Tempus AI beat Q3, but $80 million of 2027 growth rides on a December 31 Medicare deadline

Tempus AI▲+6.94% — Tempus AI, up 6.94 percent today, the Chicago cancer-diagnostics and health-data company, beat its third quarter: revenue of $411.5 million, up 23% year over year, against a $409.3 million consensus↗, with the net loss cut to $14.9 million from $80 million a year ago and operating cash flow turning positive at $9.2 million ¹². The Inference↗ reported that beat and the company's first profitable quarter on November 3 ⁵. What is new is a number tucked into the quarterly letter CFO Jim Rogers published alongside the November 2 results: about $80 million of next year's oncology growth is booked on a Medicare price change with a December 31 deadline, not on demand ².

The rate event hiding inside the beat

Oncology revenue grew 28% to $172.6 million, but test volume grew 32%, on about 101,500 tests ². Revenue trailed units by four points because the fastest-growing product, minimal residual disease (MRD) testing, which looks for traces of cancer left after treatment and carries a lower price, pulled average reimbursement down to roughly $1,700 a test; strip MRD out and it rose to $1,880 from $1,850 the quarter before ².

Hereditary cancer testing ran $111.3 million on just 2% volume growth, "a bit slower than we had expected," Rogers wrote, with daily order requisitions up 13% in September as the recovery evidence ².

The $80 million with a deadline

The fix is regulatory arithmetic. Tempus is moving the last of its xT solid-tumor book onto the FDA-approved advanced diagnostic laboratory test (ADLT) version of the assay, a designation that under the Protecting Access to Medicare Act carries its own Medicare rate set from the test's market price↗. The conversion must finish by December 31; the better price takes effect January 1 ².

It is worth about $80 million of 2027 oncology average selling price, roughly 5% of the raised $1.60 to $1.61 billion revenue guidance ¹². If the pending FDA approval for xF, Tempus' liquid-biopsy assay, lands, Rogers puts eventual gains at about $750 a test, lifting comprehensive genomic profiling reimbursement toward $2,600 ².

December brings a second lever and a lawsuit cloud

Tempus has been the exclusive distributor of Personalis' NeXT tumor-informed MRD assay since 2023↗ ³, and the acquisition of the MRD company now clears its shareholder vote November 30 with a December close ²³.

That removes the roughly $400 a test Tempus pays Personalis even as the acquired lab's sales arrive, a netting effect Rogers flagged for anyone modeling 2027 ². The deal carries friction Tempus does not control: the plaintiff firm Bleichmar Fonti & Auld is investigating↗ whether Tempus' prior stake in Personalis, 12.5% of the stock as of March 2026, and the $16.25 per share price meet Delaware's fiduciary-duty standards ⁴.

Growth is slowing just as the price lever matters most

Quarterly revenue growth has slowed from 89.6% in mid-2025 to 23.1% now, even as records fall ⁶. That makes the $80 million repricing the fulcrum: bulls count it as locked 2027 growth; bears see a rate event that only pays if the conversion closes on time while the cheapest product grows fastest ⁶. Watch three dates: the xT conversion finishing by December 31, the Personalis vote on November 30, and the Q4 print showing whether reimbursement mix improves or MRD eats the price first ⁶.