Paysign (NASDAQ:PAYS) reported what executives described as the strongest start to a year in the company’s history, with first-quarter 2026 revenue rising 50.8% year over year to $28 million and profitability expanding sharply as its patient affordability business became its largest revenue contributor.
President and CEO Mark Newcomer said on the company’s earnings call that net income increased 110% to $5.4 million, while adjusted EBITDA rose 113% to $10.6 million. He also highlighted a 1,040-basis-point improvement in operating margin, which he said demonstrated “the operating leverage inherent in our business as we scale across healthcare and financial ecosystems.”
CFO Jeff Baker said revenue exceeded the high end of the company’s prior guidance range of $27 million to $27.5 million. Operating margin came in at 23.8%, above the guided range of 20% to 22%, and net margin was 19.4%, above the top end of the company’s 17% to 19% outlook.
Patient affordability business overtakes plasma
Paysign’s pharma industry revenue, which includes its patient affordability programs, increased 81.9% year over year to $15.7 million. Baker said the growth was driven by 45 net pharma patient affordability programs launched over the past 12 months, along with increases in monthly management fees, setup fees, claim processing fees and other services such as dynamic business rules and customer service contact center support.
Processed claims increased approximately 49% compared with the first quarter of 2025. Baker said pharma surpassed plasma as Paysign’s largest revenue contributor for the first time during the quarter, calling it “a milestone that reflects the strategic direction we have been executing against.”
Newcomer said the patient affordability business delivered more than $540 million in financial assistance to patients during the quarter, up from approximately $320 million in the first quarter of last year. He said the increase reflected both a larger number of patients served and the company’s expanding role in supporting access to high-cost branded therapies.
Paysign launched four new patient affordability programs in the first quarter, bringing total active programs to 135 at quarter-end. Baker said that as of the call, the company had 141 active programs and expected to exit the second quarter with 147 to 150 active programs.
During the question-and-answer session, Matthew Turner, Paysign’s President of Patient Affordability Services, said the company’s pipeline was roughly evenly split between new clients and additional programs from existing clients. Turner said the company had the systems and staffing approach needed to support growth, adding that its technology partners are accustomed to higher claim volumes.
Plasma revenue grows despite center closures
Paysign’s plasma donor compensation business generated $11.7 million in first-quarter revenue, up 25% from $9.4 million in the year-earlier period. Baker said average monthly revenue per center increased to $6,671 from $6,517, and average loads per center rose year over year for the first time since the industry inventory correction that began in 2024.
The company ended the quarter with 573 plasma centers, up 89 from a year earlier but down 22 from the end of 2025. Newcomer said some low-performing centers were sold to collectors that do not use Paysign’s services or were closed. Baker said one customer sold centers to a competing provider, and those centers had contributed approximately $650,000 in 2025 revenue while averaging less than $3,500 per month in revenue, below the corporate average.
Paysign expects its active plasma center count to decline to 555 to 560 in the second quarter after a customer closed 19 underperforming centers in May. Executives said they do not expect a financial impact from the closures because cardholders typically transition to nearby centers.
Newcomer also discussed Paysign’s software-as-a-service opportunities in plasma and blood collection. He said the company made progress at the International Plasma Protein Congress in Milan, including discussions with plasma collection companies and device manufacturers about direct integration with Paysign’s platform. He said such integration could reduce manual steps, lower the risk of human error and ease implementation for collection centers.
Margins expand as revenue mix shifts
Gross profit margin increased to 65% from 62.9% in the first quarter of 2025. Baker attributed the improvement to a greater mix of pharma revenue, which carries higher gross margins than the plasma business.
Total operating expenses rose 25.5% to $11.6 million, well below the company’s revenue growth rate. Selling, general and administrative expenses increased 20.5% to $8.9 million, including $1.3 million of stock-based compensation. Depreciation and amortization increased by $835,000, primarily tied to intangible assets from the Gamma acquisition and capitalized software development costs.
Baker said Paysign converted approximately $9.4 million in incremental revenue into $4.2 million in operating income. Income before taxes rose to $7.5 million from $3.3 million a year earlier. Net income was $5.4 million, or $0.09 per fully diluted share, compared with $2.6 million, or $0.05 per fully diluted share, in the prior-year period.
Adjusted EBITDA was $10.6 million, or $0.17 per fully diluted share, up from $5 million, or $0.09 per fully diluted share, in the first quarter of 2025. Adjusted EBITDA margin expanded to 37.8% from 26.7%.
Guidance maintained, with confidence in upper end
Paysign maintained its full-year 2026 outlook, though Baker said the company is increasingly confident in its ability to achieve the upper end of its guidance ranges. The company continues to expect:
- Revenue of $106.5 million to $110.5 million, representing 30% to 35% year-over-year growth.
- Gross profit margins of 60% to 62%.
- Net income of $13 million to $16 million, or $0.21 to $0.26 per diluted share.
- Adjusted EBITDA of $30 million to $33 million, or $0.49 to $0.53 per diluted share.
Baker noted that both major businesses have seasonal patterns. Pharma revenue is typically highest in the first quarter as patient affordability claims peak with annual insurance deductible resets, then moderates through the rest of the year. Plasma revenue tends to be softest in the first quarter and build as donor activity normalizes after tax refund season.
The company ended the quarter with $20.5 million in unrestricted cash and no bank debt. In response to an analyst question about capital allocation, Baker said Paysign has no cash obligations beyond $6 million remaining in payments related to Gamma, to be paid annually over the next three March anniversary dates. He said the company would continue holding cash while evaluating potential uses, including acquisitions or returns to shareholders. Baker also said there were no share repurchases during the quarter.
Newcomer closed the call by saying the quarter represented “a meaningful inflection point” for the company, citing record results, growth in patient affordability and continued opportunities in plasma and related software solutions.
About Paysign (NASDAQ:PAYS)
Paysign, Inc (NASDAQ:PAYS) is a U.S.-based financial technology company specializing in prepaid payment solutions. Through its cloud-based platform, the company enables corporations, government agencies and payroll providers to issue and manage stored-value cards, digital wallets and disbursement programs. Paysign's offerings span gift and incentive cards, payroll and earned-wage access cards, government benefit distribution, tax refund solutions and health savings account disbursements.
The company's flagship Paysign Experience Platform provides configurable card programs with real-time transaction reporting, fraud monitoring and regulatory compliance tools.
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