American Shared Hospital Services (NYSE American: AMS), a leading provider of stereotactic radiosurgery equipment and advanced radiation therapy cancer treatment services, announced financial results for the first quarter ended March 31, 2026, showing a 15.9% increase in total revenue to $7.1 million compared to $6.1 million in the same period last year. The growth was primarily fueled by a 30.2% rise in direct patient services revenue, which reached $4.1 million, up from $3.1 million in the prior year quarter, driven by higher patient volumes at the company's three Rhode Island radiation therapy centers and its Puebla, Mexico facility.
Gross margin improved significantly, increasing 36.7% to $1.3 million, or 18.2% of revenue, compared to $0.9 million, or 15.4%, in the first quarter of 2025. The margin expansion was attributed to higher overall revenue and improved utilization across treatment centers, which offset higher operating costs associated with the direct patient services segment. Operating loss narrowed to $(0.9) million from $(1.3) million a year ago, while net loss attributable to the company remained flat at $(0.6) million. Adjusted EBITDA increased 18.4% to $1.1 million, up from $0.9 million in the prior year period.
Operationally, Gamma Knife procedures increased 10.1% year-over-year to 229, and proton beam radiation therapy (PBRT) treatments rose 20.7% to 1,003. The Rhode Island centers continued to ramp up utilization, and the Puebla center sustained strong growth due to improved reimbursement and operational ramp-up. Leasing revenue remained stable at $3.0 million, reflecting the impact of prior Gamma Knife agreement expirations partially offset by improved procedure volumes at upgraded sites.
Craig Tagawa, Interim Chief Executive Officer, stated, "We are encouraged by our performance in the first quarter of 2026, which reflects continued momentum in our direct patient care services segment and improved utilization across our treatment centers. Revenue growth of approximately 16% year-over-year was driven by strong contributions from our Rhode Island and Puebla radiation therapy centers, as well as growth in proton therapy volumes which is continuing into the second quarter." Executive Chairman Ray Stachowiak added, "We continue to execute on our strategy of expanding our direct patient care footprint while strengthening our clinical capabilities and partnerships. Growth across our LINAC and proton therapy platforms reflects increasing demand for advanced radiation therapy services."
Chief Financial Officer Scott Frech noted, "Our first quarter performance highlights the strength of our operating model, as higher treatment volumes translated into improved margins and a significant reduction in operating loss. As utilization continues to ramp up across our network, we expect to drive further margin expansion and increased profitability." The company ended the quarter with cash, cash equivalents, and restricted cash of $5.2 million, up from $3.7 million at December 31, 2025, driven by improved operating performance and working capital timing. Long-term debt decreased to $16.8 million from $17.3 million. Shareholders' equity stood at $23.5 million.
Management continues to engage in constructive discussions with its lender regarding a potential extension of debt obligations and remains focused on optimizing its capital structure to support future growth. The company will hold a conference call today at 12:00 pm ET, accessible via dial-in at 1-844-413-3972 (domestic) or 1-412-317-5776 (international), with a webcast available on the company's website at www.ashs.com or directly at this link.
This press release contains forward-looking statements regarding the company's expected growth and expansion of its Gamma Knife, proton therapy, and direct patient care services businesses, subject to risks including economic conditions, debt covenant compliance, variability of financial results, and changes in CMS reimbursement rates. Adjusted EBITDA is a non-GAAP financial measure defined as net loss before interest, taxes, depreciation, amortization, and stock-based compensation, used by management to evaluate period-to-period comparisons.
