v3.26.1
Revenue
 6 Months Ended
Jun. 30, 2026
Revenue from Contract with Customer [Abstract]  
Revenue Revenue
The Company disaggregates revenue from contracts with customers into types of services or products, consistent with the Company's reportable segments, as follows (in thousands):
Three Months Ended June 30,Six Months Ended June 30,
2026202520262025
Hospital division revenue$201,852 $236,302 $409,422 $440,249 
Population health management division revenue8,900 7,683 17,815 15,525 
Total revenue$210,752 $243,985 $427,237 $455,774 
Hospital division revenue. We receive payment for facility services rendered by us from federal agencies, private insurance carriers, and patients. The Physician LLCs receive payment for doctor services from these same sources. On average, greater than 99% of our net patient service revenue is paid by insurers and other non-patient third parties. The remaining revenue is paid by our patients in the form of copays, deductibles and self-payment. We generally operate as an out-of-network provider and, as such, do not have negotiated reimbursement rates with insurance companies.
The following tables present the allocation of the estimated transaction price with the patient among the primary patient classification of insurance coverage:
Three Months Ended June 30,Six Months Ended June 30,
2026202520262025
Insurance96%97%97%96%
Self-pay2%1%1%2%
Workers' compensation1%1%1%1%
Medicare/Medicaid1%1%1%1%
Total100%100%100%100%
The No Surprises Act (“NSA”) is a federal law that took effect January 1, 2022, to protect consumers from most instances of “surprise” balance billing. With respect to the Company, the NSA limits the amount an insured patient will pay for emergency services furnished by an out-of-network provider. The NSA addresses the payment of these out-of-network providers by group health plans or health insurance issuers (collectively, “insurers”). In particular, the NSA requires insurers to reimburse out-of-network providers at a statutorily calculated “out-of-network rate.” In states without an all-payor model agreement or specified state law, the out-of-network rate is either the amount agreed to by the insurer and the out-of-network provider or an amount determined through an IDR process.
Under the NSA, insurers must issue an initial payment or notice of denial of payment to a provider within thirty days after the provider submits a bill for an out-of-network service. If the provider disagrees with the insurer’s determination, the provider may initiate a thirty-business day period of open negotiation with the insurer over the claim. If the parties cannot resolve the dispute through negotiation, the parties may then proceed to the IDR process.
Effective May 1, 2024, we engaged with a third-party IDR vendor, HaloMD, to further support all our out of network claims and determine which claims would be beneficial to arbitrate (see Management's Arbitration process discussion under Part I. Item 2). The IDR process can take up to three to five months to receive payments. To facilitate the dispute arbitration process, the Company incurred fees payable to the Centers for Medicare and Medicaid Services (“CMS”), the organizations that arbitrate the payment amount between the plan and providers known as independent dispute resolution entities (“IDRE”), and commission and fees to the third-party IDR vendor. IDRE fee payments represent refundable payments if arbitrations are successful. Therefore, these payments are reported as prepaid and other current assets in the unaudited condensed consolidated balance sheets. The unsuccessful portion of the IDRE fee payments is written off to contract services expense in the unaudited condensed consolidated statements of operations. Prepaid expenses related to IDRE fees were $11.5 million and $20.9 million as of June 30, 2026 and December 31, 2025, respectively. Accounts payable to the third-party IDR vendor was $0.0 million and $37.7 million as of June 30, 2026 and December 31, 2025, respectively. Total accrued arbitration expenses were $49.7 million and $49.7 million as of June 30, 2026 and December 31, 2025, respectively.
HaloMD contract amendment, CMS fee reduction and resulting change in estimate. Effective June 30, 2026, the Company amended its Payment Dispute Resolution Services Agreement with HaloMD, L.L.C. (the “Agreement”), dated as of May 1, 2024, which supports the Company’s IDR process for certain out-of-network claims. Among other changes, the amendment transitioned the applicable fee payment structure to a pay-on-collected basis, rather than payment due upon award determination, retroactive to the effective date of the original Agreement, and amended the service fee structure applicable to various federal and state net settlement amounts obtained on or after July 1, 2026. Pursuant to the Agreement, the Company may perform dispute resolution services in-house or through the engagement of another third-party vendor or service provider with respect to certain future facilities. In addition, on June 4, 2026, CMS and other federal agencies reduced the non-refundable administrative fee for the federal IDR process from $115 to $15 per party per dispute, effective June 11, 2026. The Company accounted for these impacts as a change in estimate in accordance with ASC 250 and recognized the effects prospectively in the period of change and future periods. The effect of these changes for the three and six months ended June 30, 2026 is reflected as a reduction to contract services expense of $52.3 million in the unaudited condensed consolidated statements of operations. Additionally, as of June 30, 2026, this amount resulted in a corresponding reduction to accounts payable and a reduction to accrued arbitration expenses in the unaudited condensed consolidated balance sheets. This change increased net income and net income attributable to Nutex Health Inc. by $43.0 million and $25.0 million for both the three and six months ended June 30, 2026. Net income attributable to noncontrolling interest increased by $18.0 million for both the three and six months ended June 30, 2026. From a per-basic and per-diluted share basis, the increases were $3.64 and $3.56 for the three months ended June 30, 2026, and $3.61 and $3.52 for the six months ended June 30, 2026.