Live Earnings: Will Tempus AI Surprise Wall Street Tonight?

Tempus AI (NASDAQ: TEM | TEM Price Prediction) reports full Q4 2025 and full-year results after the market closes, with the market already holding a preliminary revenue figure. The real question tonight is what the complete financials reveal about profitability, margins, and where management sees the business heading in 2026.

Strong Prelim, But the Story Is Still Being Written

Tempus pre-announced Q4 revenue of $367 million, an 83% year-over-year gain that beat consensus. Diagnostics led the way with $266 million in revenue, up 121% year-over-year, driven by oncology volume growing 29% and hereditary volume up 23%. Data and Applications contributed $100 million, up 25%, with the Insights segment accelerating to 68% growth.

The headline that mattered most heading into Q3 was Tempus achieving positive adjusted EBITDA for the first time, a milestone CEO Eric Lefkofsky called “a 10-year goal.” Q3 adjusted EBITDA came in at $1.5 million versus negative $21.8 million a year earlier. Management guided for the full year to be slightly positive on that metric, even absorbing integration costs from the Paige acquisition. Total contract value hit a record exceeding $1.1 billion, and net revenue retention stood at 126%, signaling strong expansion within the existing customer base.

Despite those results, TEM shares have pulled back roughly 22% since the preliminary filing on January 12, significantly underperforming the broader market. That disconnect sets up tonight’s full report as a credibility moment.

Consensus Estimates

Profitability Trajectory and 2026 Guidance Will Set the Tone

Revenue growth at Tempus is no longer the debate. The conversation has shifted to whether that growth is converting into durable financial leverage. I’ll be watching the Q4 adjusted EBITDA figure closely. Tempus turned positive in Q3 despite absorbing Paige integration costs, and management guided for the full year to land slightly positive. If Q4 shows sequential improvement, it validates the operating leverage thesis embedded in the bull case.

The net loss trajectory also matters. Q3 net loss was $80 million, wider than the $75.8 million loss a year earlier despite much higher revenue. Investors will want to see that gap narrowing as scale builds.

You should pay close attention to 2026 guidance. Lefkofsky said Tempus enters the year in “an exceptionally strong position with both of our main businesses accelerating in growth and delivering the financial leverage inherent in our platform.” That language is bullish, but the market will demand specific numbers. The foundation model is expected to produce its first versions in Q1 2026, MRD reimbursement is progressing, and xT CDx ADLT submissions are underway through 2026. Each of these represents a potential revenue catalyst that guidance should begin to quantify.

The Paige integration is another thread worth tracking. Management said the acquisition added several million dollars of expense drag in Q3. How that cost base evolves in Q4 and into 2026 will shape the margin story. Analyst consensus currently sits at 7 Buy ratings and 7 Hold ratings with an average price target of $86.71, implying meaningful upside from current levels if execution holds.

Execution Is the Only Thing That Rebuilds This Stock

Tempus has delivered exceptional top-line growth and crossed a key profitability threshold. But the stock is down roughly 18% over the past year as investors weigh the pace of loss reduction against the scale of the opportunity. Tonight’s full report needs to show that Q3’s adjusted EBITDA inflection was not a one-quarter event. Clear 2026 guidance with a credible path toward sustained profitability is what this market needs to see before sentiment can meaningfully recover.

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