Nutex Health Inc. (NUTX) valuation at a glance
Nutex Health Inc. (NUTX) trades below the fair value estimate shown here. At $189.25 versus a $208.00 estimate, that is a 10% upside.
- Price
- $189.25
- Fair value estimate
- $208.00
- Upside
- +10%
- Market cap
- $1.30B
- P/S (TTM)
- 1.5×
CompaniesNUTX
NUTX
Nutex Health Inc.
HealthcareMicro HospitalsNo Surprises ActArbitrationMinority InterestsFinance LeasesSmall Float
Overview
$189.25-2.4%
Market Cap
$1.30B
SEC filings
P/E (TTM)
7.2×
SEC filings
Rev Growth YoY
-6.3%
-6.3%SEC filings
Gross Margin
51.3%
SEC filings
FCF Yield
21.2%
Calculated from SEC filings
Upside to FV
+9.9%
internal scenarios, stated multiple applied to a sta
Conviction
3/5Operating income for the six months to 30 June 2026 rose 77.5% while revenue fell 6.3%. That is not the business scaling. Share-based compensation swung from $106.4M to minus $1.0M and contract services fell $38.2M, together $145.6M of cost relief against an $88.6M rise in operating income. The company states $52.3M of the arbitration saving came from amending its arbitration vendor agreement and a CMS fee cut, and its own cash flow statement removes that $52.3M as a non-cash change in estimate. The cash is real and large, but the earnings jump is substantially an accounting true-up on a shrinking revenue line.
Research Depth
ScreeningDeep ResearchFull Model
Updated 16d ago
Quality Snowflake
Overall 55/100
Value5/5
Future0/2
Past4/4
Health3/4
Dividend0/1
Each axis scores the checks for which data is available (filled = pass, hollow = no data). Computed from the sourced metrics on this page, not a third-party rating.
Thesis
Nutex Health owns micro hospitals, small full-service emergency facilities held jointly with the physician groups that staff them, plus a smaller population health management division. Almost all of its revenue is emergency care billed out of network, and 96% of it is insured. That makes the company a creature of the No Surprises Act. Since January 2022 an insurer must pay an out-of-network emergency provider a statutory rate, and where the two sides cannot agree the amount is set by an independent dispute resolution process. Nutex arbitrates at scale through a third-party vendor, and the awards it wins are the business. Revenue went from $247.6M in 2023 to $479.9M in 2024 to $875.3M in 2025 on that mechanism. The trailing figures now look cheap on any screen, at 7.2 times attributable earnings, 3.9 times enterprise value to EBITDA and a 21.2% free cash flow yield. The half just reported complicates that. Revenue fell. Operating income rose 77.5% anyway, because two cost lines reversed, and the larger part of the arbitration saving is a retroactive true-up the company's own cash flow statement classifies as non-cash. The question is not whether the cash was earned, because it was and it is on the balance sheet. It is what this earns in a year with no reversals and a revenue line that has stopped growing.
Bull Case
Bear Case
Key Metrics
Market Cap
$1.30B
SEC filings
Enterprise Value
$1.52B
Calculated from SEC filings
Revenue (TTM)
$847M
SEC filings
P/E (TTM)
7.2×
SEC filings
Forward P/E
–
internal scenarios, stated multiple applied to a sta
P/S (TTM)
1.5×
SEC filings
P/B
3.3×
SEC filings
EV/EBITDA
3.9×
Calculated from SEC filings
PEG
–
Calculated from SEC filings
Revenue Growth
-6.3%
SEC filings
Gross Margin
51.3%
SEC filings
Operating Margin
43.0%
SEC filings
Net Margin
21.2%
SEC filings
Free Cash Flow
$274M
SEC filings
FCF Yield
21.2%
Calculated from SEC filings
Debt / Equity
0.6×
SEC filings
Current Ratio
5.0×
SEC filings
Short Interest
26.2%
Q2 2026 Form 10-Q, condensed consolidated balance sheets and statements of operations
Institutional Own.
43.9%
Q2 2026 Form 10-Q, condensed consolidated balance sheets and statements of operations
Insider Own.
29.2%
Q2 2026 Form 10-Q, condensed consolidated balance sheets and statements of operations
Shares Out.
6.8M
SEC filings
Float
4.1M
Q2 2026 Form 10-Q, condensed consolidated balance sheets and statements of operations
Valuation
Price vs Fair Value
Bear$95.90
Base$208.41
Bull$315.08
Now $189.25
Bear Case
$95.90
Revenue keeps falling, award rates compress, and the business settles at $220M of EBITDA against $333.0M on the trailing year excluding the change in estimate. The market pays 4.0 times for earnings that depend on a federal arbitration process. Enterprise value $880M, less $223.7M of claims ahead of the equity net of cash, over 6.84 million shares.
Base Case
$208.41
Revenue stabilises near the current run rate, share-based compensation normalises toward the second-quarter rate, and the guided 25% to 30% reduction in contract services holds, leaving EBITDA near $300M. That is below the $333.0M the trailing year produced once the non-cash change in estimate is removed. The market pays 5.5 times. Enterprise value $1,650M, less $223.7M, over 6.84 million shares.
Bull Case
$315.08
Arbitration volumes recover, the cheaper fee structure drops through, and EBITDA reaches $340M, slightly above the clean trailing figure. On a settled regulatory regime the market pays 7.0 times, still below the large listed hospital operators. Enterprise value $2,380M, less $223.7M, over 6.84 million shares. This case sits just above the $276.00 mean of five published analyst targets.
DCF Summary
DCF awaiting Phase 2+
Discounted cash-flow model is built once research reaches the deep-research stage.
Historical Multiples
| Year | P/E | P/S | EV/EBITDA |
|---|---|---|---|
| FY24 | – | – | – |
| FY25 | – | – | – |
| TTM · | 7.2× | 1.5× | 3.9× |
Current multiple highlighted vs trailing history.
Peer Comparison
| Ticker | Mkt Cap | P/E | P/S | EV/EBITDA | Rev Growth | Gross Mgn | Net Mgn |
|---|---|---|---|---|---|---|---|
| NUTX | $1.30B | 7.2× | 1.5× | 3.9× | -6.3% | 51.3% | 21.2% |
| THC | $21.48B | 9.6× | 0.9× | 6.7× | +3.1% | 82.8% | 9.9% |
| ARDT | $1.55B | 11.5× | 0.2× | 7.2× | +6.0% | 41.6% | 2.1% |
Financials
| Line Item | H1 2025 | H1 2026 | YoY |
|---|---|---|---|
| Total revenue The second quarter alone fell 13.6%, from $244.0M to $210.8M | $455.8M | $427.2M | -6.3% |
| Hospital division 96% of the company. Emergency care, almost all billed out of network | $440.2M | $409.4M | -7% |
| Population health management The only division growing, and it is 4% of revenue | $15.5M | $17.8M | +14.8% |
| Payroll Rose while revenue fell, on higher wages to the physician entities and bonuses | $71.1M | $84.2M | +18.3% |
| Contract services The arbitration cost line. Carries the $52.3M change in estimate | $99.8M | $61.6M | -38.2% |
| Gross profit Down, despite the arbitration relief inside it | $243.3M | $233.0M | -4.2% |
| Share-based compensation A credit rather than a charge. Fiscal 2025 charged $117.0M; the second quarter of 2026 charged $2.9M | $106.4M | ($1.0M) | n/m |
| General and administrative | $22.5M | $31.1M | +37.8% |
| Operating income $150.7M excluding the non-cash change in estimate | $114.3M | $203.0M | +77.5% |
| Net income Consolidated, before the minority | $67.0M | $159.1M | +137.6% |
| Less minority interests The physician groups' share of the joint ventures | $63.4M | $46.4M | -26.8% |
| Attributable to Nutex Diluted EPS $15.87 against $0.55. The prior half was near break-even after the minority | $3.5M | $112.6M | n/m |
| Line Item | Dec 31 2025 | Jun 30 2026 | Change |
|---|---|---|---|
| Cash and equivalents Restricted cash of $1.9M is excluded from every figure on this page | $185.6M | $205.2M | +10.6% |
| Accounts receivable Rose while revenue fell. That is the arbitration pipeline, three to five months from filing to payment | $319.4M | $351.7M | +10.1% |
| Total assets | $918.5M | $964.6M | +5% |
| Accounts payable Fell by $41.6M over the half | $45.9M | $4.3M | -90.7% |
| Accrued arbitration expenses Broadly unchanged despite the change in estimate running through the income statement | $49.7M | $49.7M | -0.2% |
| Borrowings Lines of credit plus current and long-term debt. Small, and not where the real obligations sit | $43.3M | $39.7M | -8.3% |
| Finance lease liabilities The hospital real estate. Seven times the borrowings, and inside enterprise value here | $275.9M | $276.2M | +0.1% |
| Operating lease liabilities Outside enterprise value, on the same basis every other page on this site uses | $32.2M | $31.5M | -2.3% |
| Total liabilities | $495.1M | $457.3M | -7.6% |
| Nutex shareholders' equity The accumulated deficit narrowed from $286.2M to $173.5M | $329.4M | $394.3M | +19.7% |
| Noncontrolling interests The physician groups' stake, added back in enterprise value | $94.0M | $113.0M | +20.2% |
| Line Item | H1 2025 | H1 2026 | YoY |
|---|---|---|---|
| Net income Consolidated | $67.0M | $159.1M | +137.6% |
| Share-based compensation Added back in the prior year, deducted this year. A $107.4M swing in the reconciliation alone | $106.4M | ($1.0M) | n/m |
| Non-cash effect of change in estimate The company removes the arbitration benefit here because no cash came in for it | nil | ($52.3M) | n/m |
| Operating cash flow Trailing twelve months $279.6M | $78.2M | $109.7M | +40.3% |
| Acquisitions of property and equipment Under 1% of revenue. The buildings are leased, not owned | $0.8M | $3.7M | n/m |
| Free cash flow Trailing twelve months $274.2M, a 21.2% yield on the market capitalisation | $77.4M | $106.0M | +36.9% |
Figures come from the Form 10-Q for the quarter ended 30 June 2026, filed 6 August 2026, and the Form 10-K for the year ended 31 December 2025, filed 5 March 2026. The income and cash flow tables compare the six months to 30 June 2026 with the same six months of 2025. Net income is shown both consolidated and attributable to Nutex, because the hospitals are joint ventures with physician groups and the minority takes roughly a third of the total. Source: 10-Q filed 2026-08-06 ↗
Catalysts
Aug 6 '26
Earningshigh relevance
Earnings up 77.5% on a revenue line down 6.3%
Operating income for the half was $203.0M against $114.3M while revenue fell from $455.8M to $427.2M. The gap is two cost lines. Share-based compensation swung from a $106.4M charge to a $1.0M credit and contract services fell $38.2M. The company states $52.3M of the arbitration reduction came from amending its vendor agreement and a CMS fee cut, and its cash flow statement removes that amount as a non-cash change in estimate.
Jun '26
Contracthigh relevance
The arbitration vendor agreement was amended, retroactively
The amendment to the agreement with the third-party arbitration vendor took effect 30 June 2026 and moved the fee structure to a pay-on-collected basis rather than payment due on award determination, retroactive to the original agreement's effective date. That single change contributed $38.4M of the $52.3M reduction. A further $9.6M came from a new service fee structure applying to settlements obtained from 1 July 2026.
Jun '26
Regulation
The federal arbitration fee fell from $115 to $15
The non-refundable administrative fee for the federal independent dispute resolution process reduced from $115 to $15 per party per dispute, effective 11 June 2026. That contributed $4.3M of the reduction in the half. It is the clearest example of how much of this company's cost base is set by federal agencies rather than by management, and it moved in the company's favour this time.
Q3 '26
Earningshigh relevance
The first quarter with no retroactive true-up
The third quarter is the first period after both the vendor amendment and the fee cut, with no restatement of prior accruals to carry. It is the first clean read on what the arbitration cost base actually is, and on whether the revenue decline of the first half continued. The company has said it expects roughly a 25% to 30% reduction in normalised historical contract services. That statement is testable in November.
2026-27
Regulationhigh relevance
Whatever the No Surprises Act rulemaking does next
The whole hospital division is priced by a statutory out-of-network rate and, where that is disputed, by an arbitration process whose rules, fees and claim eligibility are set by federal agencies. Those rules have been litigated every year since they took effect in January 2022. Nothing here is scheduled, which is precisely why it cannot be modelled and why a business earning a 21.2% free cash flow yield trades at 3.9 times enterprise value to EBITDA.
Risks
| Risk | Category | Severity | Probability | Impact on Thesis |
|---|---|---|---|---|
| Operating income for the half rose 77.5% while revenue fell 6.3%, and $145.6M of cost relief from two reversing lines exceeded the $88.6M rise by 1.64 times. | Earnings Quality | High | Certain | Share-based compensation went from a $106.4M charge to a $1.0M credit and contract services fell $38.2M. Neither is a sustainable source of earnings growth and one of them is a credit that cannot repeat. Any multiple struck on the trailing year is measuring a period in which the cost base moved more than the business did, in the opposite direction to sales. |
| The company's own cash flow statement removes $52.3M as a non-cash effect of a change in estimate, and $38.4M of it is a retroactive restatement of amounts already accrued. | Earnings Quality | High | Certain | The vendor agreement amendment moved fees to a pay-on-collected basis retroactive to the original agreement, so the benefit is a revision of past accruals rather than a lower cost of operating. Excluding it, operating income for the half is $150.7M rather than $203.0M and trailing EBITDA is $333.0M rather than $385.3M, moving the enterprise multiple from 3.9 times to 4.6 times. Only the $9.6M fee-structure change and the $4.3M CMS fee cut recur. |
| Revenue fell 6.3% across the half and 13.6% in the second quarter, after rising 82.4% in fiscal 2025. | Growth | High | Certain | The hospital division, 96% of the company, drove the fall. A business valued on a multiple of earnings needs those earnings to be repeatable, and the direction of the revenue line is the first test of that. Three years of near-doubling revenue have ended, and the second quarter was worse than the first, so the trend within the half also points down. |
| Substantially all hospital revenue is emergency care billed out of network and priced by the No Surprises Act, with disputes settled by a federal arbitration process. | Regulation | High | Possible | The statutory out-of-network rate, the arbitration rules, the administrative fees and the eligibility of claims are all set by federal agencies, and they have been litigated every year since the Act took effect in January 2022. The June 2026 fee cut from $115 to $15 shows how fast the machinery moves; it can move the other way on the same timetable. There is no second business of scale to absorb that, since population health management is 4% of revenue. |
| Finance lease liabilities of $276.2M are seven times the $39.7M of borrowings, and the $113.0M minority takes roughly a third of consolidated net income. | Balance Sheet | medium | Certain | A screen reading the borrowings line alone sees a net cash company. Once the finance leases carrying the hospital real estate and the minority sharing the profits are counted, the claims ahead of the equity exceed cash by $223.7M. On the earnings side the minority took $92.6M of the $272.5M earned on the trailing year, so a price to earnings ratio struck on consolidated income would understate the multiple by about half. |
| Accounts receivable of $351.7M rose $32.2M over the half while revenue fell, and it is carried at an estimate of what arbitration will award. | Revenue Quality | medium | Certain | Receivables are 41.5% of trailing revenue. The arbitration cycle runs three to five months from filing to payment, so a build is normal, but a build against falling revenue is the shape that precedes a collection problem rather than follows one. Accrued arbitration expenses of $49.7M sit on the other side and barely moved despite a $52.3M change in estimate passing through the income statement. |
| Short interest is 26.2% of a 4.14 million share float, and insiders hold 29.2% of the 6.84 million shares outstanding. | Liquidity | medium | Certain | A quarter of the tradeable stock is sold short into a genuinely contested question about what this business earns without reversals. The float is small enough that the answer, when the third quarter arrives, is unlikely to be absorbed gently in either direction. Only five analysts publish a target, and the range runs from $200.00 to $310.00. |
| The scenarios on this page rest on forward EBITDA figures that no filing states. | Data Integrity | medium | Certain | Everything historical here is transcribed from the 10-K and the 10-Q and re-derived by a numeric gate. The three scenarios are not. They apply a stated multiple to a stated EBITDA of $220M, $300M and $340M, chosen around the $333.0M the trailing year produced once the non-cash change in estimate is removed. Those three inputs are judgement, and the method is written out in each scenario so a reader who disagrees can substitute their own. |
Technical Snapshot
52-Week Range
$83.24$193.24$197.68
RSI (14)
58.5
neutral
50-Day MA
$174.99
+10.4%above
200-Day MA
$141.12
+36.9%above
Avg Vol (30d)
159K
-10%vs average
Support Levels
Resistance Levels
Technical inputs: SEC filings. closing prices, 252 sessions to the last close; average volume over the last 30 sessions
Ownership & Insider Activity
Institutional Holdersvia Q2 2026 Form 10-Q, condensed consolidated balance sheets and statements of operations
Institutional holder details unavailable
This research record does not include a holder-level table.
Insider Activity
There were 6,843,785 shares issued and outstanding at 30 June 2026, down from 7,086,670 at the year end, against a float of 4.14 million, so roughly 39% of the company does not trade. That count comes from the balance-sheet parenthetical rather than the inline caption above it, which is mislabelled in this filing. Insiders hold 29.2% and institutions 43.9% on the market data used here. Short interest is 26.2% of the float, which on this share count is a large position relative to anything that trades. The structure below the listed company matters more than the register above it: the micro hospitals are joint ventures with the physician groups that staff them, and those minority holders took $92.6M of the $272.5M of net income earned on the trailing year, leaving $179.9M attributable to Nutex. Their stake carries on the balance sheet at $113.0M and is added back in enterprise value, because revenue and EBITDA are consolidated in full.
Detailed insider transactions unavailable
This research record does not include a transaction-level table.
Peer Comparison
| Ticker | Mkt Cap | P/E | P/S | EV/EBITDA | Rev Growth | Gross Mgn | Net Mgn |
|---|---|---|---|---|---|---|---|
| NUTX | $1.30B | 7.2× | 1.5× | 3.9× | -6.3% | 51.3% | 21.2% |
| THC | $21.48B | 9.6× | 0.9× | 6.7× | +3.1% | 82.8% | 9.9% |
| ARDT | $1.55B | 11.5× | 0.2× | 7.2× | +6.0% | 41.6% | 2.1% |
Recognizable sector comparables. Source basis: SEC filings; lowest multiple in each column highlighted. Loss-making peers show no P/E.
Research Notes
2026-08-29Verified against the filed statements for both periods
Why earnings rose while sales fell
Operating income for the six months to 30 June 2026 was $203.0M against $114.3M, up $88.6M or 77.5%. Revenue over the same period was $427.2M against $455.8M, down 6.3%, and the second quarter fell 13.6%. Two cost lines explain the whole gap and more. Share-based compensation went from a $106.4M charge to a $1.0M credit, a swing of $107.4M, and contract services fell from $99.8M to $61.6M, a further $38.2M. That $38.2M is the movement in the reported line, which is a different figure from the $38.4M pay-on-collected component of the arbitration saving described below. Together that is $145.6M of relief against an $88.6M rise, which is 1.64 times. The difference is everything else getting worse: gross profit fell 4.2%, payroll rose 18.3% while revenue fell, and general and administrative expense rose 37.8%.
2026-08-29Q2 2026 Form 10-Q, hospital division and cash flow statement
The part of the arbitration saving that will not repeat
The company decomposes the $52.3M reduction in arbitration cost itself. The amendment to its vendor agreement moved fees to a pay-on-collected basis rather than payable on award determination, retroactive to the original agreement's effective date, contributing $38.4M. That component is measured against the arbitration cost the company would otherwise have booked, which is why it is slightly larger than the $38.2M the reported contract services line actually moved. A separate change to the service fee structure on settlements obtained from 1 July 2026 contributed $9.6M. The federal administrative fee falling from $115 to $15 per party per dispute on 11 June 2026 contributed $4.3M. Only the last two describe a business that is cheaper to run from here. The largest piece is a revision of amounts already accrued. The cash flow statement settles the character of it by removing the full $52.3M as a non-cash effect of a change in estimate. The company's own forward statement is that it expects roughly a 25% to 30% reduction in normalised historical contract services, which is a real improvement and a much smaller number than the half-year benefit implies.
2026-08-29Q2 2026 Form 10-Q, balance sheet
How enterprise value is struck with joint ventures and leased hospitals
Two items make the usual net debt calculation wrong here. The hospitals are owned jointly with physician groups and consolidated in full, so the $113.0M minority is added back, on the same basis this site uses elsewhere. And the real estate sits under finance leases of $276.2M against borrowings of only $39.7M, so a debt figure taken from the borrowings line understates the claim on the business by a factor of seven. Enterprise value here is the market capitalisation of $1,295.2M plus the minority, plus $39.7M of borrowings, plus $276.2M of finance leases, less $205.2M of cash, giving $1,518.8M. Operating leases of $31.5M are excluded, as on every other page. Restricted cash of $1.9M is excluded because it is not available to an owner.
2026-08-29Recomputed from the 10-K and the 10-Q
Which earnings figure the multiple is struck on
Consolidated net income for the trailing twelve months to 30 June 2026 was $272.5M, of which the minority took $92.6M, leaving $179.9M attributable to Nutex. That is 34.0% going to holders who are not shareholders of the listed company. The price to earnings ratio of 7.2 times on this page uses the attributable figure. Struck on consolidated income it would be 4.8 times, which would be wrong, and it is the shape of error a screen makes on any consolidated joint venture operator. Trailing revenue is $846.7M, operating income $364.3M and free cash flow $274.2M, all computed as fiscal 2025 less the six months to June 2025 plus the six months to June 2026.
Sources
Nutex Health Inc. valuation questions
Is Nutex Health Inc. (NUTX) stock undervalued?
Against the fair value estimate shown on this page, Nutex Health Inc. trades below: $189.25 today versus a $208.00 estimate, about +10%. The methodology and per-scenario sources are set out in the Valuation section. Treat it as research, not advice, and do your own homework.
What is Nutex Health Inc.'s fair value?
The fair value estimate shown for NUTX is $208.00. Its valuation scenarios span bear $95.90, base $208.41, bull $315.08. See the Valuation section for the basis of each.
What is Nutex Health Inc.'s market cap?
Nutex Health Inc. (NUTX) has a market capitalization (its market value, often searched as "net worth") of $1.30B, and an enterprise value of $1.52B.
What is the bull and bear case for NUTX?
Valuation scenarios: bull $315.08, base $208.41, bear $95.90. Each reflects a distinct set of assumptions; the drivers and sources are detailed in the Valuation section above.