than 7.4 million treatments delivered historically. The revenue generated from these treatments is significant, with U.S. treatment session revenue hitting $10.8 million in Q2 2025. Furthermore, the Greenbrook clinic network, now part of Neuronetics, has provided over 1.8 million treatments to more than 55,000 patients struggling with depression.

Adolescent Patients (15-21): New, growing segment for MDD treatment.

This represents a major expansion opportunity following FDA clearance in March 2024 for NeuroStar as the first and only TMS treatment for adolescents with depression. This clearance expanded Neuronetics' total addressable market (TAM) for MDD by approximately 35%, reaching 29.3 million patients. By late 2025, TRICARE West expanded NeuroStar coverage to include adolescents aged 15+, validating this segment's growing clinical and payer acceptance. Real-world data supporting this group showed 78% of adolescent patients achieved clinically meaningful improvement.

Large Behavioral Health Networks: Strategic partners like Elite DNA Behavioral Health.

Neuronetics is actively pursuing strategic partnerships to scale access, exemplified by the exclusive three-year agreement with Elite DNA Behavioral Health, one of Florida's largest networks. Elite DNA operates across 30+ locations. This collaboration, which began with a pilot launch in Q4 2025, positions Neuronetics as the sole provider of TMS devices across those sites. This model leverages the Greenbrook platform to provide fee-based operational and patient-support services, like PHQ-10 processing and scheduling, which is a direct operationalization of a strategic value from the Greenbrook acquisition.

Here's a quick look at how the financial performance reflects the mixed revenue streams from these customer segments through the first three quarters of 2025:

The shift in revenue mix, driven by the clinic segment (Greenbrook/Elite DNA model), has compressed the gross margin to 46.6% in Q2 2025, down from 74.0% in Q2 2024. Still, the company expects to realize over $22 million in annualized cost synergies.

You should track the system ASP and the growth in clinic-based revenue, as that's where the partnership strategy is showing up in the numbers. Finance: draft 13-week cash view by Friday.

Neuronetics, Inc. (STIM) - Canvas Business Model: Cost Structure

You're looking at the costs Neuronetics, Inc. incurs to run its vertically integrated business, especially after bringing the Greenbrook clinic operations in-house. This structure is heavily influenced by the service component now included.

Cost of Goods Sold (COGS) is significantly impacted by the Greenbrook clinic business. The inclusion of these service costs is the primary driver behind the revised gross margin expectation for the full fiscal year 2025, which is now guided to be between 47% and 49%. To give you a sense of the clinic's contribution, U.S. Greenbrook clinic revenue in the third quarter of 2025 was $21.8 million, but the resulting gross margin for the entire company in that quarter was 45.9%, down from 75.6% in the third quarter of 2024, clearly showing the high cost of services relative to the system sales.

Operating Expenses for the full year 2025 are expected to be in the range of $100 million to $105 million. This is a revision from earlier guidance, reflecting the combined operational structure. For context, the total operating expenses in the third quarter of 2025 were $24.4 million.

Here's a look at the components of operating expenses, using the latest available quarterly data to show where the spending is going:

• The inclusion of Greenbrook's general and administrative expenses in Q3 2025 was $6.1 million.
• Sales and marketing expenses for the three months ended March 31, 2025, were $11.999 million.
• R&D expenses for the three months ended March 31, 2025, were $1.616 million.

Sales and Marketing Costs cover the direct sales force supporting the NeuroStar system and patient awareness campaigns. The company is actively managing these costs, as evidenced by savings noted in general, administrative, sales, and marketing expenses during the third quarter of 2025, which partially offset the increase from Greenbrook's G&A.

R&D and Regulatory Costs represent the investment Neuronetics, Inc. is making to improve its device and pursue new indications. For the first quarter of 2025, Research and Development spending was $1.616 million.

You can see the quarterly expense snapshot from Q1 2025 below, which helps map out the operating cost base:

Finance: draft 13-week cash view by Friday.

Neuronetics, Inc. (STIM) - Canvas Business Model: Revenue Streams

You're looking at how Neuronetics, Inc. (STIM) actually brings in the money, which is a mix of direct service delivery and capital equipment sales, especially after integrating Greenbrook TMS Inc. The revenue streams are clearly segmented, which helps in understanding the business mix.

The core of the revenue comes from two main areas: the clinic operations and the NeuroStar system itself. For the third quarter of 2025, total worldwide revenue hit $37.3 million. This total revenue reflects the combined performance following the December 2024 acquisition.

Here's a breakdown of the key components making up that top line:

• U.S. Clinic Revenue from Greenbrook operations was $21.8 million in Q3 2025.
• U.S. NeuroStar Advanced Therapy System revenue was $3.5 million in Q3 2025.
• U.S. treatment session revenue was $10.5 million in Q3 2025.

The recurring revenue from disposable components used per session is a vital part of the model. For the second quarter of 2025, this Treatment Session Revenue was $10.8 million. This contrasts with the $10.5 million seen in the third quarter of 2025, which management noted was affected by customer inventory patterns in 2024.

When you look at the capital equipment side, the NeuroStar System Sales, the average selling price (ASP) was over $85,000 in the second quarter of 2025, marking the highest ASP in five years. In that same Q2 2025 period, the company shipped 41 systems, while Q3 2025 saw 40 systems shipped.

You need to keep an eye on the full-year expectation, as guidance was recently adjusted. Here's the quick math on the forward-looking expectation:

The full-year 2025 guidance for total worldwide revenue is now expected to fall between $147 million and $150 million. This is a slight revision from earlier projections, reflecting the current business mix. Finance: draft 13-week cash view by Friday.