American Shared Hospital Services Q2 revenue rises 19% to $8.4m
American Shared Hospital Services (NYSE American: AMS) has reported second-quarter 2026 revenue of $8.4 million, a 19% increase on the $7.1 million recorded in the same period last year. The San Francisco-based company, which provides stereotactic radiosurgery equipment and radiation therapy services to hospital networks in North and South America, said the result was driven primarily by volume growth across its direct patient services operations.
Direct patient services revenue rose 40% year on year to $4.9 million, with the company crediting higher procedure volumes at its Rhode Island radiation therapy centres and its facilities in Peru and Puebla, Mexico. Proton beam radiation therapy (PBRT) revenue grew 22% to $2.3 million, aided by a roughly 10% increase in treatment fractions and improved average reimbursement per treatment. International Gamma Knife revenue climbed 56% in the first half of 2026 to $2.7 million, helped by the 2025 installation of the Esprit system upgrade at the Lima, Peru site, which the company says has reduced treatment times and improved patient throughput.
Financial detail
Despite the headline revenue gains, AMS reported a net loss attributable to common shareholders of $514,000 ($0.07 per diluted share) for Q2 2026, compared with a loss of $280,000 ($0.04 per diluted share) a year earlier. The wider loss reflected $285,000 in legal costs associated with a third amendment to its credit agreement with Fifth Third Bank, and a $909,000 increase in the allowance for credit losses on Rhode Island accounts receivable pre-dating May 2025. Gross margin was $1.4 million, slightly below the $1.6 million reported in Q2 2025. Adjusted EBITDA came in at $1.3 million, down from $1.7 million in the prior-year quarter.
For the first half of 2026, total revenue rose 18% to $15.5 million. Operating cash flow reached $4.4 million, and the company ended June with $6.8 million in cash, cash equivalents and restricted cash, up from $3.7 million at end-2025.
Subsequent to the quarter close, AMS completed the Third Amendment to its credit agreement alongside a forbearance arrangement with Fifth Third Bank. The company also secured $2.0 million in subordinated financing from RCS/TIG Holdings LLC, an entity controlled by Executive Chairman Ray Stachowiak, to provide near-term liquidity while it explores longer-term capital structure alternatives.
Market context
The precision radiation oncology market is expanding, underpinned by ageing populations, rising global cancer incidence and a sustained shift toward ablative and stereotactic treatment modalities that can reduce inpatient burden. AMS operates in a niche where scale and technology access define competitive position. Larger healthcare systems and specialist oncology groups have invested heavily in linac-based stereotactic body radiotherapy and proton centres in recent years, creating a well-resourced competitive field. For a company of AMS's size, the ability to partner with hospital networks on a shared-capital model offers a degree of differentiation, though the current debt profile and reliance on insider financing will remain a point of scrutiny for investors assessing balance sheet risk. Reimbursement trends at the Centers for Medicare and Medicaid Services (CMS) for both PBRT and Gamma Knife procedures will also be a key watch item, given management's acknowledgement of reimbursement sensitivity in its safe-harbour disclosures.
Interim chief executive Craig Tagawa said the results demonstrate "the strength of our diversified radiation oncology platform" and pointed to continued momentum in direct patient services as the primary growth driver heading into the second half.