Built by Grok 4.6 HighQuest Diagnostics reports third-quarter 2026 results before the open on Thursday, October 22, 2026. Prepared September 24, 2026. The quarter ending September 30 has not been reported. The call is 8:30 a.m. Eastern. Last reported quarter is Q2 2026, released July 23, 2026. Quest's fiscal year is the calendar year.
DGX | Earnings Preview
| Q3 company guide | Not guided · cadence only: Q3 steps down from Q2 | FY2026 still in force | $11.95–$12.05B revenue · $11.05–$11.25 adj. EPS |
| FMP vs that range | Revenue on the $12.00B mid · EPS $11.19, upper half | What the call is about | Base volume near 4%, 2H margin, and 2027 CLFS dollars |
Q3 2026 has not printed. The baseline is Q2 2026, compared with Q2 2025, not with Q1. Net revenue was $3,043 million, +10.2% versus $2,761 million. Organic revenue growth was +10.0%, +480 bps versus +5.2% a year earlier. Adjusted diluted EPS was $3.12, +19.1% versus $2.62. Diagnostic Information Services, which is the company, was $2,978 million.
The organic step-up is real and it is mostly two relationships. From +5.2% in Q2 2025 the organic rate went to +6.8%, paused 40 bps at +6.4% in Q4 2025, then re-accelerated to +9.0% and +10.0%. Corewell and Fresenius are classified as organic. Volume excluding them was only +3.8% then +4.0%, +20 bps. Revenue per requisition excluding that mix improved from +2.5% to +3.0%, +50 bps. Reported revenue per requisition went the other way, from −1.3% to −2.8%, −150 bps, because those books carry a lower revenue per requisition. One plus the other on the ex-partnership split is roughly 7% base growth. That 7% is what the second half has to do. Another 10% organic quarter would be ahead of the guide.
Margins are the line that is not confirming the revenue story. Q2 adjusted operating margin was 16.5%, −40 bps versus 16.9%. Q1 had been +10 bps. First-half adjusted operating income of $447 million plus $502 million on $5,938 million of revenue is about 16.0%, versus about 16.1% a year earlier, roughly −13 bps. Full-year 2025 adjusted operating margin was 15.9%. A full-year margin that expands is therefore a second-half statement. Sam Samad still expects it. He has not put a basis-point number on it.
What the street is underwriting. Quest does not guide the quarter. FMP, pulled September 24, has Q3 revenue at $3,042.7 million, +8.1% versus $2,816 million, and adjusted EPS at $2.87, +10.4% versus $2.60. That revenue rate is about 210 bps slower than Q2's +10.2%. It is inside the second half implied by the full-year range (+6.9% to +8.7%), near the top of that band, not above the year. FMP full-year revenue of $12.007 billion is on the $12.00 billion midpoint. FMP full-year adjusted EPS of $11.19 is in the upper half of $11.05–$11.25, about $0.06 under the high end. Q3 plus Q4 street numbers add up to the midpoint-implied second half. There is no leftover gap between the standing guide and the street.
Watch items
- Guidance, not a quarterly bogey. The July 23 range is still the wide, pre-tightening version: $11.95 billion–$12.05 billion and $11.05–$11.25. Two raises are already in. Last year the informative guide was the one they tightened on the Q3 call. A third raise on October 22 requires the quarter, or the Q4 exit, to clear a street number that already equals the midpoint. A reaffirmation after twelve straight adjusted-EPS beats would be the soft version of "in line."
- Margin, not tariffs. On the year-ago call, tariff cost was described as absorbed, with contracts on about 80% of supply spend and China exposure under 1% of a roughly $2 billion supply bill. That is not the Q3 swing factor. The second-half costs inside the guide are Project Nova, still about −$0.25 of EPS for the year but with more of the spend now in the second half, and fuel, about a $10 million headwind sitting in the second half. Q3's margin compare of 16.3% is easier than Q2's 16.9%. If margin is down again, the expansion sentence is what breaks, not the volume story.
- The base, not the headline. Hold ex-Corewell/Fresenius volume near +4.0% and ex-mix revenue per requisition near +3.0%. The partnership lap is a Q4 event. ACA exchange subsidies remain a ~30 bp full-year revenue headwind, heavier in the second half, and management refused to take that assumption down after a flattish Q2.
- 2027 CLFS, which does not hit this P&L. On September 21 CMS posted preliminary 2027 Clinical Laboratory Fee Schedule rates. Cuts are capped at 15% in each of 2027, 2028, and 2029 and take effect January 1, 2027. Comments are due October 21, the day before the print. Before the file, management framed a worst case a bit above $100 million if every affected test took the full 15%, with an offset of less than half. Quest has not published a revised company dollar. FMP's FY2027 revenue growth of about +4.7% is not that bridge.
The beat habit is intact and the sandbag is not. Revenue and adjusted EPS beat FMP in 12 of 12 quarters through Q2 2026, and the EPS surprise has widened. Q2's +10.6% included about $0.10 from a tax-contingency resolution that does not repeat. Ex that item the beat was still about +7.1%. Revenue surprises have clustered near +2% to +3%. A beat is the base rate. Copying the last EPS surprise forward is not.
The only IR-confirmed diagnostic print before this release is Danaher on the morning of October 21 (Cepheid and Beckman). Labcorp is after Quest on every date checked. Abbott's October 21 slot is an FMP row only.
Quest guides the year, not the quarter. Nothing filed after the July 23 release has revised the range. Daloopa's 2026Q3 document index was empty in the Phase 2 pull. September conference appearances restated the July bridge and did not print a new range. Classification: conservative versus Quest's own record, and in line with today's street. The sandbag is gone. Operating-margin expansion is the aggressive line.
The standing range, issued July 23:
| Metric | Low | Mid | High | YoY at mid | FMP | Vs mid |
|---|---|---|---|---|---|---|
| FY2026 net revenue | $11.95B | $12.00B | $12.05B | +8.7% | $12.007B | +0.06%. On the mid. Inside the range. |
| Revenue growth | +8.3% | +8.7% | +9.2% | vs $11,035M | +8.8% | In line. No prospective M&A in the bar. |
| FY2026 adj. diluted EPS | $11.05 | $11.15 | $11.25 | +13.2% | $11.19 | +0.4%. Upper half. Not through the high. |
| FY2026 reported diluted EPS | $9.97 | $10.07 | $10.17 | +15.1% | n/a | Do not put FMP $11.19 on this line. FMP matches adjusted. |
| Cash from operations | ~$1.8B | ~$1.8B | ~$1.8B | below 2025 | n/a | Vs $1,886M in FY2025. Raised only $50M. |
| Capex | $550M | $550M | $550M | above 2025 | n/a | Unchanged since the initial guide. FY2025 outflow $527M. |
| Adj. operating margin | Not Guided | Expand | Not Guided | vs 15.9% | n/a | Aggressive. H1 is about −13 bps. No bps were given. |
How the range got here. From the initial guide to the standing guide, the revenue low is up $250 million and adjusted EPS is up $0.55 at both ends. Capex never moved.
| Metric | Initial, Q4 2025 | Raised, Q1 2026 | Standing, Q2 2026 |
|---|---|---|---|
| Revenue | $11.70B–$11.82B | $11.78B–$11.90B | $11.95B–$12.05B |
| Revenue growth | 6.0%–7.1% | 6.8%–7.8% | 8.3%–9.2% |
| Adj. diluted EPS | $10.50–$10.70 | $10.63–$10.83 | $11.05–$11.25 |
| Reported diluted EPS | $9.45–$9.65 | $9.58–$9.78 | $9.97–$10.17 |
| Cash from operations | $1.75B | $1.75B | $1.80B |
| Capex | $550M | $550M | $550M |
Implied second half is arithmetic, not a company disclosure. First-half revenue is $2,895 million plus $3,043 million, or $5,938 million, +9.7% versus $5,413 million a year earlier. The full-year range leaves $6.012–$6.112 billion for the second half, +6.9% to +8.7% versus second-half 2025 of $5,622 million. The guide embeds a deceleration of roughly 100 to 280 bps from the first half to the second. FMP Q3 plus Q4 revenue is $6,049 million, about $13 million (0.2%) under the midpoint-implied $6,062 million.
First-half adjusted EPS is $2.50 plus $3.12, or $5.62, including the ~$0.10 tax item. The full-year adjusted range leaves $5.43–$5.63 for the second half, midpoint $5.53, +10.2% versus $5.02 in the second half of 2025. FMP's $2.87 plus $2.68 is $5.55, within about $0.02 of that midpoint. The $0.10 sits in the first half. It should not be added again to the second half.
Width is the remaining sandbag. The July range is $100 million wide on revenue and $0.20 wide on adjusted EPS. The October 2025 range, at the same point last year, had already been narrowed to $40 million and $0.08. In both 2024 and 2025 Quest raised through the year, tightened on the Q3 call, and then finished a hair above that tight range. Beating the February guide is the process. It is not new information.
Eight reported quarters. Columns are periods. Q3 2026 is not on this grid because it has not been reported. Growth rates are versus the year-ago quarter.
| Metric | Q3 2024 | Q4 2024 | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 |
|---|---|---|---|---|---|---|---|---|
| Net revenue ($M) | 2,488 | 2,621 | 2,652 | 2,761 | 2,816 | 2,806 | 2,895 | 3,043 |
| Revenue YoY | +8.4% | +14.6% | +12.1% | +15.2% | +13.1% | +7.1% | +9.2% | +10.2% |
| Organic revenue growth | +4.2% | +5.0% | +2.5% | +5.2% | +6.8% | +6.4% | +9.0% | +10.0% |
| Organic volume YoY | +0.5% | +0.6% | −0.9% | +2.1% | +3.9% | +7.9% | +10.8% | +13.0% |
| Volume ex Corewell / Fresenius | — | — | — | — | — | — | +3.8% | +4.0% |
| Rev / requisition YoY | +3.3% | +0.2% | +0.3% | −0.4% | +0.8% | −0.1% | −1.3% | −2.8% |
| Rev / req ex partnership mix | — | — | — | — | — | — | +2.5% | +3.0% |
| Adj. diluted EPS | $2.30 | $2.23 | $2.21 | $2.62 | $2.60 | $2.42 | $2.50 | $3.12 |
| Adj. EPS YoY | +3.6% | +3.7% | +8.3% | +11.5% | +13.0% | +8.5% | +13.1% | +19.1% |
| Adj. operating margin | 15.5% | 15.6% | 15.3% | 16.9% | 16.3% | 15.3% | 15.4% | 16.5% |
| Adj. margin YoY | — | — | — | — | +80 bps | −30 bps | +10 bps | −40 bps |
Organic volume at +13.0% is not the run-rate. The +4.0% ex-partnership row is. Reported revenue per requisition has decelerated for four straight comparable quarters, from +0.8% in Q3 2025 to −2.8% in Q2 2026, and that decline is mix. Annual anchors, so the quarterly rate has a base: FY2025 revenue was $11,035 million, +11.8% versus FY2024 $9,872 million. FY2025 adjusted EPS was $9.85 versus $8.93. FY2025 organic growth was 5.3%. FY2025 adjusted operating margin was 15.9% versus 15.6%, +30 bps. The 2026 guide of +8.3% to +9.2% is a slower reported rate than FY2025's +11.8% only because last year still had LifeLabs in it. There is no separate 2026 organic range. With no prospective M&A in the guide, 8.3–9.2% is effectively the organic bar, more than double the 3.5–4.0% organic range they were willing to print at this point last year.
Current quarter — Q3 2026
Not guided on every row. Consensus is FMP for the quarter ending September 30. Internal is n/a. Percent change is consensus versus Q3 2025.
| Metric | Q3 2025 | Guide | FMP consensus | YoY | Read |
|---|---|---|---|---|---|
| Net revenue | $2,816M | Not Guided | $3,042.7M | +8.1% | ~210 bps slower than Q2's +10.2%. Inside the implied H2 band, near the top. |
| Adj. diluted EPS | $2.60 | Not Guided | $2.87 | +10.4% | Seasonal slice of the $11.15 midpoint. Step down from Q2's $3.12. Low $2.84 / high $2.92. |
| DIS revenue | $2,755M | Not Guided | n/a | — | No street line. This is the P&L. |
| Organic revenue growth | +6.8% | Not Guided | n/a | — | Q2 was +10.0%. Another 10% would be ahead of the H2 math. |
| Volume ex partnerships | Not tagged | Not Guided | n/a | — | Hold near Q2's +4.0%. A slip under that tightens the FY low end. |
| Rev / req ex mix | Not tagged | Flat unit price, year | n/a | — | Hold near +3%. Reported rev/req staying negative is the base case, not a miss. |
| Adj. operating margin | 16.3% | Not Guided | n/a | — | Easier compare than Q2's 16.9%. Expansion vs this quarter is the sentence not yet earned. |
| EBITDA (FMP definition) | n/a | Not Guided | $543.3M | — | Not mapped to a Daloopa EBITDA actual. Do not treat it as Quest's margin bridge. |
FMP Q3 revenue low is $3,002.7 million and the high is $3,092.8 million. EPS low is $2.84 and the high is $2.92. After a consensus Q3, the FY revenue low still leaves about $2.97 billion for Q4 (+5.8% versus $2,806 million) and the FY high leaves about $3.07 billion (+9.4%). A repeat of the recent ~2% revenue beat would still fit under the high end.
FQ+1 — Q4 2026
Quest will not issue a Q4 range on this call. These are FMP figures versus Q4 2025, not an implied split the company gave. The collaboration lap, the Elevance anniversary, and the heavier ACA drag all land here.
| Metric | Q4 2025 | Guide | FMP | YoY | Read |
|---|---|---|---|---|---|
| Net revenue | $2,806M | Not Guided | $3,006.6M | +7.1% | Only ~100 bps below street Q3. Mild for a quarter management flagged as the lap. |
| Adj. diluted EPS | $2.42 | Not Guided | $2.68 | +10.7% | Growth holds near +11% because Q4 2025 margin of 15.3% is the soft quarter. |
| Organic revenue growth | +6.4% | Not Guided | n/a | — | This is when Corewell and Fresenius are lapped. Organic volume was +7.9%. |
| Adj. operating margin | 15.3% | Not Guided | n/a | — | Fresenius was described as reaching the company-average margin by Q4. |
FY guide in force, and the year after
FY2026 is the guide this print will confirm or move. FY2027 is not guided. FMP's year ending December 31, 2027 is revenue of $12.574 billion and EPS of $12.07, about +4.7% and +7.8% versus FMP's own FY2026 averages. Those are street numbers. The consumer "20% to 30%" remark is not an FY2027 guide. Do not describe +4.7% as a measured PAMA case. It also has to absorb the partnership lap.
| Metric | FY2025 actual | FY2026 guide mid | FMP FY2026 | FMP FY2027 |
|---|---|---|---|---|
| Net revenue | $11,035M | $12.00B | $12.007B | $12.574B |
| Revenue growth | +11.8% | +8.7% | +8.8% | +4.7% vs FMP FY2026 |
| Adj. diluted EPS | $9.85 | $11.15 | $11.19 | $12.07 |
| Adj. EPS growth | +10.3% | +13.2% | +13.6% | +7.8% vs FMP FY2026 |
| Organic revenue | +5.3% | Not Guided | n/a | Not Guided |
| EBITDA (FMP) | n/a | Not Guided | $2.498B | $2.594B |
Other items that sit under the July guide and were not walked back in September: Corewell still about $250 million of 2026 revenue at a low-single-digit margin, moving toward mid-single-digit. Fresenius close to $100 million of year-over-year revenue, margin said to reach the company average by Q4 2026. Unit price roughly flat. Share count slightly below 2025. Interest expense consistent with 2025. Adjusted tax rate now expected to be consistent with 2025, which removed the +100 bp tax headwind that was still in the bridge at Q1. Bad debt assumed stable. No prospective M&A. Invigorate still on a 3% annual savings track. Haystack paced to reimbursement, not a 2026 needle-mover. Weather reserved against a mild 2025 summer, and the reserve was not quantified.
The operating tone is still confident. The policy tone, after September 21, is worse. Management has raised the full-year revenue and EPS ranges twice, said underlying utilization is not slowing, and left the second-half bridge intact at both September conferences. They have not sounded defensive about Q3 demand. They have started to sound defensive about 2027 rates.
Tone across the calls that set this year:
- February 10, 2026 (Q4 2025). Confident strategy, cautious numbers. The initial guide was a list of why the year was only 6–7%: January weather, Nova at about $0.25, Corewell at about $250 million and a low-single-digit margin, an extra payroll cycle, cash from operations down because 2025 had one-time tax cash, a 30 bp exchange drag, and a higher tax rate. Cadence was explicit. A bit more than 49% of EPS in the first half, Q2 the high quarter, Q3 a step down, Q4 a step down from Q3. This was a team publishing a guide they had room to raise.
- April 21, 2026 (Q1). The adjectives stepped up and the range moved up. The caveat list did not shrink. They raised because the quarter beat, not because they took risk out of the back half. Organic volume excluding Corewell and Fresenius was 3.8%. A worse summer than 2025 was already in the guide, and they raised anyway.
- July 23, 2026 (Q2). The most confident of the three, and still operational. "Again raising." No utilization slowdown assumed. In the same breath: more Nova in the second half than previously expected, fuel higher in the second half, exchange still −30 bps after a flattish quarter, and adjusted margin down 40 bps with the full year still expected to expand. The tax-rate language flipped from a headwind to "consistent with 2025." That is a real positive inside the EPS raise, separate from the $0.10 already booked. Confidence on demand is high. Confidence on the second-half margin math is asserted, not demonstrated.
- September 14 and 15. No third raise and no cut. Samad at Morgan Stanley and Davis at Baird repeated the July bridge. Davis said 2026 is running ahead of the old 4–5% revenue and 7–9% earnings framework, and that an updated long-term target is a March 2027 investor day, not this call. Apple Health was not expected to contribute until December.
What changed after those conferences is the fee file, not the operating tape. No guidance press release between July 23 and September 24. The IR seat turned over — Damini Chokshi, from Merck, replaced an interim — and Jim Davis remains chairman and CEO and Sam Samad remains CFO. That is not a guidance tell. The October 22 date was set by a September 22 release and is not delayed.
On the July 23 print itself, the session that priced a before-the-open release was July 23. The Daloopa split-adjusted close went from $209.83 on July 22 to $227.90 on July 23, +8.6%, on about 2.0x the prior session's volume, and the July 24 close was flat. That is a reaction fact, not a multiple.
Assumptions still inside the guide, in the order that matters for the print. Physician utilization was described as high-single-digit excluding wellness. Hospital reference and same-store co-lab were mid-single-digit. The first three weeks of July matched Q2. Consumer was at the high end of 20–30% on a book sized at about $250 million last year; at Morgan Stanley, Samad described it as annualizing around $300 million and growing about 30%. Advanced diagnostics was described at that conference as about a $1 billion book growing mid-teens. Those two figures are conference commentary, not filings, and neither is large enough, in one quarter, to explain a miss or a beat against a $3.043 billion estimate. They are large enough to explain the ex-mix revenue-per-requisition acceleration.
The Q2 margin drains Samad named were Nova about 20 bps, Corewell plus Fresenius about 30 bps, and supplemental deferred-compensation mark-to-market about 20 bps, together about 70 bps. Offsets he named for the second half are volume drop-through (he later put incremental volume at roughly a 35–40% margin) and less dilution as the two relationships mature. Q3 still has the partnership comparison benefit. Q4 does not.
The only scheduled pre-print diagnostic with a company release is Danaher, Wednesday, October 21, 6:00 a.m. Eastern. Read-through is Cepheid molecular and Beckman core lab, the morning before. Abbott's October 21 date is an FMP row without an IR release and should not be treated as confirmed. Labcorp is after this print on both FMP (October 27) and the dates circulating elsewhere. Last year Labcorp printed October 28, the week after Quest. Labcorp's July 30 quarter was the same utilization tape without Quest's partnership spike: organic revenue about +4%, requisitions about +3%, and a raised full-year guide. That 4% lines up with Quest's ex-partnership volume. It is not evidence of an air pocket.
Listen for, in order. Whether they tighten and raise again, which is what they did on the Q3 2025 call. Organic volume excluding Corewell and Fresenius. Adjusted operating margin versus Q3 2025's 16.3%. And any Quest-specific dollar on the CMS file, whose comment window closes the day before the call. A 2026 guide that stays silent on 2027 price is fine. A 2027 comment that pretends the preliminary rates are immaterial would be new, and it would be aggressive.
get_stock_prices for company_id 542 and have no fundamental id.The street is underwriting a controlled slowdown, not a break in demand. Consensus followed the July script. It did not fade the quarter after the September 21 fee-schedule release. Yahoo Finance, checked the same day as the Phase 2 note and used only as a revision check, showed the Q3 EPS average up versus 7 and 30 days earlier. The level used here is FMP.
| Catalyst | Latest trajectory | What Q3 consensus assumes | What would move the print |
|---|---|---|---|
| Base utilization | Volume ex Corewell and Fresenius +4.0% vs +3.8%. Stable, +20 bps. No slowdown assumed for the second half. | No volume line. +8.1% revenue is the discrete headwinds, not a drop in the base. | Base volume under ~4%, or a walk-back of "no utilization slowdown." |
| Corewell and Fresenius | Corewell was 9.0% of DIS volume in Q2, up from 7.0% in Q1. Still about $250 million for the year. Fresenius close to $100 million of YoY revenue. Lap is Q4. | Q3 +8.1%, then Q4 +7.1%. Small step-down now, larger one when the anniversary hits. Already in the guide the street copied. | A cut to those dollars, or a margin rate that is not grinding up. The Michigan joint lab is early 2027. |
| Revenue per requisition | Reported −2.8%, worse by 150 bps vs Q1. Ex mix, +3.0%, up 50 bps. Unit price still roughly flat. Tests per requisition are the driver. | Buried in the +8.1%. The street is not paying for a reported price recovery. | Ex-mix revenue per requisition rolling over. Reported revenue per requisition staying negative is not a miss. |
| Consumer and Apple Health | Not a segment. High end of 20–30% on a book of about $250 million last year. September conference color: about $300 million annualizing, about +30%. Apple Health is a $119 panel later this year, not in every state, and not until December on Davis's Baird comment. | No consumer estimate. A $119 panel cannot move a $3 billion quarter in its first weeks. | A launch date inside Q4, or any walk-back of the ~30% comment. The announcement alone will not move consensus. |
| Advanced diagnostics and Haystack | Brain health growing at a high-double-digit rate on the July call. Conference color: advanced book about $1 billion, mid-teens. Haystack is in all 50 states. OncoEMR nationwide launch was planned for the second half. Reimbursement is still the constraint. Elevance covers pTau217 and not yet the amyloid marker. | Immaterial to $3.043 billion. Absence of a Haystack number is the base case. | A volume or revenue figure, or a payer win on the amyloid marker. Either would be new. |
| Margin, Nova, fuel | Q2 adjusted margin 16.5%, −40 bps. Nova about 20 bps of that, partnerships about 30, deferred comp about 20. Nova dollars unchanged at about −$0.25, more of them now in the second half. Fuel about $10 million, also in the second half. | EPS +10.4% on revenue +8.1% is much less leverage than Q2's +19% on +10%. The street believes the cost timing. It does not believe in another $0.30 beat. | Margin down again against the easier 16.3% compare. That threatens the full-year sentence. A modest increase is what the guide requires. |
| ACA exchanges | Still a 30 bp full-year revenue headwind, larger in the second half. Q2 exchange revenue roughly flat: requisitions down about 8%, tests per requisition up about 6%. Sicker members stayed. Enrollment was down more than 20%. | Already inside the guide, and FMP revenue is inside that guide. The street is not haircutting a worse ACA outcome. Taken literally, 30 bps on a $12 billion year is about $36 million. | Exchange revenue turning down rather than staying flat. That is the part of the second half at risk. It does not, by itself, explain a 100–280 bp deceleration. |
| PAMA / 2027 CLFS | Zero impact on 2026 rates. Preliminary file: weighted medians about 16% below 2026 on average; chemistry about −16%, molecular pathology about −22%, genomic sequencing about −23%, proprietary lab analyses only about −2.4%. Cap of 15% a year in 2027–2029. Pre-file worst case a bit above $100 million, offset of less than half. Government payers were 16% of the Q2 mix, unchanged, and CLFS is only a slice of that. | Not in the Q3 estimate. A hit a bit above $100 million is under 1% of the ~$12 billion guide, and it is a 2027 item. | Quest's own dollar off the September 21 file, and whether 2027 commentary changes. The Q3 P&L should not. |
The contradiction the street has only partly absorbed is between headline organic growth and base growth. Organic revenue went from +2.5% in Q1 2025 to +10.0% in Q2 2026. Strip out two relationships and volume is +4.0%. Consensus revenue growth of +8.1% in Q3 and +7.1% in Q4 is the right shape if those relationships hold and the base holds near 4%. It is the wrong shape if the base is what has been accelerating. It has not.
The second tension is margin. Revenue growth accelerated and adjusted margin just went negative year over year, because the new revenue is low-margin and Nova and fuel hit the second half. Q3's 16.3% compare is easier than Q2's 16.9%. If margin is down again, the full-year expansion comment is what breaks.
PAMA is the catalyst investors are reacting to, and it is the one that does not belong in this quarter's model. Management's own worst case is modest next to a $12 billion revenue base and next to the growth the partnerships are still delivering in 2026. What the call can supply, and what consensus has not been given, is Quest's test-level exposure on the September 21 file.
Window is July 24 through September 24, 2026. The Q3 print has not happened. No acquisition close, no CEO or CFO change, and no guidance revision. The material item is reimbursement. Everything else extends consumer testing or advanced diagnostics, and almost all of it lands in Q4 2026 or 2027.
| Date | Item | Why it matters for this print | Source |
|---|---|---|---|
| Sep 21 | CMS preliminary CY2027 CLFS | The only material item since the July print. 6,411 laboratories submitted, versus 1,942 in the 2017 cycle. Average potential change versus 2026 rates about 16% lower. 1,171 codes lower. Statute caps any one test at 15% a year in 2027–2029, so the gap does not hit in one year. Final rates expected in November, effective January 1, 2027. Zero effect on Q3 2026 revenue. The call is where the "somewhat more than $100 million" worst case should be updated. ACLA says the file would cut nearly 1,200 tests, including 775 at the full 15% in 2027, on data covering about 2% of labs paid under Medicare Part B in 2024. | CMS release · fact sheet |
| Sep 21–22 | Quest response, no new dollar | Quest told Newsweek the preliminary rates show the flaws in PAMA and that Congress should pass the RESULTS Act. It did not publish a company-level dollar and it did not change 2026 guidance. Jefferies on September 22 called the file the worst end of outcomes for Quest and Labcorp, with some offset through contracting and M&A. That is a street reaction, not a management update. | Newsweek statement · ACLA · AHA |
| Sep 16 | RESULTS Act voter survey | Advocacy, fielded in June, timed ahead of the file. About 130 congressional sponsors and 70+ groups. Confirms the public line. Not operating data. | PR Newswire |
| Sep 14–15 | Morgan Stanley and Baird | Before the CMS file. Davis: worst case somewhat more than $100 million if every affected test took 15%, and he would not handicap RESULTS versus another delay. Samad: exposure not expected above $100 million because of the cap, and mitigation not above half of Quest's exposure. Consumer at least +30% in 2026. Fresenius margins at the company average in Q4 and accretive in 2027. No guidance change. | Conference recaps, not a new 8-K |
| Sep 9 | Apple Health ordering | Panel of 50+ biomarkers for $119 at about 2,000 patient service centers, later in 2026, not in every state. A Q4 consumer on-ramp. Not a Q3 revenue item. Dollar contribution undisclosed and should be assumed small versus a ~$3 billion quarter. | Quest IR |
| Sep 1 | Renalytix distribution | kidneyintelX.dkd ordered through Quest connectivity, targeted for Q1 2027. Renalytix runs and bills the assay. Near-term Quest revenue is draw and connectivity. Optional in-license is 2027 and later. | Renalytix RNS |
| Sep 1 | CEO Form 4 | James E. Davis sold 10,000 shares under a pre-adopted Rule 10b5-1 plan. A same-size sale posted on June 1. Scheduled tranche, not a discretionary exit. Not a management red flag. | SEC Form 4 |
| Aug 24 | Roche pTau217 and AD-Detect | FDA-cleared Elecsys pTau217 offered nationwide in Q4, folded into AD-Detect panels in 2027. A multi-biomarker lab-developed test was set for the end of August. Labcorp announced the same Roche assay the same morning, so it is not exclusive. Q3 contribution from a late-August LDT is immaterial. | PR Newswire |
| Aug 25 | Humanity biological age, $29 | Add-on on questhealth.com. Shows the consumer menu is still adding SKUs. Will not move consolidated revenue or margin. | PR Newswire |
| Aug 12 | Dividend $0.86, unchanged | Payable October 21 to holders of record October 6. Same rate as the May declaration. No signal on the quarter. | PR Newswire |
| Sep 22 | Earnings date set | Results before the open on October 22, call at 8:30 a.m. Eastern. Not delayed. The homepage calendar's October 20 and 2026Q4 label are the announcement-month quarter, two days early, and are not used. | PR Newswire |
Not in the table, on purpose: the July 23 release itself, and broker target changes after the CMS file. A September 21 Quest/UNC letter on tick-borne co-seropositivity and a July 30 bacterial-vaginosis study are menu support, not a revenue swing. No new hospital deal was announced in the window. Trade press still describes Quest and Labcorp as the outlet when hospitals shed lab cost. That pipeline was not refreshed with a named transaction.
Consistent beater. The EPS surprise is widening. From Q3 2023 through Q2 2026, Quest beat FMP on net revenue in 12 of 12 quarters and on adjusted diluted EPS in 12 of 12. The last four quarters are 4 of 4 on both lines. No miss, and no dead zero. Revenue surprises drifted from about +1.5% in the middle four quarters to about +2.4% over the last four. Adjusted-EPS surprises went from +2.1% to +5.7%, and Q2 2026 was the widest of the twelve at +10.6% / +$0.30. Q3 2026 has not printed.
FMP scores adjusted diluted EPS, not GAAP. Q2 GAAP diluted EPS was $2.84 against adjusted $3.12. A beat is any positive surprise. Surprise is (actual − FMP estimate) / FMP estimate.
| Metric | Q3 23 | Q4 23 | Q1 24 | Q2 24 | Q3 24 | Q4 24 | Q1 25 | Q2 25 | Q3 25 | Q4 25 | Q1 26 | Q2 26 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Revenue vs FMP | +1.0% | +1.5% | +3.5% | +0.3% | +2.3% | +1.6% | +0.8% | +1.3% | +2.9% | +1.9% | +2.3% | +2.4% |
| Adj. EPS vs FMP | +1.4% | +1.9% | +9.7% | +0.4% | +1.8% | +1.8% | +2.8% | +1.9% | +4.0% | +2.5% | +5.5% | +10.6% |
Green = beat versus FMP. No misses, so #C0392B is unused. Darker green is a larger beat. #1E8449 anchors the revenue high at +3.5%. #145A32 is only the two large EPS surprises, Q1 2024 +9.7% and Q2 2026 +10.6%. Q3 2026 is not on the grid.
Read left to right. The revenue row stays pale to mid green, with one dark cell in Q1 2024 and the lightest cell of the grid in Q2 2024, then a steadier mid-green from Q3 2025 on. The EPS row is the one that changes character: a long stretch of 1–2% beats, one dark cell in Q1 2024, then a second darkening that starts in Q3 2025 and peaks in Q2 2026.
| Metric | First 4 | Middle 4 | Last 4 | All 12 |
|---|---|---|---|---|
| Window | Q3 23–Q2 24 | Q3 24–Q2 25 | Q3 25–Q2 26 | Q3 23–Q2 26 |
| Avg EPS surprise | +3.3% | +2.1% | +5.7% | +3.7% |
| Avg revenue surprise | +1.6% | +1.5% | +2.4% | +1.8% |
| Avg EPS beat, dollars | $0.07 | $0.05 | $0.15 | $0.09 |
| Beat rate, both lines | 4/4 | 4/4 | 4/4 | 12/12 |
The first-four EPS average of +3.3% is inflated by Q1 2024's +9.7%. Strip that quarter and the other early beats were three or four cents. The last four EPS path was +$0.10, +$0.06, +$0.13, +$0.30. Dollar revenue beats over those four prints were about $80 million, $52 million, $66 million, and $70 million. The floor is what changed: after Q2 2024's +0.3% and Q1 2025's +0.8%, every later revenue surprise is +1.3% or better.
Why the surprises look the way they do. When the beat was weather-distorted and organic was soft, they reaffirmed (Q1 2025, organic revenue only +2.5%). When utilization was clean, they raised (Q2 2025, Q3 2025, Q1 2026, Q2 2026). The 2024 revenue beats were acquisitions, mostly LifeLabs, and they did not become EPS blowouts because organic volume was still around half a percent. The 2026 beats are different. Organic growth is real, a large piece of the volume is lower-priced collaboration work that was already in management's plan, and the EPS beat widened anyway. Davis's account of the Q2 EPS variance is productivity: adjusted EPS up 19.1% on revenue up 10.2%. The $0.10 tax item is part of the +10.6% surprise and does not repeat. Ex that item, $3.02 versus the $2.82 estimate is still about a +7.1% beat.
For October 22, underwrite the recent revenue band, not the Q2 EPS spike. A +2% to +3% revenue surprise on a $3.0 billion quarter is on the order of $60–$90 million. That is the miss the street has been making while organic growth went from +6.8% to +10.0%. Two items already placed in the second half argue for a smaller EPS drop-through than Q2: Nova, about 70% of the year's $0.25 now in the second half, up from a prior expectation of about 60%, and Corewell at a low-single-digit margin that Samad said is tracking the plan. The street's +10.4% EPS growth is already a step down from +19.1%. Some of that phasing is probably in the $2.87. It was not enough in Q1 or Q2.
Pattern math, labeled as such and not a forecast: the trailing-four average EPS beat of about +5.7% on $2.87 is about $3.03. Cleaned for the $0.10, about +4.8% is about $3.01. The trailing-four revenue beat of +2.4% on $3.043 billion is about $3.12 billion, roughly +10.6% year over year, which would be no deceleration from Q2 and would still leave the full-year high end intact if Q4 grows about +7%. The pattern says another beat is the base rate. It does not say the July guide is about to break.