v3.25.2
Revenue Recognition
 6 Months Ended
Jun. 30, 2025
Revenue from Contract with Customer [Abstract]  
Revenue Recognition Revenue Recognition
Disaggregated Revenue
The following table summarizes the Company’s disaggregated revenue by payor category:
Three months ended June 30,
20252024
GeneDx
Other1
Total
GeneDx
Other1
Total
Diagnostic test revenue:
Patients with third-party insurance$81,104 $— $81,104 $50,462 $1,590 $52,052 
Institutional customers18,380 — 18,380 16,695 — 16,695 
Self-pay patients339 — 339 692 — 692 
Total diagnostic test revenue99,823 — 99,823 67,849 1,590 69,439 
Other revenue1,961 908 2,869 1,075 — 1,075 
Total$101,784 $908 $102,692 $68,924 $1,590 $70,514 
Six months ended June 30,
20252024
GeneDx
Other1
Total
GeneDx
Other1
Total
Diagnostic test revenue:
Patients with third-party insurance$149,163 $— $149,163 $93,340 $2,551 $95,891 
Institutional customers35,984 — 35,984 33,369 — 33,369 
Self-pay patients435 — 435 1,283 — 1,283 
Total diagnostic test revenue185,582 — 185,582 127,992 2,551 130,543 
Other revenue3,317 908 4,225 2,393 — 2,393 
Total$188,899 $908 $189,807 $130,385 $2,551 $132,936 

(1)For the three and six months ended June 30, 2024, Other represents revenues associated with the Legacy Sema4 operating segment. For the three and six months ended June 30, 2025, revenues of the Fabric Genomics and Legacy Sema4 operating segments. See Note 15, “Segment Reporting” for more information.
Reassessment of Variable Consideration
Subsequent changes to the estimate of the transaction price, determined on a portfolio basis when applicable, are generally recorded as adjustments to revenue in the period of the change. The Company updates estimated variable consideration quarterly.
For the three months ended June 30, 2025 and 2024, the total change in estimate recognized, which pertains to performance obligations fulfilled in the previous year, resulted in a net increase to revenue of $5.6 million and $7.2 million, respectively. This change is due to adjustments in the estimated transaction price stemming from contractual modifications, updated information obtained from payors and patients that was previously unknown at the time those performance obligations were met, as well as potential and actual settlements with third party payors. The change in estimate also included an increase in revenue related to a partial release of a previously established payor reserve, as further disclosed in the “Certain Payor Matters” section below.
Certain Payor Matters
As noted above, third-party payors, including government programs, may decide to deny payment or seek to recoup payments for tests performed by the Company that they contend were improperly billed, not medically necessary or against their coverage determinations, or for which they believe they have otherwise overpaid, including as a result of their own error. As a result, the Company may be required to refund payments already received, and the Company’s revenues may be subject to retroactive adjustment as a result of these factors among others, including without limitation, differing interpretations of billing and coding guidance, and changes by government agencies and payors in interpretations, requirements, policies and/or “conditions of participation” in various programs. The Company processes requests for recoupment from third-party payors in the ordinary course of its business, and it is likely that the Company will continue to do so in the future. If a third-party payor denies payment for testing or recoups money from the Company in a later period, reimbursement and the associated recognition of revenue for the Company’s testing services could decline.
From time to time, the Company may have an obligation to reimburse Medicare, Medicaid, and third-party payors for overpayments regardless of fault. Settlements with third-party payors for retroactive adjustments due to audits, reviews, or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing services. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor, the Company’s historical settlement activity (if any), and the Company’s assessment of the probability a significant reversal of cumulative revenue recognized will occur when the uncertainty is subsequently resolved. Estimated settlements are adjusted in future periods as such adjustments become known (that is, if new information becomes available), or as years are settled or are no longer subject to such audits, reviews, and investigations.
As of June 30, 2025 and December 31, 2024, the Company’s third-party payor reserves were $17.6 million and $12.6 million, respectively, and were recorded in accounts payable and accrued expenses and other liabilities, respectively. Included in these reserve balances are $12.0 million in scheduled payments to settle the claims related to coverage and billing matters allegedly resulting in the overpayments by a third-party payor to Legacy Sema4 (the “Disputed Claims”), with $10.0 million due in December 2025 and $2.0 million due in June 2026.