Castle Biosciences (NASDAQ:CSTL) Announces Earnings Results, Beats Expectations By $0.15 EPS

Castle Biosciences (NASDAQ:CSTL) announced its earnings results on Thursday. The company reported ($0.08) earnings per share for the quarter, beating the consensus estimate of ($0.23) by $0.15, FiscalAI reports. The company had revenue of $81.88 million during the quarter, compared to the consensus estimate of $81.19 million. Castle Biosciences had a negative net margin of 3.56% and a positive return on equity of 1.73%.

Here are the key takeaways from Castle Biosciences’ conference call:

• Castle reported Q4 revenue of $87.0 million and full-year 2025 revenue of $344.2 million, beating guidance, and guided 2026 revenue of $340–350 million (mid-to-high teens growth ex certain assets).
• DecisionDx‑Melanoma delivered 39,083 test reports (≈9% YoY), reached ~31% patient penetration with nearly 17,000 ordering clinicians and 58 peer‑reviewed publications, and Castle is preparing a de novo 510(k) submission (targeting late this year/early next) to help commercial reimbursement under state biomarker laws.
• TissueCypher test volume grew 86% to 39,014 reports in 2025, surpassed 80,000 orders to date, was highlighted in the AGA Barrett’s esophagus guideline, and management sees only ~11% patient penetration today with a long runway for further adoption.
• AdvanceAD‑Tx launched in limited access in late Nov 2025 (≈150 initial accounts) and generated ≈500 orders by mid‑Feb; Castle expects immaterial 2026 revenue with material contribution in 2027–2028 and reimbursement updates expected in H2 2026.
• Profitability pressured in 2025: net loss of $24.2 million (vs. prior‑year income), adjusted EBITDA fell to $44.0 million, and adjusted gross margin compressed partly due to loss of DecisionDx‑SCC revenue and a one‑time ~$20.1 million amortization acceleration, while operating expenses increased—offset by a strong cash position of ~$299.5 million.

Castle Biosciences Stock Performance

CSTL traded down $2.42 during midday trading on Friday, hitting $29.46. 340,764 shares of the company were exchanged, compared to its average volume of 414,262. The company’s 50 day simple moving average is $37.37 and its 200 day simple moving average is $31.06. The firm has a market capitalization of $859.97 million, a price-to-earnings ratio of -66.00 and a beta of 1.06. Castle Biosciences has a 1-year low of $14.59 and a 1-year high of $44.28. The company has a current ratio of 6.47, a quick ratio of 6.31 and a debt-to-equity ratio of 0.02.

Insider Transactions at Castle Biosciences

In related news, insider Derek J. Maetzold sold 817 shares of the firm’s stock in a transaction dated Wednesday, February 4th. The stock was sold at an average price of $37.99, for a total transaction of $31,037.83. Following the sale, the insider directly owned 83,698 shares of the company’s stock, valued at $3,179,687.02. This trade represents a 0.97% decrease in their ownership of the stock. The transaction was disclosed in a legal filing with the Securities & Exchange Commission, which is available at this hyperlink. Also, COO Kristen M. Oelschlager sold 14,888 shares of the business’s stock in a transaction that occurred on Wednesday, December 17th. The shares were sold at an average price of $39.31, for a total value of $585,247.28. Following the completion of the transaction, the chief operating officer directly owned 12,323 shares of the company’s stock, valued at $484,417.13. The trade was a 54.71% decrease in their ownership of the stock. Additional details regarding this sale are available in the official SEC disclosure. Insiders sold 29,617 shares of company stock worth $1,167,887 in the last 90 days. Company insiders own 6.50% of the company’s stock.

Institutional Investors Weigh In On Castle Biosciences

Several hedge funds have recently modified their holdings of the company. Wells Fargo & Company MN boosted its position in Castle Biosciences by 42.7% during the fourth quarter. Wells Fargo & Company MN now owns 34,212 shares of the company’s stock worth $1,331,000 after purchasing an additional 10,233 shares in the last quarter. Jump Financial LLC acquired a new position in shares of Castle Biosciences during the 2nd quarter worth approximately $446,000. Janus Henderson Group PLC raised its stake in shares of Castle Biosciences by 64.6% during the 4th quarter. Janus Henderson Group PLC now owns 15,037 shares of the company’s stock worth $585,000 after buying an additional 5,900 shares during the period. JPMorgan Chase & Co. lifted its position in shares of Castle Biosciences by 4.2% during the 3rd quarter. JPMorgan Chase & Co. now owns 27,778 shares of the company’s stock valued at $633,000 after buying an additional 1,115 shares in the last quarter. Finally, Invesco Ltd. grew its stake in Castle Biosciences by 25.4% in the 2nd quarter. Invesco Ltd. now owns 40,429 shares of the company’s stock valued at $826,000 after acquiring an additional 8,178 shares during the period. 92.60% of the stock is owned by hedge funds and other institutional investors.

Key Stories Impacting Castle Biosciences

Here are the key news stories impacting Castle Biosciences this week:

• Positive Sentiment: Q4 and full‑year results beat on revenue and test‑volume growth; Castle reported FY2025 revenue of $344M (above guidance) and core test reports rose ~37%, showing demand strength in DecisionDx‑Melanoma and TissueCypher. Castle Biosciences Reports Fourth Quarter and Full–Year 2025 Results
• Positive Sentiment: Company issued 2026 revenue guidance of $340–$350M (above the prior consensus ~$335M), signaling management expects continued top‑line momentum into 2026. Castle Biosciences outlines 2026 revenue target of $340M-$350M
• Positive Sentiment: Analyst support picked up: Robert W. Baird raised its price target to $44 and kept an Outperform rating, suggesting upside vs. the current share price and supporting investor interest. Baird raises price target
• Neutral Sentiment: Commercial development: the limited access launch of AdvanceAD‑Tx expands Castle’s addressable market in atopic dermatitis; this is strategic for longer‑term growth but early in commercialization. AdvanceAD-Tx launch coverage
• Negative Sentiment: Profitability and one‑time items weighed on the quarter: Castle reported a GAAP net loss of $24.2M for 2025, adjusted EBITDA fell to $44M from $75M in 2024, and there were amortization/one‑time adjustments tied to prior assets. Those metrics increase near‑term risk to margins and investor sentiment. Q4 & FY2025 results (profitability details)
• Negative Sentiment: Operational headwinds: the company discontinued the IDgenetix test and faced a Medicare coverage change for DecisionDx‑SCC that reduced related revenue — plus notable insider selling activity flagged by data services, both of which can sap confidence. QuiverQuant summary (discontinued test, insider activity)

Analyst Upgrades and Downgrades

Several research analysts recently weighed in on CSTL shares. BTIG Research boosted their target price on Castle Biosciences from $38.00 to $50.00 and gave the stock a “buy” rating in a research note on Friday, December 12th. Weiss Ratings reissued a “sell (d)” rating on shares of Castle Biosciences in a report on Monday, December 29th. KeyCorp restated an “overweight” rating and set a $50.00 price objective on shares of Castle Biosciences in a report on Thursday, January 29th. Lake Street Capital increased their price objective on shares of Castle Biosciences from $35.00 to $52.00 and gave the company a “buy” rating in a research report on Monday, January 12th. Finally, Guggenheim boosted their target price on shares of Castle Biosciences from $43.00 to $47.00 and gave the stock a “buy” rating in a research report on Monday, January 26th. One research analyst has rated the stock with a Strong Buy rating, seven have issued a Buy rating and one has assigned a Sell rating to the company’s stock. According to MarketBeat.com, the stock presently has a consensus rating of “Moderate Buy” and an average price target of $47.57.

Castle Biosciences Company Profile

Castle Biosciences, Inc is a molecular diagnostics company specializing in the development and commercialization of prognostic and diagnostic tests for patients with dermatologic conditions. The company’s proprietary portfolio of genomic assays is designed to improve risk assessment and guide clinical decision-making for individuals with skin cancers and other skin-related diseases. By combining genomic data with advanced statistical algorithms, Castle Biosciences seeks to provide actionable insights that help physicians tailor treatment plans and monitoring strategies.

The company’s flagship test, DecisionDx-Melanoma, evaluates the probability of metastasis in patients diagnosed with cutaneous melanoma, supporting more personalized surveillance and therapeutic approaches.