--- title: "Tempus AI beat Q3, but $80 million of 2027 growth rides on a December 31 Medicare deadline" description: "Q3 revenue of $411.5 million beat consensus, but the quarterly letter books about $80 million of 2027 growth on a Medicare repricing that only pays if the xT conversion finishes by December 31, while the cheapest product, MRD testing, grows fastest and drags reimbursement down." publisher: "The Inference" section: "Health" published: 2026-11-06T15:27:31.916Z modified: 2026-11-06T15:27:31.916Z canonical: https://theinference.org/article/tempus-ai-beat-q3-but-80-million-of-2027-growth-rides-on-a-december-31-medicare-deadline language: en keywords: "Tempus AI, Earnings, Medicare, Oncology, Guidance" --- # Tempus AI beat Q3, but $80 million of 2027 growth rides on a December 31 Medicare deadline > Q3 revenue of $411.5 million beat consensus, but the quarterly letter books about $80 million of 2027 growth on a Medicare repricing that only pays if the xT conversion finishes by December 31, while the cheapest product, MRD testing, grows fastest and drags reimbursement down. [Tempus AI](https://theinference.org/markets/companies/tempus-ai), 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](https://www.iongenomics.bio/p/tempus-ai-q3-revenue-jumps-23-percent), 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 [1][2]. [The Inference](https://www.theinference.com/article/tempus-ai-s-first-profit-came-with-47-1-million-of-other-income-and-a-fifth-of-data-revenue-from-pathos-ai) reported [that beat and the company's first profitable quarter on November 3](https://theinference.org/article/tempus-ai-s-first-profit-came-with-47-1-million-of-other-income-and-a-fifth-of-data-revenue-from-pathos-ai) [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](https://www.apoapenews.com/articles/tempus-xt-adlt-conversion-80-million-2027-asp/). 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 [1][2]. 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]. *Chart: **MRD drags reimbursement to $1,700 a test; xF conversion could lift it toward $2,600** Bar chart comparing Medicare reimbursement per test: about $1,700 with MRD included, $1,880 excluding MRD, and an eventual $2,600 if the xF assay converts.* *Medicare reimbursement per test, USD. Q3 averages from the quarterly letter as reported; the $2,600 figure is CFO Jim Rogers' eventual estimate if the xF liquid-biopsy assay wins FDA approval and converts to ADLT. Sources: iongenomics.bio; ApoApe News. [1][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](https://finance.yahoo.com/healthcare/articles/tempus-ai-tem-said-q3-161401239.html) [3], and the acquisition of the MRD company now clears its shareholder vote November 30 with a December close [2][3]. 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](https://www.morningstar.com/news/business-wire/20261021867913/psnl-stock-notification-personalis-inc-is-being-investigated-after-the-1625-per-share-merger-deal-announced-investors-are-alerted-to-contact-bfa-law) 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 *Chart: **Tempus AI revenue kept climbing as growth decelerated** Line chart of Tempus AI total quarterly revenue from Q4 2024 through Q3 2026, rising from $200.7 million to $411.5 million.* *Total quarterly revenue, USD millions, from Tempus AI's SEC filings, Q4 2024 through Q3 2026, retrieved November 6, 2026. [6]* 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]. ## Takeaway Tempus beat Q3 with $411.5 million of revenue, but $80 million of 2027 growth only pays if the xT Medicare conversion finishes by December 31, and fast-growing MRD testing keeps pulling reimbursement down. ## Sources 1. [iongenomics.bio, "Tempus AI Q3 Revenue Jumps 23 Percent Driven by Oncology Testing", 2 November 2026](https://www.iongenomics.bio/p/tempus-ai-q3-revenue-jumps-23-percent) 2. [ApoApe News, "Tempus Expects $80 Million Oncology Pricing Gain in 2027 From xT Switch", Drew Thornley, 3 November 2026](https://www.apoapenews.com/articles/tempus-xt-adlt-conversion-80-million-2027-asp/) 3. [MarketBeat via Yahoo Finance, "What Tempus AI (TEM) Said on Its Q3 Earnings Call", 2 November 2026](https://finance.yahoo.com/healthcare/articles/tempus-ai-tem-said-q3-161401239.html) 4. [Business Wire via Morningstar, "Personalis, Inc. is being Investigated after the $16.25 per share Merger Deal Announced", 21 October 2026](https://www.morningstar.com/news/business-wire/20261021867913/psnl-stock-notification-personalis-inc-is-being-investigated-after-the-1625-per-share-merger-deal-announced-investors-are-alerted-to-contact-bfa-law) 5. [The Inference, "Tempus AI's first profit came with $47.1 million of other income and a fifth of data revenue from Pathos AI", 3 November 2026](https://www.theinference.com/article/tempus-ai-s-first-profit-came-with-47-1-million-of-other-income-and-a-fifth-of-data-revenue-from-pathos-ai) 6. [Tempus AI, quarterly figures from its SEC filings, retrieved 6 November 2026 via company_series](https://www.sec.gov/cgi-bin/browse-edgar?action=getcompany&CIK=0001717115) --- Tempus AI beat Q3, but $80 million of 2027 growth rides on a December 31 Medicare deadline — The Inference. Canonical: https://theinference.org/article/tempus-ai-beat-q3-but-80-million-of-2027-growth-rides-on-a-december-31-medicare-deadline