Quest Diagnostics reported a strong Q3 2025 with 13.1% revenue growth, raised full-year guidance, and highlighted broad-based demand across physician and consumer channels. Management noted back-in-network gains with Elevance, a major Fresenius partnership, and surging Alzheimer's blood test volumes. PAMA reform remains uncertain, with a $100M risk next year if no delay passes. Consolidated revenue $2.82B (+13.1% y/y), organic revenue +6.8%; adjusted EPS $2.60 (+13% y/y).
Buzzberg readRaises full-year 2025 revenue and EPS guidanceQuest Diagnostics reported a strong Q3 2025 with 13.1% revenue growth, raised full-year guidance, and highlighted broad-based demand across physician and consumer channels. Management noted back-in-network gains with Elevance, a major Fresenius partnership, and surging Alzheimer's blood test volumes. PAMA reform remains uncertain, with a $100M risk next year if no delay passes. Consolidated revenue $2.82B (+13.1% y/y), organic revenue +6.8%; adjusted EPS $2.60 (+13% y/y).Read full analysisCollapse analysis
Quest Diagnostics reported a strong Q3 2025 with 13.1% revenue growth, raised full-year guidance, and highlighted broad-based demand across physician and consumer channels. Management noted back-in-network gains with Elevance, a major Fresenius partnership, and surging Alzheimer's blood test volumes. PAMA reform remains uncertain, with a $100M risk next year if no delay passes. Consolidated revenue $2.82B (+13.1% y/y), organic revenue +6.8%; adjusted EPS $2.60 (+13% y/y).
Consumer channel growing 30-40% y/y; partnerships with Whoop, Aura, Function Health driving momentum.
Demand & capex
Demand
Bookings & conversion
Quest raised full-year guidance on broad-based demand, organic growth acceleration, and margin expansion, signaling sustained momentum.
Capex
Investment and capacity
Management raised full-year 2025 capital expenditure guidance to approximately $500 million, reflecting investments in automation, AI, and digitization, including the Project Nova order-to-cash transformation with Epic. They expect to spend $250-$310 million over six to seven years on Project Nova, which will be a mix of operating and capital expenses.
Tone · Confident
Management repeatedly highlighted strong growth, raised full-year guidance, and expressed optimism about consumer and advanced diagnostics momentum, while acknowledging headwinds like PAMA and employee health costs.
Supply-chain alpha
A1
Quest is using excess daytime lab capacity to process Fresenius dialysis tests, indicating the lab industry has idle capacity that can absorb new volume without incremental fixed costs.
“We look forward to processing these tests during periods of the day when we have open capacity, enabling us to further optimize the productivity of our labs.”
Quest's Alzheimer's blood test (AD-Detect) revenue more than doubled in Q3 following new clinical guidelines, signaling rapid market adoption and potential pressure on amyloid PET and CSF testing.
Quest has won a large enterprise agreement to serve Fresenius dialysis centers, adding revenue and utilizing excess capacity.
“We also began to roll out clinical lab testing to Fresenius Medical Care's dialysis centers, which serve about 200,000 dialysis patients annually in the U.S.”
Jim DavisPresident and Chief Executive Officer, Quest Diagnostics
… business and enterprise accounts, including functional medicine providers who utilize comprehensive laboratory testing to improve health and wellness. During the quarter, we completed our acquisition of select clinical testing assets from Fresenius Medical Care, which will enable us to offer lab testing used in dialysis delivery to independent dialysis clinics in the US. More significantly, under a separate enterprise agreement, We also began to roll out clinical lab testing to Fresenius Medical Care's dialysis centers, which serve about 200,000 dialysis patients annually in the U.S. We expect to finish scaling these services in early 2026. We look forward to processing these tests during periods of the day when we have open capacity, enabling us to further optimize the productivity of our labs. In the hospital channel, revenues grew low single digits with collaborative lab solutions driving our growth in the quarter. We offer hospitals many flexible options for accessing our leading science, innovation, and scale. These include reference testing, our co-lab solutions, outreach acquisitions, and other business relationships, all of which provide meaningful improvements in …
Hey, good morning, guys. Thanks for taking the question. Jim, maybe just on the backdrop, the utilization backdrop, it looks like it remains elevated. What are you guys seeing there and expectations into year-end? And then just a quick follow-up for Sam. maybe on the PAMA side, latest expectations, what you're hearing there, and the potential offsets you would have as we head into 26, maybe just the probability of how you're thinking about that. Thank you, guys.
Management answer
Jim DavisPresident and Chief Executive Officer, Quest Diagnostics
Yeah. Hey, thanks, Patrick. So on the utilization, as we said in the script, our raw rec volume was up 3.9%, and then organic rep per rec up 3%. So let me comment on each one of those. On the rec volume side, first, as you know, we're back in network with Elevance in some key states, Nevada, Colorado, and Virginia. And we're certainly picking up share and picking up momentum as we've progressed through the year. So you're just seeing a continuation of those volumes building in each of those states. In addition, Sentara is another health plan that we're back in network with in the Virginia area as well. goes down the coast a bit and so all of that has helped our our three-point you know aided the 3.9% organic rec growth now in addition to that you know we mentioned the strong mix on the call autoimmune testing way up cardio advanced cardio metabolic testing way up our brain health volumes more than doubled in the quarter so all of that helping both tests per rack plus test volume and And then the last thing I mentioned is our consumer business. The consumer health business, our own direct channel has been incredibly strong, growing 30% to 40% on a year-to-date basis. And then our partnerships with companies like Function Health, also helping our growth on the consumer side. In the quarter, we announced partnerships. It didn't really impact our volume in the quarter, but your comment about how do we think about things, you know, going into the fourth quarter, our partnerships with Whoop and Aura, we definitely expect that to contribute volume on the consumer health side. So I would tell you the expectations for Q4 is that the utilization levels will continue as we've seen them in Q3.
Quest is distributing Guardant's colorectal cancer screening test, expanding Guardant's reach into primary care.
“collaborations that leverage Quest's national scale in phlebotomy and connectivity to broaden access to cancer screening liquid biopsy tests, including garden health shields tests for colorectal cancer”
Jim DavisPresident and Chief Executive Officer, Quest Diagnostics
… Haystack MRD's clinical utility as a guide in making post-operative therapy decisions. We are also pleased that HPH, a major lab provider in Hamburg, recently introduced an in-house MRD test in Germany based on a license to our Haystack MRD technology. We are highly focused on delivering innovations that can identify risk of cancer and other diseases in early preventable stages. During the quarter, we announced collaborations that leverage Quest's national scale in phlebotomy and connectivity to broaden access to cancer screening liquid biopsy tests, including garden health shields tests for colorectal cancer. Turning to operational excellence, we continue to target 3% annual cost savings and productivity improvements through our Invigorate program. We are deploying innovative automation and AI technologies, including digitizing processes to improve quality, productivity, and customer and employee experiences. During the quarter, we announced Epic as our technology partner for Project Nova, our multi-year order-to-cash transformation. By deploying a suite of epic solutions, including Beaker, MyChart, and Care Everywhere, we will deliver deeper, more connected insights with …
SamExecutive Vice President and Chief Financial Officer, Quest Diagnostics
… consolidated revenues were $2.82 billion, up 13.1% versus the prior year. Consolidated organic revenues grew by 6.8%. Revenues for diagnostic information services were up 13.5% compared to the prior year, reflecting organic growth in our physician, hospital, and consumer channels, as well as recent acquisitions. Total volume measured by the number of requisitions increased 12.5% versus the third quarter of 2024, with organic volume up 3.9%. Recall, the impact of weather and the CrowdStrike global IT outage was a headwind on our volume in the third quarter last year. We estimate that our volume in the third quarter of 2025 experienced the benefit of approximately 50 basis points due to the impact from those disruptions in the same period last year. Total revenue per requisition was up 0.8% versus the prior year, as an increase in organic revenue per requisition was substantially offset by the impact of the LifeLabs acquisition, which carries a lower revenue per requisition. On an organic basis, revenue per requisition was up 3% in the quarter versus last year, driven primarily by an increase in the number of tests per requisition and test mix. Unit price reimbursement remained …
Quest's Alzheimer's blood test (AD-Detect) revenue more than doubled in Q3 following new clinical guidelines, signaling rapid market adoption and potential pressure on amyloid PET and CSF testing. — Blood-based biomarkers are displacing more expensive imaging and CSF tests, which could reduce volumes for PET tracer suppliers and CSF assay platforms.
Jim DavisPresident and Chief Executive Officer, Quest Diagnostics
… questhealth.com consumer-initiated test platform. In advanced diagnostics, we delivered double-digit revenue growth across several clinical areas of our portfolio. This includes advanced cardiometabolic and endocrine, as well as autoimmune disease testing with our analyzer autoimmune solution. Analyzer experienced strong growth as primary care physicians increasingly utilized this solution to direct high-risk patients to specialty care. In brain health, demand for our Quest AD Detect blood tests for Alzheimer's disease accelerated and more than doubled in the third quarter. New guidelines introduced in July recognized the value of blood-based biomarker testing in assessing Alzheimer's disease pathology in patients with cognitive impairment. At the same time, we continue to publish evidence on our AD Detect tests, including a study published this month that found two of our innovative panels provide confirmatory accuracy for aiding Alzheimer's diagnosis. In oncology during the quarter, we received breakthrough device designation from the FDA for our Haystack MRD test. This milestone reinforces the high caliber of our cancer monitoring innovation and opens avenues for developing …
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