Waystar lifts Q3 revenue 21% to $325.6m as subscription sales grow 34%

Waystar Holding, the Nasdaq-listed healthcare payment software company, reported third-quarter 2026 revenue of $325.6 million on 2 November, up 21% on a year earlier¹. The company tied the growth to providers consolidating more of their revenue cycle work onto its platform and taking up more of its AI-powered capabilities¹.

What the quarter showed

Profitability held at a high level. Net income was $31.0 million, a 10% margin, and non-GAAP net income was $87.1 million, or $0.44 per diluted share¹. Adjusted EBITDA came to $139.3 million, a margin of 43%¹. Cash flow from operations was $103.9 million and unlevered free cash flow $114.8 million¹.

The mix of revenue is the more telling number for investors. Subscription revenue rose 34% to $180.7 million, while volume-based revenue, which tracks transaction counts, grew 8% to $142.9 million¹. By customer type, provider revenue increased 28% to $243.4 million and patient revenue 5% to $82.2 million¹. The number of clients contributing more than $100,000 in revenue over the last twelve months reached 1,488, up 14%, and net revenue retention was 108%¹.

For the full 2026 financial year, Waystar expects revenue of $1.277 billion to $1.287 billion and adjusted EBITDA of $543 million to $549 million¹. It guides to non-GAAP net income of $322 million to $337 million, or $1.63 to $1.71 per diluted share¹.

Chief executive Matt Hawkins said the company would "leverage AI and agentic capabilities to reshape the revenue cycle" as it works to extend its market position¹.

What it means for the market

Waystar's results give a public-market read on how health providers are spending on revenue cycle software as vendors add AI to it¹. Subscription revenue growing more than four times as fast as volume-based revenue suggests clients are buying more software modules rather than simply pushing more transactions through the platform, which fits Hawkins' description of providers consolidating onto one connected system¹.

For competing revenue cycle and AI agent start-ups, the figures set a benchmark: a vendor guiding to at least $1.277 billion of revenue this year with a 43% adjusted EBITDA margin and 108% net revenue retention¹. For health system buyers, the release shows a large incumbent positioning agentic AI as an extension of its existing payments platform¹.

The balance sheet has become more leveraged over the year. Net debt stood at $1,193,706 thousand at 30 September 2026, against $813,739 thousand a year earlier, and the adjusted net leverage ratio rose to 2.2x from 1.9x¹. Cash and equivalents fell to $30,820 thousand from $421,056 thousand, partly offset by $246,075 thousand of investment securities¹. The company also bought back $33,487 thousand of stock in the first nine months of the year¹.

Caveats

Most headline profit measures are non-GAAP, and the company's own reconciliations show adjustments for stock-based compensation, acquisition and integration costs, and costs linked to a cybersecurity incident disclosed in its second-quarter filing¹. The release does not break out revenue from AI products, so the share of growth that AI tools are driving cannot be measured from it¹. Among its stated risks, Waystar lists the integration of its Iodine acquisition and its substantial debt and the covenants attached to it¹.