Tempus AI Q1 2026 earnings preview

The bar — management's prior guide vs. sell-side consensus

Where consensus sits relative to the guide is often a stronger read on post-close direction than the absolute beat or miss. Note: Tempus does not provide quarterly guidance — only full-year. The Q1 row reflects that.

Guide source: Q4 2025 earnings 8-K, accession 0001193125-26-066931. Tempus's FY2026 guide is a point estimate (revenue ~$1.59B, adj EBITDA ~$65M), not a range — reflected in the table's "(point estimate)" label. Consensus values are pulled from public news write-ups by the refresh task; when aggregators agree within a small threshold (±1% on revenue, ±$0.01 on adj EPS) the page shows a single value, otherwise the median and full range with per-source citations.

Because Tempus does not provide quarterly guidance, the FY2026 row is the only place where a guide-vs-consensus delta is meaningful. When consensus sits above the FY guide (e.g. consensus FY revenue > $1.59B), the bar has been raised by sell-side; if the print or the call commentary fails to ratify that, the post-close move tends to be sharper than the absolute beat-or-miss number suggests. The Q1 row instead anchors expectations purely off sell-side consensus, with no management number to compare against.

Options-implied move and the implied-vs-realized history

What the options market is pricing for the post-close session, set against how big the realized 1-day moves have actually been across Tempus's post-IPO prints (the company direct-listed on June 14, 2024, so the available history is shorter than enterprise-software comps).

Tempus's post-IPO history is shorter than longer-listed peers — it covers seven prints (Q3 2024 through Q4 2025) — so the dumbbell strip is shorter and the historical implied-move data may be sparser than for an established name. Reading the dumbbell history is one of the better ways to anchor expectations for Tuesday: the asymmetry between upward and downward realized moves, and whether the market has tended to overpay or underpay for protection going in.

Post-IPO reaction history

The base rate for beat / miss / FY-guide-raise outcomes across Tempus's seven post-IPO prints (Q3 2024 → Q4 2025). Tempus IPO'd June 14, 2024 via direct listing; this is the full available history.

Reading this table for Tuesday's setup means asking which prior quarter's print combination most resembles what's expected — particularly the FY-guide-raise direction and the Insights NRR commentary the call has historically anchored on — then anchoring on that quarter's realized move. With only seven quarters of post-IPO history, the base rate is thinner than for established names; weight the Q4 2025 print (the immediately-prior quarter, with the same management team and a clearer post-Ambry comp baseline) more heavily than older quarters.

Composition watchlist — the Tempus-specific lines

Six cards covering the cuts the call will dissect: Diagnostics + Oncology volume, Hereditary post-Ambry, Data and applications, Insights NRR, named pharma partners, and adj EBITDA + FCF trajectory.

No single one of these moves the stock by itself, but the collective read — Diagnostics-volume cadence alongside Insights NRR stabilizing or re-accelerating, paired with adj EBITDA tracking the FY guide pacing — is what shapes the after-print analyst tone. The single most-watched line is Insights NRR (140% FY2024 → 126% FY2025); whether the deceleration trend continues, stabilizes, or re-accelerates is the load-bearing operating signal for the data-licensing thesis. Listen for whether management foregrounds the strongest line or hedges around the weakest.

Run-up panel — what's already happened heading in

Position, sentiment, and price action over the trailing month.

A YTD return reading sets the bar in ways that don't show up in consensus — a cold run-in lowers the bar; a hot run-in raises it. Short interest at the FINRA-mirror cadence and days-to-cover give the squeeze-risk read; healthcare-AI names with thinner float can register larger short-interest %s than enterprise-software peers, so anchor the days-to-cover number against TEM's own trailing band, not against PLTR or NOW.

Insider transactions — since the last print (2026-02-24)

Form 4 filings walked from SEC EDGAR for CIK 1717115. Lefkofsky's Class B holdings are held through Black/Blue/Gray Media LLC entities, so those LLCs may appear as the reporting entities; Class B sales carry outsized voting-power implications relative to dollar value (Class B votes 30:1).

Tempus's dual-class structure (Class A 1 vote, Class B 30 votes/share) means that a Form 4 sale of Class B shares — even a small one — can represent a meaningful shift in voting-power concentration. Watch the row notes for explicit Class B flags. Lefkofsky's Black/Blue/Gray Media LLC entities are the typical Class B reporting holders; sales by those LLCs versus open-market sales by other officers carry different signal weight.

Newsflow timeline — since the last print (2026-02-24)

Pharma-partnership announcements, lab-network expansions, FDA-related disclosures, named-customer reveals, integration milestones from Ambry. 17 entries through 2026-05-02.

Peer cross-reads — what adjacent printers said in the last two weeks

Four card categories: hyperscaler capex (the AI-demand backdrop), healthcare diagnostics (GH/EXAS/NTRA), data-licensing / life-sciences (VEEV/IQV/SDGR), and AI-platform analog (PLTR — the same-week May 4 print). Short paraphrases with citations; one read-through-to-TEM line per card.

The healthcare-diagnostics cluster is the closest direct peer set — Guardant, Exact Sciences, and Natera all sell diagnostics tests with various Oncology / Hereditary cohort exposures, and any one of them printing softly on test-volume cadence is a directly relevant read. The data-licensing peer set (Veeva, IQVIA, Schrödinger) provides the read-through to the Insights NRR and pharma-partnership lines. The PLTR cross-read should be treated with care — Palantir is enterprise software, Tempus is healthcare diagnostics + data licensing, different end markets — but the same-week timing makes it useful as a tape-tone reference.

Valuation context — forward P/S vs. peers

Forward P/S = market cap ÷ FY2026 consensus revenue. TEM at 6.1x sits in the healthcare-AI band typically priced 5-15x; the data-licensing optionality has historically pulled it richer than diagnostics-only peers.

Healthcare-AI peers typically trade 5-15x forward sales; Tempus has historically traded richer than diagnostics-only peers because the Insights data-licensing line carries software-like margins and recurring-revenue characteristics. A multiple compression scenario — where the print is fine but the multiple normalizes toward diagnostics-only peers — is the dominant valuation risk for any disappointment. Conversely, an Insights NRR re-acceleration or a third-major-pharma partnership announcement is what's required to defend (let alone expand) the current multiple.

Scenarios — bull / base / bear

Three print combinations and the qualitative reaction call for each. Anchor 1-day move ranges to the post-IPO reaction history above.

What would most surprise me?

Earnings-call agenda primer

What to listen for during the call itself — structure, analyst pressure points, and recurring management hedges. Tuesday May 5 will be the first call with the new product-line-CEO structure (Fukushima → CEO Data, Schoenherr → CEO Diagnostics) established by the February 20, 2026 restructuring.