MDxHealth SA (MDXH) Cash Flow Statement
Where MDXH’s cash came from and went, 2025
December 31, 2025 · U.S. dollars- Cash from operations
- −$10.4M
- Capital expenditures
- $1.2M 1.1% of revenue
- Free cash flow
- −$11.6M −10.7% margin
- Returned to shareholders
- —
- Change in cash
- −$17.8M cash at year-end $29.0M
Cash from operations
−$10.4M
Capital expenditures
−$1.2M
Acquisitions & other
−$18.9M
Net borrowing (repayment)
+$21.6M
Other financing
−$8.9M
Change in cash
−$17.8M
Drawn to scale: where the cash came from and how it was used. Hover for values.
MDXH operating cash flow, capex and free cash flow
Operating cash flowCapital expendituresFree cash flowFCF margin (right axis)
MDXH cash flow trends, 2016–2025
| Metric | Trend | Then | Latest | Change |
|---|---|---|---|---|
| Operating cash flow | −$16.6M2016 | −$10.4M2025 | — | |
| Capital expenditures | $4.9M2016 | $1.2M2025 | −14.8%/yr | |
| Free cash flow | −$21.5M2016 | −$11.6M2025 | — | |
| Free cash flow margin | −71.9%2016 | −10.7%2025 | +61.2 pts | |
| Stock-based compensation | $568,0002016 | $2.2M2025 | +16.3%/yr | |
| Dividends paid | $02019 | $02025 | — | |
| Capex / revenue | 16.4%2016 | 1.1%2025 | −15.3 pts |
Change is the average annual growth (CAGR) or the difference between the first and latest year.
MDXH cash flow by activity
OperatingInvestingFinancingChange in cash
MDXH net income vs operating cash flow
Net incomeOperating cash flow
Operating cash flow above net income usually means earnings are backed by cash (depreciation and stock-based pay are non-cash expenses).
MDXH cash flow statement
| 2025 | 2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018 | 2017 | 2016 | |
|---|---|---|---|---|---|---|---|---|---|---|
| Operating activities | ||||||||||
| Net income | −$14.4M | −$24.7M | −$27.3M | −$37.9M | −$26.8M | −$27.1M | −$43.2M | −$32.1M | −$12.3M | −$12.8M |
| Depreciation & amortization | $9.2M | $8.0M | $6.9M | $4.9M | $3.0M | $3.3M | $3.4M | $2.9M | $1.9M | $1.7M |
| Stock-based compensation | $2.2M | $1.7M | $665,000 | $867,000 | $1.2M | $1.3M | $872,000 | $1.0M | $943,000 | $568,000 |
| Change in working capital | $939,000 | −$3.9M | −$2.1M | −$1.6M | $360,000 | $2.0M | $10.3M | −$291,000 | −$1.0M | −$6.1M |
| Other non-cash items | −$8.4M | $286,000 | $421,000 | −$429,000 | −$325,000 | $299,000 | $6.3M | −$97,000 | −$39,000 | $101,000 |
| Cash from operating activities | −$10.4M | −$18.5M | −$21.5M | −$34.1M | −$22.5M | −$20.2M | −$22.3M | −$28.5M | −$10.5M | −$16.6M |
| Investing activities | ||||||||||
| Capital expenditures | −$1.2M | −$2.2M | −$5.0M | −$4.2M | −$896,000 | −$537,000 | −$73,000 | −$1.3M | −$4.9M | −$4.9M |
| Investments (net) | — | −$1.6M | −$6.5M | −$29.2M | −$885,000 | −$537,000 | −$73,000 | −$1.3M | −$6.1M | — |
| Acquisitions & other investing | −$18.9M | $2.2M | $7.5M | $4.3M | $896,000 | $537,000 | $73,000 | $1.3M | $4.9M | −$431,000 |
| Cash from investing activities | −$20.1M | −$1.6M | −$3.9M | −$29.0M | −$885,000 | −$537,000 | −$73,000 | −$1.3M | −$6.1M | −$5.3M |
| Financing activities | ||||||||||
| Dividends paid | $0 | $0 | $0 | $0 | $0 | $0 | $0 | — | — | — |
| Net borrowing (repayment) | $21.6M | $11.6M | −$3.3M | $22.1M | −$1.1M | $1.5M | $8.7M | −$358,000 | $346,000 | — |
| Shares issued | $0 | $40.7M | $39.6M | $40.2M | $68.6M | $13.9M | $9.6M | $42.4M | $0 | $0 |
| Other financing | −$8.9M | −$7.7M | −$4.0M | −$41.6M | −$1.0M | −$1.1M | −$324,000 | −$393,000 | $227,000 | $21.1M |
| Cash from financing activities | $12.7M | $44.6M | $32.3M | $20.7M | $66.5M | $14.3M | $18.0M | $41.7M | $573,000 | $21.1M |
| Summary | ||||||||||
| Net change in cash | −$17.8M | $24.4M | $6.9M | −$43.0M | $42.5M | −$6.1M | −$4.2M | $9.4M | −$14.0M | −$809,000 |
| Cash at end of period | $29.0M | $46.8M | $22.4M | $15.5M | $58.5M | $16.0M | $22.1M | $26.2M | $16.8M | $30.9M |
| Free cash flow | −$11.6M | −$20.7M | −$26.5M | −$38.3M | −$23.4M | −$20.8M | −$22.4M | −$29.9M | −$15.3M | −$21.5M |
| Free cash flow margin | −10.7% | −23.0% | −37.8% | −103.3% | −105.4% | −112.6% | −189.7% | −105.5% | −37.9% | −71.9% |
| Capex / revenue | 1.1% | 2.4% | 7.2% | 11.2% | 4.0% | 2.9% | 0.6% | 4.7% | 12.0% | 16.4% |
| Jun '26 | Mar '26 | Dec '25 | Sep '25 | Jun '25 | Mar '25 | Dec '24 | Sep '24 | Jun '24 | Mar '24 | Dec '23 | Sep '23 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Operating activities | ||||||||||||
| Net income | −$7.1M | −$29.7M | −$29.7M | −$8.0M | −$3.8M | −$4.6M | −$10.7M | −$6.1M | −$14.0M | −$6.6M | −$10.9M | −$4.6M |
| Depreciation & amortization | $2.4M | $4.7M | $4.7M | $2.3M | $2.3M | $2.2M | $4.3M | $2.1M | $3.7M | $1.9M | $3.4M | $1.9M |
| Stock-based compensation | $605,000 | −$1.4M | −$1.4M | $447,000 | $1.4M | $391,000 | $1.0M | $365,000 | $694,000 | $168,000 | $387,000 | $179,000 |
| Change in working capital | −$3.5M | $6.2M | $6.2M | −$521,000 | −$5.2M | −$1.3M | −$3.5M | −$1.8M | −$368,000 | −$978,000 | −$4.3M | −$1.3M |
| Other non-cash items | $1.8M | $20.6M | $20.6M | $7.5M | $3.8M | $619,000 | $81,000 | −$290,000 | $205,000 | −$1,000 | −$275,000 | −$420,000 |
| Cash from operating activities | −$5.8M | $378,000 | $378,000 | $1.7M | −$1.6M | −$2.6M | −$8.7M | −$5.6M | −$9.8M | −$5.5M | −$11.6M | −$4.3M |
| Investing activities | ||||||||||||
| Capital expenditures | −$39,000 | −$54,000 | −$54,000 | −$263,000 | −$364,000 | −$476,000 | −$402,000 | −$210,000 | −$1.8M | −$764,000 | −$1.9M | −$878,000 |
| Investments (net) | — | — | — | −$775,000 | −$19.6M | $13,000 | −$229,000 | −$13,000 | −$776,000 | −$618,000 | −$676,000 | −$439,000 |
| Acquisitions & other investing | −$7.6M | $1.8M | $1.8M | $263,000 | $364,000 | $476,000 | $389,000 | $210,000 | $1.1M | $764,000 | $1.4M | $878,000 |
| Cash from investing activities | −$7.7M | $1.8M | $1.8M | −$775,000 | −$19.6M | $13,000 | −$242,000 | −$13,000 | −$1.4M | −$618,000 | −$1.1M | −$439,000 |
| Financing activities | ||||||||||||
| Dividends paid | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Net borrowing (repayment) | −$698,000 | $18.7M | −$752,000 | −$538,000 | −$678,000 | $23.6M | −$125,000 | −$1.5M | — | — | — | — |
| Shares issued | $0 | $0 | $0 | $0 | $0 | $0 | $3.5M | $37.2M | $0 | $0 | $0 | $0 |
| Other financing | −$9.7M | −$23.9M | −$4.4M | −$1.1M | −$11.0M | −$2.1M | $31.0M | −$2.2M | $10.2M | −$1.8M | −$4.6M | −$2.3M |
| Cash from financing activities | −$10.4M | −$5.2M | −$5.2M | −$1.7M | −$11.7M | $21.5M | $34.4M | $33.6M | $10.2M | −$1.8M | −$4.6M | −$2.3M |
| Summary | ||||||||||||
| Net change in cash | −$23.9M | −$3.0M | −$3.0M | −$797,000 | −$32.9M | $18.9M | −$2.5M | $27.9M | $6.8M | −$7.9M | −$10.3M | −$6.8M |
| Cash at end of period | $19.2M | $29.0M | $29.0M | $32.0M | $32.8M | $65.7M | $46.8M | $49.3M | $21.3M | $14.5M | $22.4M | $32.7M |
| Free cash flow | −$5.9M | $324,000 | $324,000 | $1.4M | −$2.0M | −$3.1M | −$9.1M | −$5.8M | −$11.6M | −$6.3M | −$13.5M | −$5.1M |
| Free cash flow margin | −21.6% | 0.6% | 0.6% | 5.1% | −7.4% | −12.8% | −19.0% | −25.0% | −27.5% | −31.7% | −34.9% | −26.6% |
| Capex / revenue | 0.1% | 0.1% | 0.1% | 1.0% | 1.4% | 2.0% | 0.8% | 0.9% | 4.2% | 3.9% | 4.9% | 4.5% |
Negative numbers are cash paid out. Quarterly columns are labeled by the month the quarter ended. Figures in U.S. dollars as reported; data from EODHD.
MDXH cash generation
In fiscal 2025 (ended December 31, 2025), MDxHealth generated -$10.4 million of cash from operations and spent $1.2 million on capital expenditures, leaving free cash flow of -$11.6 million, −10.7% of revenue. Cash and equivalents fell by $17.8 million over the year.
Related: MDXH income statement, MDXH balance sheet. See the MDXH stock overview for the latest quote and news.
MDXH cash flow FAQ
What is MDxHealth's free cash flow?
MDxHealth's free cash flow was -$11.6 million in fiscal 2025: -$10.4 million of operating cash flow minus $1.2 million of capital expenditures It was -$20.7 million a year earlier..
How much cash does MDxHealth generate from operations?
MDxHealth generated -$10.4 million of cash from operating activities in fiscal 2025.
How much does MDxHealth spend on capital expenditures?
MDxHealth spent $1.2 million on capital expenditures in fiscal 2025, 1.1% of revenue, compared with $2.2 million the year before.