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Revenue Recognition - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Revenue Recognition
Total revenues	$ 1,099,278	$ 943,549	$ 791,010
Subscription revenue
Revenue Recognition
Total revenues	558,408	457,975	401,013
Volume-based revenue
Revenue Recognition
Total revenues	534,755	479,913	386,276
Implementation services and other revenue
Revenue Recognition
Total revenues	$ 6,115	$ 5,661	$ 3,721

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

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+ Details

Other Accrued Expenses

12 Months Ended

Dec. 31, 2025

Accrued Liabilities, Current [Abstract]

Other Accrued Expenses

Other accrued expenses consist of the following (in thousands):


	Year ended December 31,
	2025		2024
Accrued income taxes	$	4,957	$	4,111
Other taxes payable	2,882		3,915
Accrued severance	920		—
Retirement plan payable	307		497
Accrued self insurance claims	1,160		1,064
Accrued interest	655		597

ESPP payable	1,721		—
Other	10,388		5,746
Total	$	22,990	$	15,930

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Financial Statement Presentation

The financial statements include the consolidated balance sheets, statements of operations, statements of comprehensive loss, statements of changes in stockholders’ equity, and statements of cash flows of Waystar and its subsidiaries and have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”).

Segment information

Operating segments are defined as components of an enterprise about which separate financial information is evaluated regularly by the chief operating decision maker in deciding how to allocate resources and assessing performance. We define the term “chief operating decision maker” to be our Chief Executive Officer. Our Chief Executive Officer reviews the financial information presented on an entire company basis for purposes of allocating resources and evaluating our financial performance. Accordingly, we have determined that we operate in a single reportable operating segment.

Use of Estimates

The preparation of the consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities, the disclosures of contingent assets and liabilities as of the date of the financial statements, and the reported amounts of revenues and expenses during the reporting periods. Significant estimates and assumptions are used for, but are not limited to: (1) revenue recognition, including estimated expected customer life; (2) recoverability of accounts receivable and taxes receivable; (3) impairment assessment of goodwill and long-lived intangible assets; (4) fair value of intangibles acquired in business combinations; (5) litigation reserves; (6) depreciation and amortization; (7) fair value of stock options issued to employees and assumed as part of business combinations; (8) fair value of interest rate swaps; and (9) leases, including incremental borrowing rate. Future events and their effects cannot be predicted with certainty, and accordingly, accounting estimates require the exercise of judgment. We evaluate and update assumptions and estimates on an ongoing basis and may employ outside experts to assist in evaluations. Actual results could differ from the estimates used.

Principals of Consolidation

The accompanying consolidated financial statements include the accounts of Waystar Holding Corp. and its subsidiaries. All material intercompany balances and transactions have been eliminated.

Revenue Recognition

We derive revenue primarily from providing access to our solutions for use in the healthcare industry and in doing so generate two types of revenue: (i) subscription revenue and (ii) volume-based revenue, which account for 99% of total revenue for all periods presented. We also derive revenue from implementation fees for our software, as well as hardware sales to facilitate patient payments.

We recognize revenue in accordance with Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC 606”), through the following five steps:

•identification of the contract, or contracts, with a client;

•identification of the performance obligations in the contract;

•determination of the transaction price;

•allocation of the transaction price to the performance obligations in the contract; and

•recognition of revenue when, or as, we satisfy a performance obligation

Our customers, referred to as clients elsewhere in this report, represent healthcare providers across all types of care settings, including physician practices, clinics, surgical centers, and laboratories, as well as large hospitals and health systems.

We account for a contract when it has approval and commitment from both parties, the rights of the parties are identified, payment terms are identified, the contract has commercial substance and collectability of consideration is probable. The length of our contracts vary but are typically two to three years and generally renew automatically for successive one-year terms. Our revenue is reported net of applicable sales and use tax and is recognized as, or when, control of these services or products are transferred to clients, in an amount that reflects the consideration we expect to be entitled to in exchange for the contract’s performance obligations.

Revenue from our subscription services as well as from our volume-based services represents a single promise to provide continuous access (i.e., a stand-ready obligation) to our software solutions in the form of a service. Our software products are made available to our clients via a cloud-based, hosted platform where our clients do not have the right or practical ability to take possession of the software. As each day of providing access to the software solutions is substantially the same and the client simultaneously receives and consumes the benefits as services are provided, these services are viewed as a single performance obligation comprised of a series of distinct daily services.

Revenue from our subscription services is recognized over time on a ratable basis over the contract term beginning on the date that the service is made available to the client. Volume-based services are priced based on transaction, dollar volume or provider count in a given period. Given the nature of the promise is based on unknown quantities or outcomes of services to be performed over the contract term, the volume-based fee is determined to be variable consideration. The volume-based transaction fees are recognized each day using a time- elapsed output method based on the volume or transaction count at the time the clients’ transactions are processed.

Our other services are generally related to implementation activities across all solutions and hardware sales to facilitate patient payments. Implementation services are not considered performance obligations as they do not provide a distinct service to clients without the use of our software solutions. As such, implementation fees related to our solutions are billed upfront and recognized ratably over the contract term. Implementation fees and hardware sales represent less than 1% of total revenue for all periods presented.

Our contracts with clients typically include various combinations of our software solutions. Determining whether such software solutions are considered distinct performance obligations that should be accounted for separately versus together requires significant judgment. Specifically, judgment is required to determine whether access to our SaaS solutions is distinct from other services and solutions included in an arrangement.

We follow the requirements of ASC 606-10-55-36 through -40, Revenue from Contracts with Customers, Principal Agent Considerations, in determining the gross versus net revenue presentations for our performance obligations in the contract with a client. Revenue recorded where we act in the capacity of a principal is reported on a gross basis equal to the full amount of consideration to which we expect in exchange for the good or service transferred. Revenue recorded where we act in the capacity of an agent is reported on a net basis, exclusive of any consideration provided to the principal party in the transaction.

The principal versus agent evaluation is a matter of judgment that depends on the facts and circumstances of the arrangement and is dependent on whether we control the good or service before it is transferred to the client or whether we are acting as an agent of a third party. This evaluation is performed separately for each performance obligation identified. For the majority of our contracts, we are considered the principal in the transaction with the client and recognize revenue gross of any related channel partner fees or costs. We have certain agency arrangements where third parties control the goods or services provided to a client, and we recognize revenue net of any fees owed to these third parties.

Payment terms and conditions vary by contract type, although our standard payment terms generally require payment within 30 to 60 days. In instances where the timing of revenue recognition differs from the timing of payment, we have determined our contracts do not generally include a significant financing component. The primary purpose of our invoicing terms is to provide clients with simplified and predictable ways of purchasing our products and services, not to receive financing from our clients or to provide clients with financing.

Contract Costs

Incremental Costs of Obtaining a Contract

Incremental costs of obtaining a contract primarily include commissions paid to our internal sales personnel. We consider all such commissions to be both incremental and recoverable since they are only paid when a contract is secured. These capitalized costs are amortized on a straight-line basis over the expected period of benefit, which is determined based on the average customer life, which includes anticipated renewals of contracts. As of December 31, 2025 and 2024, the total unamortized costs reported as deferred costs on our balance sheet amounted to $32.4 million and $29.0 million, respectively, for internal sales commissions. For the years ended December 31, 2025, 2024, and 2023, amortization related to the sales commission asset was $13.0 million, $10.7 million, and $7.6 million, respectively. The aforementioned amortization amounts are included in sales and marketing in our consolidated statements of operations.

Costs to Fulfill a Contract

We capitalize costs incurred to fulfill contracts that i) relate directly to the contract, ii) are expected to generate resources that will be used to satisfy performance obligations under the contract, and iii) are expected to be recovered through revenue generated under the contract. Costs incurred to implement clients on our solutions (e.g., direct labor) are capitalized and amortized on a straight-line basis over the estimated customer life if we expect to recover those costs. As of December 31, 2025 and 2024, the total unamortized costs reported as deferred costs on our balance sheet amounted to $61.6 million and $53.8 million, respectively, for fulfillment costs. For the years ended December 31, 2025, 2024, and 2023, amortization related to the fulfillment cost asset was $16.2 million, $12.3 million, and $8.8 million, respectively. The aforementioned amortization amounts are included in the costs of revenue in our consolidated statements of operations.

There were no impairment losses relating to deferred costs for the years ended December 31, 2025, 2024 and 2023.

Channel Partners

We account for fees paid to channel partners within sales and marketing expenses in the accompanying statements of operations. For the years ended December 31, 2025, 2024, and 2023, we recorded fees to all channel partners of $77.9 million, $65.3 million and $52.3 million, respectively. As we are primarily responsible for contracting with and fulfilling contracts for the end user, we record revenue gross of related channel partner fees.

Cash and cash equivalents

We consider highly liquid investments with an original maturity of three months or less to be cash equivalents. We maintain our cash in bank deposit accounts, which, at times, may exceed federally insured limits. We have not experienced any credit losses in such accounts.

Restricted cash

For a fee, we provide lockbox solutions through a banking institution to certain clients. When participating customers’ cash is received from their clients or patients, it is deposited in a lockbox account owned by us and is contractually required to be disbursed to the participating clients the following day. Any funds residing in these accounts are categorized as restricted cash.

Our restricted cash balance also consists of cash collected on behalf of healthcare providers from patients that has yet to be remitted to the providers. There is also an associated liability corresponding to cash held for others.

Accounts receivable

Accounts receivable are primarily generated from billings related to our cloud-based technology and do not bear interest. Unbilled accounts receivable arise when services have been rendered for which revenue has been recognized but the customers have not been billed. Substantially all accounts receivable are from companies in the healthcare service industry. Accounts receivable are net of an allowance for doubtful accounts and are considered past due when they are outstanding beyond agreement terms. We estimate the allowance for doubtful accounts based primarily on an analysis of historical collections experience, review of accounts receivable aging schedules, and specific identification of individual clients management believes to be at risk. If additional amounts become uncollectible, they will be charged to operations when that determination is made. Accounts receivable are written off against the allowance for doubtful accounts once all collection efforts have been exhausted, and recovery is deemed remote. If amounts previously written off are collected, they will be included as a deduction in general and administrative expense when received. Credit is extended based on historical experience with similar clients. Generally, collateral is not required.

Changes in the allowance for doubtful accounts are as follows (in thousands):


	December 31,
	2025		2024
Beginning balance	$	(5,885)	$	(5,335)
Provision for losses on receivables	(3,320)		(2,669)
Write-offs	4,001		2,792
Recoveries	(966)		(673)
Ending balance	$	(6,170)	$	(5,885)

Property and equipment

Property and equipment are stated at cost. Depreciation of property and equipment is computed using the straight-line method for financial reporting purposes at rates based on the estimated useful lives and pattern of usage of the assets. The estimated useful lives of the assets are 5 years for computer hardware and office equipment, 7 years for furniture and fixtures, and 40 years for buildings. Purchased computer software is depreciated over the estimated useful life of 3–5 years. Leasehold improvements are amortized over the life of the lease or their estimated useful lives, whichever is shorter. We evaluate the useful lives of these assets and test for impairment whenever events or changes in circumstances occur that could impact the recoverability of these assets.

Expenditures for major renewals and betterments that extend the useful lives of property and equipment are capitalized. Expenditures for maintenance and repairs are charged to expense as incurred. Refer to Note 8 for more information on property and equipment.

Software licenses and maintenance contracts

Software licenses and prepaid software maintenance contracts are accounted for as prepaid expenses and are amortized over the related service period, which is typically 12 months or less. In instances where contracts exceed 12 months, a portion of the contract is recorded as other long-term assets. As of December 31, 2025 and 2024, total unamortized costs of $9.2 million and $7.2 million, respectively, were included in prepaid expenses. As of December 31, 2025 and 2024, total unamortized costs of $0.8 million and $0.1 million, respectively, were included in other long-term assets.

Long-Lived Assets

Long-lived assets are amortized over their useful lives. We evaluate the remaining useful life of long-lived assets periodically to determine if events or changes in circumstances warrant a revision to the remaining period of amortization. The carrying amounts of these assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying value of these assets may not be recoverable. We measure the recoverability of these assets by comparing the carrying amount of the asset group to the future undiscounted cash flows the assets are expected to generate. If the undiscounted cash flows used in the test for recoverability are less than the carrying amount of the asset groups, then the carrying amount of such assets is reduced to fair value. Refer to Notes 8, 9, and 10 for more information on long-lived assets.

Goodwill

We account for business combinations under the acquisition method of accounting in accordance with ASC 805, Business Combinations, where the total purchase price is allocated to the tangible and identified intangible assets acquired and liabilities assumed based on their estimated fair values. The purchase price is allocated using the information currently available, and may be adjusted, up to one year from acquisition date, after obtaining more information regarding, among other things, asset valuations, liabilities assumed and revisions to preliminary estimates. The purchase price in excess of the fair value of the tangible and identified intangible assets acquired less liabilities assumed is recognized as goodwill.

We account for goodwill under the provisions of ASC 350, Intangibles—Goodwill and Other. Goodwill is evaluated for impairment annually on October 1st or whenever there is an impairment indicator. There was no impairment to goodwill during the years ended December 31, 2025, 2024 and 2023, respectively. Refer to Note 9 for more information on goodwill.

Deferred Offering Costs

We capitalize within other assets certain legal, accounting, and other third-party fees that are directly related to our in-process equity financings, including the planned IPO, until such financings are consummated. After consummation of the equity financing, these costs are recorded as a reduction of the proceeds received as a result of the offering. Should a planned equity financing be abandoned, terminated, or significantly delayed, the deferred offering costs are immediately written off to operating expenses. Through June 6, 2024, the effective date of the Prospectus for our IPO, we had capitalized $8.8 million of deferred offering costs, which were recorded in stockholders' equity upon the completion of the IPO (see Note 1). There were no deferred offering costs capitalized as of both December 31, 2025 and 2024.

Capitalized software development costs

We capitalize internal-use software costs under the provisions of ASC 350 which includes costs incurred in connection with the development of new software solutions and enhancements to existing software solutions that are expected to result in increased functionality. The costs incurred in the preliminary stages of development are expensed as incurred. Once the software has reached the development stage, internal and external costs, if direct and incremental, are capitalized until the software is complete and available for general release. Capitalized software development costs are recorded in property and equipment and are amortized on a straight-line basis over their estimated useful life of two years. We evaluate the useful lives of these assets and test for impairment whenever events or changes in circumstances occur that could impact the recoverability of these assets. There were no impairments of capitalized software development costs for the years ended December 31, 2025, 2024 and 2023.

Research and development costs

Research and development (“R&D”) costs consist primarily of personnel and related expenses for employees engaged in research and development activities as well as third-party fees. All such costs are expensed as incurred, except for capitalized software development costs.

Debt Issuance Costs

Debt issuance costs, net of amortization, are reflected on our balance sheet as a direct reduction in the carrying amount of our long-term debt. In addition, debt issuance costs, net of amortization, related to our revolver debt are included in other assets. Debt issuance costs include fees paid to creditors and third-party fees incurred for the issuance of new debt. Debt

issuance costs are amortized over the respective term of the debt instruments using the effective interest method, and amortization charges are included in interest expense.

Derivative instruments

We hold three interest rate swaps with one maturing on January 31, 2026 and two maturing on March 31, 2027, as well as an interest rate cap maturing on April 30, 2026. We held one interest rate swap that matured on October 31, 2024 and two interest rate swaps that matured on November 30, 2022 designated as cash flow hedges to a portion of our outstanding debt. At inception and on an ongoing basis, we assess whether our swaps qualify for hedge accounting. These interest rate swaps have been deemed highly effective under ASC 815 so they meet the hedge accounting treatment criteria and qualify for hedge accounting. The swaps have been recorded on the balance sheet at fair value as either assets or liabilities and any changes to the fair value are recorded through accumulated other comprehensive income and reclassified into interest expense in the same period in which the hedged transaction is recognized in earnings. Cash flows from interest rate swaps are reported in the same category as the cash flows from the items being hedged.

Fair value of financial instruments

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. It also establishes a three-level hierarchy that prioritizes the inputs used to measure fair value. The three levels of the hierarchy are defined as follows:

•Level 1—Observable inputs that reflect quoted prices (unadjusted) for identical assets and liabilities in active markets.

•Level 2—Include other inputs that are directly or indirectly observable in the marketplace.

•Level 3—Unobservable inputs which are supported by little or no market activity.

As of December 31, 2025 and 2024, the carrying value of cash equivalents, accounts receivable, accounts payable, accrued liabilities, and other current assets and liabilities approximates fair value due to the short maturities of these instruments. Swaps are Level 2 instruments whose fair value is derived from discounted cash flows adjusted for nonperformance risk.

Investment securities

Our short-term investments, which consist of debt securities, are stated at fair value. These debt securities have been categorized as available-for-sale and classified as current assets given their maturity date is 12 months or less. Unrealized holding gains and losses for debt securities, net of applicable deferred taxes, are included in other comprehensive income or loss as a component of stockholders’ equity until realized from a sale or an expected credit loss is recognized. For the purpose of determining realized gross gains and losses for debt securities sold, that are included as a component of interest income/(expense) in the consolidated statements of income, the cost of investment securities sold is based upon specific identification. We recorded $2.1 million of interest income on investment securities for the year ended December 31, 2025, within “Other expense” of our statements of operations. We recorded no interest income on investment securities for the years ended December 31, 2024 and 2023.

Under the current expected credit losses model, expected losses on available for sale debt securities are recognized through an allowance for credit losses rather than as reductions in the amortized cost of securities. For debt securities whose fair value is less than their amortized cost, which we do not intend to sell or are not required to sell, we evaluate the expected cash flows to be received as compared to amortized cost and determine if an expected credit loss has occurred. In the event of any expected credit loss, only the amount of impairment associated with the expected credit loss is recognized in income with the remainder, if any, of the loss recognized in other comprehensive income. To the extent we have the intent to sell the debt security, or it is more likely than not we will be required to sell the debt security before recovery of our amortized

cost basis, we recognize an impairment loss in income in an amount equal to the full difference between the amortized cost basis and the fair value.

There were no impairment losses relating to our investment securities during the periods presented.

Stock-based compensation

We measure and recognize compensation expense for all stock-based payment awards made to employees and members of the Board of Directors based on estimated fair values and when vesting criteria is assessed as probable of being achieved. We utilize the straight-line vesting method to recognize compensation expense for all service-based payment awards. The value of the portion of the award that is ultimately expected to vest is recognized as expense over the requisite service periods in the consolidated statement of operations. Such expense consists of stock-based compensation expense related to stock option grants to employees and directors. See Note 18 for additional information.

We estimate the fair value of service condition stock-based payment awards on the date of grant using the Black-Scholes option pricing model (“Black-Scholes”). We estimate the fair value of the performance condition stock-based payment awards that include a market condition on the date of grant using the Monte Carlo pricing model. We account for forfeitures as they occur. Our determination of fair value is affected by an estimate of our stock value as well as assumptions regarding several highly complex and subjective variables. These variables include, but are not limited to, our expected stock price volatility over the term of the awards and the expected term of the awards. We estimate expected stock price volatility using historical data of a peer group of public companies.

Advertising costs

We expense advertising costs as incurred. Advertising expense amounted to approximately $14.7 million, $12.5 million, and $10.5 million for the years ended December 31, 2025, 2024 and 2023, respectively.

Income taxes

Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred income tax assets and liabilities of a change in tax rates is recognized in income tax expense in the period that includes the enactment date. A valuation allowance is provided against deferred tax assets if it is more-likely-than-not that some portion or all of the deferred tax assets will not be realized. Any change in the valuation allowance is charged to income tax expense in the period such determination was made. Deferred tax balances are presented as noncurrent liabilities. See Note 11 for additional information.

We evaluate tax positions taken or expected to be taken in the course of preparing our tax returns to determine whether the tax positions are more-likely-than-not of being sustained upon examination by the applicable tax authority, based on the technical merits of the tax position, and then recognizing the tax benefit that is more-likely-than-not to be realized.

Interest and penalties on material uncertain tax positions are classified as interest expense and operating expense, respectively.

Loss contingencies

In accordance with ASC 450, Contingencies, estimated losses from contingencies are accrued when both of the following conditions are met: (1) it is probable a loss has been incurred; and (2) the amount of loss can be reasonably estimated. Any legal fees are recognized as incurred.

Recently Adopted Accounting Pronouncements

In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023 - 09, Income Taxes (Topic 740): “Improvements to Income Tax Disclosures,” which requires disaggregated information about a reporting entity’s effective tax rate reconciliation as well as information on income taxes paid. The standard is intended to benefit investors by providing more detailed income tax disclosures that would be useful in making capital allocation decisions. For public business entities, the ASU will be effective for annual periods beginning after

December 15, 2024. We adopted ASU 2023-09 during the year ended December 31, 2025 on a full retrospective basis. Refer to Note 11 for further details.

In November 2023, the FASB issued ASU 2023 - 07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures.” The standard is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. For public business entities, the ASU was effective for annual periods beginning after December 15, 2023. We adopted ASU 2023-07 on a retrospective basis during the year ended December 31, 2024. Refer to Note 4 for further details.

Recently Issued Accounting Pronouncements Not Yet Adopted

In December 2025, the FASB issued ASU 2025-11, an update to improve the guidance in Topic 270, Interim Reporting, by improving the navigability of the required interim disclosures and clarifying when that guidance is applicable. For public companies, the update is effective for interim reporting periods within annual reporting periods beginning after December 15, 2027. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements.

In November 2025, the FASB issued ASU 2025-09, an update to ASU 2017-12, "Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities." Consistent with the original objective of ASU 2017-12, the objective of this update is to more closely align hedge accounting with the economics of an entity's risk management activity. The amendments included in the five issues addressed in this update are intended to better reflect those strategies in financial reporting by enabling entities to achieve and maintain hedge accounting for highly effective economic hedges of forecasted transactions. For public companies, the new guidance will be effective for annual reporting periods beginning after December 15, 2026, and interim periods within those annual reporting periods. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements.

In September 2025, the FASB issued ASU 2025-06, “Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software” to modernize the accounting guidance for the costs to develop software for internal use. The new guidance amends the existing standard that refers to various stages of a software development project to align better with current software development methods, such as agile programming. The new guidance will be effective for all entities for annual periods beginning after December 15, 2027. Early adoption is permitted. The guidance can be applied on a fully prospective basis, a modified basis for in-process projects, or a full retrospective basis. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements.

In November 2024, the FASB issued ASU 2024-03, “Income Statement—Reporting Comprehensive Income—

Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses.” The standard is intended to benefit investors by providing more detailed information about expenses that is critically important in understanding an entity’s performance, assessing an entity’s prospects for future cash flows, and comparing an entity’s performance over time and with that of other entities. For public companies, this ASU will be effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The amendments in this ASU should be applied either (1) prospectively to financial statements issued for reporting periods after the effective date of this ASU or (2) retrospectively to any or all prior periods presented in the financial statements. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements.

Summary of Significant Accounting Policies - Deferred Offering Costs (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024	Jun. 30, 2024	Jun. 06, 2024
Summary of Significant Accounting Policies
Deferred offering costs capitalized	$ 0.0	$ 0.0
IPO
Summary of Significant Accounting Policies
Deferred offering costs capitalized			$ 8.8	$ 8.8

Cover - USD ($)	12 Months Ended
Cover - USD ($)	Dec. 31, 2025	Feb. 11, 2026	Jun. 30, 2025
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2025
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-42125
Entity Registrant Name	Waystar Holding Corp.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	84-2886542
Entity Address, Address Line One	1550 Digital Drive, #300
Entity Address, City or Town	Lehi
Entity Address, State or Province	UT
Entity Address, Postal Zip Code	84043
City Area Code	844
Local Phone Number	492-9782
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	WAY
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 2,106,581,546
Entity Common Stock, Shares Outstanding		191,681,592
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Part III incorporates certain information by reference from the registrant’s definitive proxy statement for the 2026 annual meeting of stockholders, which will be filed no later than 120 days after the registrant’s fiscal year ended December 31, 2025.
Entity Central Index Key	0001990354
Document Fiscal Year Focus	2025
Amendment Flag	false
Document Fiscal Period Focus	FY

Income Taxes - Cash Paid for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Effective Income Tax Rate Reconciliation [Line Items]
Federal	$ 18,971	$ 41,500	$ 34,095
Cash taxes paid (refunds received), net	31,721	50,497	50,110
Tax credits purchased	15,000
Other
Effective Income Tax Rate Reconciliation [Line Items]
State and local jurisdictions	9,352	8,997	12,555
California
Effective Income Tax Rate Reconciliation [Line Items]
State and local jurisdictions	1,820	0	0
Louisville, KY
Effective Income Tax Rate Reconciliation [Line Items]
State and local jurisdictions	$ 1,579	$ 0	$ 3,460

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2025

Property, Plant and Equipment [Abstract]

Schedule of Balances of the Major Classes of Property and Equipment

The balances of the major classes of property and equipment are as follows (in thousands):


	December 31,
	2025		2024

Computer hardware	$	44,045	$	39,833
Capitalized internal-use software	53,373		40,281
Purchased computer software	23,188		22,789
Furniture and fixtures	4,184		3,642
Office equipment	271		247
Leasehold improvements	4,994		3,778


Internal-use software in progress	19,110		15,361
	149,165		125,931
Accumulated depreciation	(97,516)		(79,200)
Total	$	51,649	$	46,731

Summary of Significant Accounting Policies - Goodwill (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Impairment to goodwill	$ 0.0	$ 0.0	$ 0.0

- Definition

Amount of impairment loss from asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References + Details

Leases - Supplemental Balance Sheet Information (Details)	Dec. 31, 2025	Dec. 31, 2024
Weighted average remaining lease term (years):
Operating leases	3 years 6 months	4 years 1 month 6 days
Financing leases	0 years	9 years 1 month 6 days
Weighted average discount rate:
Operating leases	5.00%	4.70%
Financing leases	0.00%	5.90%

Revenue Recognition - Deferred Revenue Balances (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Deferred Revenue
Beginning balance	$ 16,266	$ 17,108	$ 16,454
Revenue recognized	(21,330)
Revenue recognized		(10,917)	(9,900)
Additional amounts deferred	16,672	10,075	10,554
Deferred revenue assumed as part of acquisitions (see Note 7)	61,743	0	0
Ending balance	73,351	$ 16,266	$ 17,108
Iodine Acquisition
Deferred Revenue
Revenue recognized	$ (10,800)

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2025

Business Combination [Abstract]

Schedule of Estimated Fair Values of Assets Acquired and Liabilities Assumed

The following table summarizes the estimated fair values of assets acquired and liabilities assumed as of the acquisitions date (in thousands):


Cash and cash equivalents	$	9,381
Accounts receivable	27,798
Income tax receivable	1,606
Prepaid expenses	3,772
Property, plant and equipment	974
Customer relationships	290,600
Developed technology	76,600
Tradenames and trademarks	5,200
Other long-term assets	2,110
Goodwill	996,819
Total acquired assets	$	1,414,860
Accounts payable	1,836
Accrued compensation	5,394
Other accrued expenses	3,677
Deferred revenue	60,988
Deferred tax liability	81,060
Other long-term liabilities	1,399
Deferred revenue - long-term	755
Total acquired liabilities	$	155,109
Total net assets acquired	$	1,259,751

Stock-based Compensation - Stock Options Activity (Details) - $ / shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Number of options (in shares)
Beginning balance (in shares)	16,511,128	13,032,541	13,123,170
Granted (in shares)	132,065	4,003,703	208,725
Exercised (in shares)	(2,317,930)	(392,016)	(39,204)
Forfeited (in shares)	(333,090)	(133,100)	(260,150)
Ending balance (in shares)	13,992,173	16,511,128	13,032,541	13,123,170
Weighted average exercise price per share (in dollars per share)
Beginning balance (in shares)	$ 17.57	$ 15.20	$ 15.10
Granted (in shares)	36.94	24.20	37.20
Exercised (in shares)	10.63	4.53	21.51
Forfeited (in shares)	25.95	22.28	23.70
Ending balance (in shares)	$ 18.71	$ 17.57	$ 15.20	$ 15.10
Weighted average remaining contractual life	5 years 1 month 6 days	5 years 9 months 18 days	5 years 8 months 12 days	6 years 7 months 6 days

Segments - Additional Information (Details)	12 Months Ended
Segments - Additional Information (Details)	Dec. 31, 2025 segment
Segment Reporting [Abstract]
Number of operating segments	1
Number of reportable segments	1

Subsequent Events (Details) - USD ($) $ in Thousands		12 Months Ended
Subsequent Events (Details) - USD ($) $ in Thousands	Feb. 13, 2026	Dec. 31, 2025	Dec. 31, 2024
Subsequent events
Outstanding amount		$ 1,481,246	$ 1,243,545
Receivables Facility \| Line of Credit
Subsequent events
Outstanding amount		$ 80,000	$ 80,000
Interest rate (as a percent)		1.61%
Subsequent Event \| Receivables Facility \| Line of Credit
Subsequent events
Outstanding amount	$ 100,000
Interest rate (as a percent)	1.10%

Segments

12 Months Ended

Dec. 31, 2025

Segment Reporting [Abstract]

Segments

Operating segments are defined as components of an enterprise about which separate financial information is evaluated regularly by the chief operating decision maker in deciding how to allocate resources and assessing performance. We have one business activity and there are no segment managers who are held accountable for operations, operating results and plans for products or components below the consolidated unit level. The geographical location of our customers has no impact on strategy or products offered. The “chief operating decision maker,” or CODM, assesses performance and allocates resources using a consolidated profitability metric as discussed below. Accordingly, we have determined that we operate in a single reportable operating segment.

Our CODM is our Chief Executive Officer. On a monthly basis, our CODM reviews the following financial information presented on a consolidated basis. The key profitability metric used for purposes of making key personnel staffing

decisions, approving operating budgets and forecasts, and making strategy decisions is Net Income as detailed below. See Note 3 for our disaggregated revenue by type.


	Years ended December 31,
($in thousands)	2025		2024		2023
Total Revenue	$	1,099,278	$	943,549	$	791,010
Less:
Materials and connectivity	244,993		225,333		173,077
Labor and associated expenses	103,169		90,397		76,690
Research & development	54,623		48,775		35,332
Sales and marketing	178,017		156,935		124,437
General and administrative	128,623		111,753		62,924
Depreciation	21,938		38,744		17,062
Amortization	118,610		147,887		159,405
Interest and non-operating expenses, net	77,542		146,270		205,917
Income tax expense/(benefit)	59,674		(3,420)		(12,500)
Segment net income/(loss)	$	112,089	$	(19,125)	$	(51,334)
Consolidated net income/(loss)	$	112,089	$	(19,125)	$	(51,334)

See Note 8 for segment assets by major asset class.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

Acquisitions - Schedule of Estimated Fair Values of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Oct. 01, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Acquisitions
Goodwill	$ 4,016,818		$ 3,019,999	$ 3,030,013	$ 3,009,558
Iodine Acquisition
Acquisitions
Cash and cash equivalents		$ 9,381
Accounts receivable		27,798
Income tax receivable		1,606
Prepaid expenses		3,772
Property, plant and equipment		974
Other long-term assets		2,110
Goodwill		996,819
Total acquired assets		1,414,860
Accounts payable		1,836
Accrued compensation		5,394
Other accrued expenses		3,677
Deferred revenue		60,988
Deferred tax liability		81,060
Other long-term liabilities		1,399
Deferred revenue - long-term		755
Total acquired liabilities		155,109
Total net assets acquired		1,259,751
Iodine Acquisition \| Customer relationships
Acquisitions
Finite lived intangible assets		290,600
Iodine Acquisition \| Developed technology
Acquisitions
Finite lived intangible assets		76,600
Iodine Acquisition \| Tradenames and trademarks
Acquisitions
Finite lived intangible assets		$ 5,200

Acquisitions

12 Months Ended

Dec. 31, 2025

Business Combination [Abstract]

Acquisitions

Iodine Acquisition

On October 1, 2025, we completed the acquisition of Iodine pursuant to the Agreement and Plan of Merger (the "Merger Agreement"), which offers solutions across the mid-revenue cycle connecting clinical documentation integrity, utilization management and prebill workflows from admission through claim submission. We accounted for the acquisition as a business combination using the acquisition method of accounting. The total consideration paid was allocated to the net tangible and identifiable intangible assets acquired based on their fair values at the acquisition date. The excess consideration paid over the fair value of the net tangible and identifiable intangible assets acquired was recorded as goodwill. Goodwill for the acquisition primarily represents future customer relationships. The goodwill is not deductible for tax purposes. We deem the initial valuation of the assets and liabilities to be provisional and have left the measurement period open as the closing statement as outlined in the Merger Agreement is being finalized. These fair values may be adjusted in a future period, not to exceed one year after the acquisition date, to reflect new facts and circumstances, which existed as of the acquisition date.

We have included the financial results of Iodine in the consolidated financial statements subsequent to the date of acquisition. Pro forma results, including the acquired business since the beginning of fiscal 2025, would not be materially different than the reported results. Revenue and net earnings since the completion of the acquisition were immaterial.

The total consideration paid for Iodine was $1,259.8 million, which consisted of $638.9 million of cash consideration and $620.8 million of equity consideration. The equity consideration was made up of 16,639,920 shares of Waystar common stock issued to previous Iodine holders with a value of $37.31 per share as outlined within the Merger Agreement.

The following table summarizes the estimated fair values of assets acquired and liabilities assumed as of the acquisitions date (in thousands):


Cash and cash equivalents	$	9,381
Accounts receivable	27,798
Income tax receivable	1,606
Prepaid expenses	3,772
Property, plant and equipment	974
Customer relationships	290,600
Developed technology	76,600
Tradenames and trademarks	5,200
Other long-term assets	2,110
Goodwill	996,819
Total acquired assets	$	1,414,860
Accounts payable	1,836
Accrued compensation	5,394
Other accrued expenses	3,677
Deferred revenue	60,988
Deferred tax liability	81,060
Other long-term liabilities	1,399
Deferred revenue - long-term	755
Total acquired liabilities	$	155,109
Total net assets acquired	$	1,259,751

The fair values of the tangible assets were determined primarily using the income approach. The fair values of the acquired identifiable intangible assets were determined using Level 3 inputs such as discounted cash flows which are not observable in the market. Intangible assets acquired from the acquisition include customer relationships, developed technologies, and trade names and trademarks which are all amortized on a straight-line basis approximating the useful life of the assets. The useful lives of the acquired identifiable intangible assets are 18 years for customer relationships, 5 years for developed technology, and 2 years for trade names and trademarks. The weighted-average remaining useful life for all acquired intangibles is 15.1 years.

Total acquisition costs of $12.7 million were expensed as incurred and recorded in general and administrative expense in the statement of operations for the year ended December 31, 2025.

HealthPay24 Acquisition

On August 3, 2023, we completed the acquisition of all issued and outstanding membership interests of HealthPay24 for total consideration of $31.4 million which entirely consisted of cash consideration. We accounted for the acquisition as a business combination using the acquisition method of accounting. As part of the acquisition, we recognized intangible assets of $29.6 million, including goodwill of $13.9 million.

Olive AI Asset Acquisition

On October 31, 2023, we acquired certain assets of Olive AI, Inc.’s Clearinghouse and Patient Access businesses for total consideration of $10 million. We accounted for the Olive AI acquisition as a business combination using the acquisition method of accounting. As part of the acquisition, we recognized total intangible assets of $10.6 million, including goodwill of $6.5 million.

- Definition

The entire disclosure for business combination.

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+ Details

Business	12 Months Ended
Business	Dec. 31, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business	Business Waystar Holding Corp. (“Waystar”, “we” or “our”) is a provider of mission-critical cloud technology to healthcare organizations. Our enterprise-grade platform transforms the complex and disparate processes comprising healthcare payments received by healthcare providers from payers and patients, from pre-service engagement through post-service remittance and reconciliation. Our platform enhances data integrity, eliminates manual tasks, and improves claim and billing accuracy, which results in better transparency, reduced labor costs, and faster, more accurate reimbursement and cash flow. The market for our solutions extends throughout the United States and includes Puerto Rico and other U.S. Territories. Risks and Uncertainties — We are subject to risks common to companies in similar industries, including, but not limited to, our operation in a highly competitive industry; our ability to retain our existing clients and attract new clients; our ability to successfully execute on our business strategies in order to grow; our ability to accurately assess the risks related to acquisitions and successfully integrate acquired businesses, including the acquisition of Iodine; our ability to establish and maintain strategic relationships; the growth and success of our clients and overall healthcare transaction volumes; consolidation in the healthcare industry; our selling cycle of variable length to secure new client agreements; our implementation cycle that is dependent on our clients’ timing and resources; our dependence on our senior management team and certain key employees, and our ability to attract and retain highly skilled employees; the accuracy of the estimates and assumptions we use to determine the size of our total addressable market; our ability to develop and market new solutions, or enhance our existing solutions, to respond to technological changes or evolving industry standards; the interoperability, connectivity, and integration of our solutions with our clients’ and their vendors’ networks and infrastructures; the performance and reliability of internet, mobile, and other infrastructure; the consequences if we cannot obtain, process, use, disclose, or distribute the highly regulated data we require to provide our solutions; our reliance on certain third-party vendors and providers. On occasion, we enter into standard indemnification arrangements in the ordinary course of business. Pursuant to these arrangements, we indemnify, hold harmless, and agree to reimburse the indemnified parties for losses suffered or incurred by the indemnified party, in connection with any trade secret, copyright, patent, or other intellectual property infringement claim by any third party with respect to its technology. The terms of these indemnification agreements are generally perpetual any time after the execution of the agreement. The maximum potential future payments we could be required to make under these agreements is not determinable because it involves claims that may be made against us in the future but have not yet been made. Historically, we have not incurred costs to defend lawsuits or settle claims related to these indemnification agreements. We have entered into agreements with our directors or officers that may require us to indemnify them against liabilities that may arise by reason of their status or service as directors or officers, other than liabilities arising from their willful misconduct. No liability associated with such indemnifications was recorded as of December 31, 2025 and December 31, 2024. Reverse Stock Split On May 15, 2024, we effected a 0.605-for-1 reverse stock split of our common stock and a 0.605-for-1 reverse stock split of our Class A common stock. The reverse stock split did not result in an adjustment to the par value of common stock or Class A common stock. The reverse stock split was originally made effective on May 15, 2024 with a 0.62-for-1 ratio and this was retroactively amended on May 22, 2024 which updated the ratio to 0.605-for-1. All references in the accompanying consolidated financial statements and related Note 15, Note 17, and Note 19 have been updated to reflect the effects of the reverse stock split at the amended 0.605-for-1 ratio. The number of shares of common stock, Class A common stock, additional paid-in-capital, options to purchase common stock, and loss per share amounts, which are presented and disclosed in the financial statements and aforementioned footnotes, have been restated on a retroactive basis for all periods presented to reflect the effects of this action. Initial Public Offering In June 2024, we completed our initial public offering (“IPO”) in which we issued and sold 45,000,000 shares of our common stock at $21.50 per share. We received total proceeds of $914.3 million after deducting the underwriters’ discounts and commissions of $53.2 million. Deferred offering costs, which consist of direct incremental legal, accounting and other third-party fees that are directly related to the IPO, were capitalized and offset against proceeds upon the consummation of the IPO. Through the date of the IPO, we had capitalized $8.8 million of deferred offering costs. These costs were offset against proceeds upon the consummation of the IPO. As part of the IPO we granted the underwriters an overallotment option, for a period of 30 days from the date of the prospectus, to purchase up to 6,750,000 additional shares of common stock from us at the initial public offering price less the underwriting discount. On July 5, 2024, the underwriters exercised the overallotment option to purchase 5,059,010 additional shares of common stock, resulting in additional net proceeds of $102.8 million after deducting underwriting discounts and commissions of $6.0 million. The remaining option to purchase additional shares expired unexercised at the end of the 30-day period. We used the net proceeds from the IPO and the underwriters’ exercise of the overallotment option on July 5, 2024, to repay $909.1 million and $110.9 million, respectively, of outstanding principal indebtedness under our First Lien Credit Facility (as defined below). See Note 12 below for details. Secondary Offerings On February 24, 2025, the Institutional Investors closed an underwritten public offering of 23,000,000 shares of our common stock (inclusive of the underwriters’ option to purchase additional shares) (the “First Secondary Offering”). On May 15, 2025, the Institutional Investors closed another underwritten public offering of 14,375,000 shares of our common stock (inclusive of the underwriters' option to purchase additional shares) (the "Second Secondary Offering"). Additionally on September 10, 2025, the Institutional Investors closed another underwritten public offering of 18,000,000 shares of our common stock (the "Third Secondary Offering"). We did not sell any shares in these offerings or receive any proceeds from these offerings. Pursuant to the terms of the Amended and Restated Registration Rights Agreement, dated as of June 10, 2024, by and among Waystar, the Institutional Investors, and certain other parties thereto, we paid $4.6 million in certain expenses on behalf of the selling stockholders related to these offerings for the twelve months ended December 31, 2025, while the selling stockholders paid all applicable underwriting discounts and commissions.

Derivative Financial Instruments

12 Months Ended

Dec. 31, 2025

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivative Financial Instruments

To mitigate the risk of an increase in interest rates on the First Lien Credit Facility, we entered into swaps on January 13, 2023, April 1, 2025, and April 9, 2025, along with an interest rate cap on October 1, 2025. We attempt to minimize our interest risk exposure by fixing our rate through the utilization of interest rate swaps, which are derivative instruments. The interest rate swaps mitigate the exposure on the variable component of interest on our First Lien Credit Facility. Our swaps are entered into with financial institutions that participate in the First Lien Credit Facility. By using a derivative instrument to hedge exposures to changes in interest rates, we expose ourselves to credit risk due to the possible failure of the counterparty to perform under the terms of the derivative contract.

As of December 31, 2025, we have the following interest rate swap or cap agreements designated as a hedging instrument:


Effective Dates	Floating Rate Debt			Fixed Rates
May 31, 2023 through January 31, 2026	$	506.7	million	3.87	%
April 1, 2025 through January 30, 2026	$	80.0	million	3.59	%
October 1, 2025 through April 30, 2026	$	127.0	million	3.50	%
January 31, 2026 through March 31, 2027	$	275.0	million	3.59	%
January 31, 2026 through March 31, 2027	$	275.0	million	3.27	%

As of December 31, 2024, we had the following interest rate swap agreement designated as a hedging instrument:


Effective Dates	Floating Rate Debt			Fixed Rates
May 31, 2023 through January 31, 2026	$	506.7	million	3.87	%

The gain or loss on the swaps is recognized in accumulated other comprehensive loss and reclassified into earnings as adjustments to interest expense in the same period or periods during which the swaps affect earnings. Gains or losses on the swaps representing hedge components excluded from the assessment of effectiveness are recognized in current earnings. The effect of derivative instruments designated as hedging instruments on the accompanying consolidated financial statements is as follows (in thousands):


Derivatives—Cash Flow Hedging Relationships	Amount of Gain or (Loss) Recognized in AOCI/AOCL on Derivative		Location of Gain or (Loss) Reclassified from AOCI/AOCL into Income	Amount of Gain or (Loss) Reclassified from AOCI/AOCL into Income		Total interest Expense on Consolidated Statements of Operations
Interest rate swaps:
Year Ended December 31, 2025	$	(1,511)	Interest expense	$	2,324	$	(77,542)
Year Ended December 31, 2024	$	(14,921)	Interest expense	$	29,175	$	(146,270)
Year Ended December 31, 2023	$	30,327	Interest expense	$	5,244	$	(155,325)

The net amount of accumulated other comprehensive income expected to be reclassified to interest income in the next year is $0.3 million.

- Definition

The entire disclosure for derivative instruments and hedging activities including, but not limited to, risk management strategies, non-hedging derivative instruments, assets, liabilities, revenue and expenses, and methodologies and assumptions used in determining the amounts.

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-Publisher FASB
-URI https://asc.fasb.org/815/tableOfContent

Reference 30: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480237/815-40-50-5

Reference 31: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480434/815-10-50-5C

+ Details

Income Taxes - Effective Income Tax Rate Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Book Income	$ 171,763	$ (22,545)	$ (63,834)
Amount
U.S. Federal Tax At Statutory Rate	36,071	(4,735)	(13,309)
State & local income tax, net of federal tax effect	11,459	2,836	2,893
Effects of changes in tax laws	0	0	0
Tax Credits
Purchased Tax Credits	(976)	0	0
Research and development tax credit	(1,711)	(2,108)	(1,885)
Nontaxable or nondeductible items
Stock based compensation	8,214	(942)	0
Nondeductible compensation	4,663	0	0
Transaction Costs	1,561	0	0
Change in Uncertain Tax Liability	(279)	1,241	281
Other, net	672	288	(480)
Income tax benefit	$ 59,674	$ (3,420)	$ (12,500)
Percent
U.S. Federal Tax At Statutory Rate (as a percent)	21.00%	21.00%	21.00%
State & local income tax, net of federal tax effect (as a percent)	7.00%	(13.00%)	(5.00%)
Effects of changes in tax laws (as a percent)	0.00%	0.00%	0.00%
Tax Credits
Purchased Tax Credits (as a percent)	(1.00%)	0.00%	0.00%
Research and development tax credit (as a percent)	(1.00%)	9.00%	3.00%
Nontaxable or nondeductible items
Stock based compensation (as a percent)	5.00%	4.00%	0.00%
Nondeductible compensation (as a percent)	3.00%	0.00%	0.00%
Transaction Costs (as a percent)	1.00%	0.00%	0.00%
Change in Uncertain Tax Liability (as a percent)	0.00%	(6.00%)	0.00%
Other, net (as a percent)	0.00%	(1.00%)	1.00%
Effective Tax Rate (as a percent)	35.00%	15.00%	20.00%

Income/ (Loss) Per Share - Narrative (Details) - shares	12 Months Ended
Income/ (Loss) Per Share - Narrative (Details) - shares	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Earnings Per Share [Abstract]
Anti-dilutive effect of stock option shares excluded from the diluted earning per share calculation (in shares)	1,385,208	5,761,255	5,213,559

Stock-based Compensation - Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Stock-based compensation
Stock-based compensation expense	$ 42,069	$ 54,437	$ 8,848
Cost of revenue
Stock-based compensation
Stock-based compensation expense	1,514	2,403	645
General and administrative
Stock-based compensation
Stock-based compensation expense	25,678	31,288	5,034
Sales and marketing
Stock-based compensation
Stock-based compensation expense	8,562	12,440	1,866
Research and development
Stock-based compensation
Stock-based compensation expense	$ 6,315	$ 8,306	$ 1,303

Summary of Significant Accounting Policies - Channel Partners (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Fees to channel partners	$ 77.9	$ 65.3	$ 52.3

Investment Securities (Tables)

12 Months Ended

Dec. 31, 2025

Investments, Debt and Equity Securities [Abstract]

Schedule of Unrealized Positions for Investment Securities Classified as Available-For-Sale Fixed-Maturity Debt Securities

The following table summarizes the unrealized positions for our investment securities classified as available-for-sale fixed-maturity debt securities, disaggregated by class of instrument (in thousands) as of December 31, 2025.


	Amortized Cost		Allowances for Credit Losses		Total Unrealized Gains		Total Unrealized Losses		Fair Value
Available-for-sale fixed-maturity securities
Commercial Paper	$	12,439	$	—	$	—	$	4	$	12,435

U.S. Treasury Bills	7,459		—		1		—		7,460
U.S. Government Agencies	4,982		—		—		—		4,982
Total	$	24,880	$	—	$	1	$	4	$	24,877

- Definition

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
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-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
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-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

+ Details

Summary of Significant Accounting Policies - Advertising Costs (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Advertising expense	$ 14.7	$ 12.5	$ 10.5

Consolidated Statements of Operations - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Revenue	$ 1,099,278	$ 943,549	$ 791,010
Operating expenses
Cost of revenue (exclusive of depreciation and amortization expenses)	348,162	315,730	249,767
Sales and marketing	178,017	156,935	124,437
General and administrative	128,623	111,753	62,924
Research and development	54,623	48,775	35,332
Depreciation and amortization	140,548	186,631	176,467
Total operating expenses	849,973	819,824	648,928
Income from operations	249,305	123,725	142,083
Other expense
Income/(loss) before income taxes	171,763	(22,545)	(63,834)
Income tax expense / (benefit)	59,674	(3,420)	(12,500)
Net income/(loss)	$ 112,089	$ (19,125)	$ (51,334)
Net income/(loss) per share:
Basic (in dollars per share)	$ 0.63	$ (0.13)	$ (0.42)
Diluted (in dollars per share)	$ 0.61	$ (0.13)	$ (0.42)
Weighted-average shares outstanding:
Basic (in shares)	177,926,745	149,915,839	121,675,430
Diluted (in shares)	184,783,285	149,915,839	121,675,430
Nonrelated Party
Other expense
Interest expense	$ (74,063)	$ (141,762)	$ (198,309)
Related Party
Other expense
Interest expense	$ (3,479)	$ (4,508)	$ (7,608)

Debt - Schedule of Debt Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Debt
Total outstanding debt	$ 1,481,246	$ 1,243,545
Unamortized debt issuance costs	(8,343)	(11,255)
Current portion of long-term debt	(14,194)	(11,668)
Total long-term debt, net	1,458,709	1,220,622
Line of Credit \| First lien term loan facility outstanding debt
Debt
Total outstanding debt	1,401,246	1,163,545
Line of Credit \| Receivables facility outstanding debt
Debt
Total outstanding debt	$ 80,000	$ 80,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

Stock-based Compensation - Stock Options, Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands, shares in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Stock-based compensation
Weighted average grant date fair value (in dollars per share)	$ 18.69	$ 12.89	$ 19.66
Number of options fully vested (in shares)	6.6
Fully vested options, weighted average exercise price (in dollars per share)	$ 15.06
Fully vested options, aggregate intrinsic value	$ 117,900
Fully vested options, weighted average remaining contractual term	4 years
Total fair value of options	$ 17,700	$ 9,500	$ 8,500
Stock-based compensation expense	42,069	54,437	8,848
Aggregate intrinsic value, options exercised	66,100	7,300	$ 400
Option with Performance Condition
Stock-based compensation
Stock-based compensation expense		$ 33,100
Total unrecognized stock-based compensation expense	0
Time-Based Option
Stock-based compensation
Total unrecognized stock-based compensation expense	$ 35,200
Expected compensation expense, weighted average period	3 years 1 month 6 days

Insider Trading Arrangements

3 Months Ended

Dec. 31, 2025

Trading Arrangements, by Individual

Non-Rule 10b5-1 Arrangement Adopted

false

Rule 10b5-1 Arrangement Terminated

false

Non-Rule 10b5-1 Arrangement Terminated

false

Matthew Hawkins [Member]

Trading Arrangements, by Individual

Material Terms of Trading Arrangement

During the three months ended December 31, 2025, the following officers and directors entered into Rule 10b5-1 trading arrangements:

Name and Title

Date of Adoption

Date of Expiration(1)

Plan Terms

Matthew Hawkins, Chief Executive Officer and Director

12/4/2025

8/19/26

Provides for the exercise of up to 600,000 vested stock options and the associated sale of up to 600,000 shares of the Company’s common stock

_________________________________________________

(1)Each plan terminates on the earlier of: (i) the expiration date listed in the table above, (ii) the first date on which all trades set forth in the plan have been executed, or (iii) such date the plan is otherwise terminated according to its terms.

Name

Matthew Hawkins

Title

Chief Executive Officer and Director

Rule 10b5-1 Arrangement Adopted

true

12/4/2025

8/19/26

258 days

600,000

Derivative Financial Instruments - Additional Information (Details) $ in Millions	12 Months Ended
	Dec. 31, 2025 USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Net amount of accumulated other comprehensive income expected to be reclassified in the next twelve months	$ 0.3

Fair Value Measurements and Disclosures (Tables)

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Schedule of Fair Value Hierarchy for Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis

The following table presents the fair value hierarchy for financial assets and liabilities measured at fair value on a recurring basis (in thousands):


	Balance Sheet Classification	Carrying Value		Level 1		Level 2		Level 3
December 31, 2025
Available-for-sale fixed-maturity securities
Commercial paper	Investment securities	$	12,439	$	—	$	12,439	$	—

U.S. Treasury Bills	Investment securities	$	7,459	$	—	$	7,459	$	—
U.S. Government Agencies	Investment securities	$	4,982	$	—	$	4,982	$	—
Money market funds	Cash and cash equivalents	$	25,292	$	25,292	$	—	$	—
Other financial assets:
Interest rate cap	Other current assets	$	274	$	—	$	274	$	—
Other financial liabilities:
Interest rate swaps	Other accrued expenses	$	621	$	—	$	621	$	—
Interest rate swaps	Other long-term liabilities	$	414	$	—	$	414	$	—
December 31, 2024
Other financial assets:
Interest rate swaps	Other current assets	$	1,127	$	—	$	1,127	$	—
Interest rate swaps	Other long-term assets	$	22	$	—	$	22	$	—

Income Taxes - Changes in Valuation Allowance (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Valuation Allowance [Roll Forward]
Beginning balance	$ 1,056	$ 197
Increase/(decrease)	130	859
Acquisitions	1,424
Ending balance	$ 2,610	$ 1,056

Goodwill and Other Intangible Assets - Changes in the Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Changes in the carrying amount of goodwill
Balance as of beginning of period	$ 3,019,999	$ 3,030,013	$ 3,009,558
Goodwill recorded in connection with acquisitions (Note 7)	996,819		20,455
Rollover options deferred tax asset adjustment		(10,014)
Balance as of end of period	$ 4,016,818	$ 3,019,999	$ 3,030,013

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Income/ (Loss) Per Share - Reconciliation of The Numerators and The Denominators of The Basic and Diluted (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Basic income/(loss) per share:
Net income/(loss)	$ 112,089	$ (19,125)	$ (51,334)
Net income/(loss) attributable to common shares	$ 112,089	$ (19,125)	$ (51,334)
Basic weighted average common stock outstanding	177,926,745	149,915,839	121,675,430
Basic income/(loss) per share (in dollars per share)	$ 0.63	$ (0.13)	$ (0.42)
Diluted income/(loss) per share:
Net income/(loss)	$ 112,089	$ (19,125)	$ (51,334)
Net income/(loss) attributable to common shares	$ 112,089	$ (19,125)	$ (51,334)
Diluted weighted average common stock outstanding (in shares)	184,783,285	149,915,839	121,675,430
Diluted income/(loss) per share (in dollars per share)	$ 0.61	$ (0.13)	$ (0.42)
Voting
Basic income/(loss) per share:
Basic weighted average common stock outstanding	177,926,745	149,915,839	121,238,629
Diluted income/(loss) per share:
Diluted weighted average common stock outstanding (in shares)	184,783,284	149,915,839	121,238,629
Voting \| Stock Options
Diluted income/(loss) per share:
Dilutive effect (in shares)	5,846,245	0	0
Voting \| RSUs
Diluted income/(loss) per share:
Dilutive effect (in shares)	1,003,061	0	0
Voting \| ESPP
Diluted income/(loss) per share:
Dilutive effect (in shares)	7,233	0	0
Non-voting
Basic income/(loss) per share:
Basic weighted average common stock outstanding	0	0	436,801
Diluted income/(loss) per share:
Diluted weighted average common stock outstanding (in shares)	0	0	436,801

Stock-based Compensation (Tables)

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Schedule of Information Pertaining to Option Activity (Including Rollover Options)

Information pertaining to option activity under all plans (including rollover options) during the years ending December 31, 2025, 2024, and 2023 is as follows:


	Number of options	Weighted average exercise price per share		Weighted average remaining contractual life
Outstanding December 31, 2024	16,511,128	$	17.57	5.8
Granted	132,065	36.94
Exercised	(2,317,930)	10.63
Forfeited	(333,090)	25.95
Outstanding December 31, 2025	13,992,173	18.71		5.1


	Number of options	Weighted average exercise price per share		Weighted average remaining contractual life
Outstanding December 31, 2023	13,032,541	$	15.20	5.7
Granted	4,003,703	24.20
Exercised	(392,016)	4.53
Forfeited	(133,100)	22.28
Outstanding December 31, 2024	16,511,128	17.57		5.8


	Number of options	Weighted average exercise price per share		Weighted average remaining contractual life
Outstanding December 31, 2022	13,123,170	$	15.10	6.6
Granted	208,725	37.20
Exercised	(39,204)	21.51
Forfeited	(260,150)	23.70
Outstanding December 31, 2023	13,032,541	15.20		5.7

Summary of Significant Assumptions Used in Estimating the Fair Value of Options Granted

The following is a summary of the significant assumptions used in estimating the fair value of options granted the years ended December 31, 2025, 2024, and 2023:


	Years ended December 31,
	2025		2024		2023
Risk free interest rate	3.95	%	3.76%–4.59%		3.51%–4.55%
Expected dividend yield	—	%	—	%	—	%
Expected term of stock award	6.2		5.0–6.5		1.2–5.0
Expected volatility in stock price	46.24	%	49.62%–51.89%		51.64%–55.00%

Summary of RSU Activity

The following tables summarize RSU activity during the years ended December 31, 2025 and 2024, respectively. There was no RSU activity prior to the initial grant of RSUs on June 10, 2024.


	Number of shares	Weighted average grant date fair value
Outstanding December 31, 2024	2,089,241	$21.91
Granted	2,698,171	37.43
Vested	(483,491)	21.92
Forfeited	(83,763)	30.67
Outstanding December 31, 2025	4,220,158	31.65


	Number of shares	Weighted average grant date fair value
Outstanding December 31, 2023	—	$	—
Granted	2,107,499	21.90
Vested	—	—
Forfeited	(18,258)	21.50
Outstanding December 31, 2024	2,089,241	21.91

Summary of Significant Assumptions in Estimating the Fair Value of PSUs Granted

The following is a summary of the significant assumptions used in estimating the fair value of PSUs granted during the year ended December 31, 2025. There were no PSU activity prior to the initial grant of PSUs on June 10, 2024.


	Years ended December 31,
	2025		2024	2023
Risk free interest rate	3.92	%	N/A	N/A
Expected dividend yield	0	%	N/A	N/A
Expected term of stock award	4.0		N/A	N/A
Expected volatility in stock price	40.00	%	N/A	N/A

Summary of PSU Activity

The following table summarizes PSU activity during the year ended December 31, 2025.


	Number of shares	Weighted average grant date fair value
Outstanding December 31, 2024	—	$	—
Granted	396,197	61.67
Vested	—	—
Forfeited	—	—
Outstanding December 31, 2025	396,197	61.67

Schedule of Stock-Based Compensation Expense

Stock-based compensation expense was recorded in the following cost and expense categories in the consolidated statements of operations:


	Years ended December 31,
	2025		2024		2023
Cost of revenue	$	1,514	$	2,403	$	645
General and administrative	25,678		31,288		5,034
Sales and marketing	8,562		12,440		1,866
Research and development	6,315		8,306		1,303
Total	42,069		54,437		8,848

Stock-based Compensation - Stock Options Assumptions (Details) - Stock Options	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Significant assumptions
Risk free interest rate (as a percent)	3.95%
Risk free interest rate, minimum (as a percent)		3.76%	3.51%
Risk free interest rate, maximum (as a percent)		4.59%	4.55%
Expected dividend yield (as a percent)	0.00%	0.00%	0.00%
Expected term of stock award	6 years 2 months 12 days
Expected volatility in stock price (as a percent)	46.24%
Expected volatility in stock price, minimum (as a percent)		49.62%	51.64%
Expected volatility in stock price, maximum (as a percent)		51.89%	55.00%
Minimum
Significant assumptions
Expected term of stock award		5 years	1 year 2 months 12 days
Maximum
Significant assumptions
Expected term of stock award		6 years 6 months	5 years

Acquisitions - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands				12 Months Ended
	Oct. 01, 2025	Oct. 31, 2023	Aug. 03, 2023	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Acquisitions
Equity consideration				$ 620,835	$ 0	$ 0
Goodwill				4,016,818	$ 3,019,999	$ 3,030,013	$ 3,009,558
Iodine Acquisition
Acquisitions
Total consideration	$ 1,259,800
Consideration paid	638,900
Equity consideration	$ 620,800
Number of shares to be issued as part of consideration (in shares)	16,639,920
Share price (in dollars per share)	$ 37.31
Useful lives	15 years 1 month 6 days
Total acquisition costs				$ 12,700
Goodwill	$ 996,819
Iodine Acquisition \| Customer relationships
Acquisitions
Useful lives	18 years
Total intangible assets	$ 290,600
Iodine Acquisition \| Developed technology
Acquisitions
Useful lives	5 years
Total intangible assets	$ 76,600
Iodine Acquisition \| Tradenames and trademarks
Acquisitions
Useful lives	2 years
Total intangible assets	$ 5,200
HealthPay24
Acquisitions
Consideration paid			$ 31,400
Total intangible assets			29,600
Goodwill			$ 13,900
Olive AI, Inc
Acquisitions
Total consideration		$ 10,000
Goodwill		6,500
Intangible asset, including goodwill		$ 10,600

Consolidated Statements of Changes in Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit
Balance at the beginning (in shares) at Dec. 31, 2022		121,670,948
Balance at the beginning at Dec. 31, 2022	$ 2,106,232	$ 1,217	$ 2,225,618	$ 29,838	$ (150,441)
Changes in stockholder's equity
Share-based compensation	8,848		8,848
Issuance of common stock under employee equity plans (in shares)		26,268
Issuance of common stock under employee equity plans	425	$ 1	424
Repurchase of shares (in shares)		(17,314)
Repurchase of shares	(688)	$ (1)	(687)
Capital distributions	485		485
Net income/(loss)	(51,334)				(51,334)
Other comprehensive income (loss)	(14,036)			(14,036)
Balance at the end (in shares) at Dec. 31, 2023		121,679,902
Balance at the end at Dec. 31, 2023	2,049,932	$ 1,217	2,234,688	15,802	(201,775)
Changes in stockholder's equity
Share-based compensation	54,943		54,943
Issuance of common stock under employee equity plans (in shares)		392,016
Issuance of common stock under employee equity plans	1,683	$ 6	1,677
Repurchase of shares (in shares)		(22,688)
Repurchase of shares	(844)	$ (1)	(843)
Capital distributions	(99)		(99)
Issuance of common stock in initial public offering (inclusive of underwriters’ exercise of the overallotment option on July 5, 2024), net of issuance costs (in shares)		50,059,010
Issuance of common stock in initial public offering (inclusive of underwriters’ exercise of the overallotment option on July 5, 2024), net of issuance costs	1,008,217	$ 500	1,007,717
Net income/(loss)	(19,125)				(19,125)
Other comprehensive income (loss)	(14,921)			(14,921)
Balance at the end (in shares) at Dec. 31, 2024		172,108,240
Balance at the end at Dec. 31, 2024	3,079,786	$ 1,722	3,298,083	881	(220,900)
Changes in stockholder's equity
Share-based compensation	41,850		41,850
Issuance of common stock under employee equity plans (in shares)		2,839,033
Issuance of common stock under employee equity plans	25,779	$ 27	25,752
Common stock issued related to acquisition (see Note 7) (in shares)		16,639,920
Common stock issued related to acquisition (see Note 7)	620,835	$ 167	620,668
Net income/(loss)	112,089				112,089
Other comprehensive income (loss)	(1,513)			(1,513)
Balance at the end (in shares) at Dec. 31, 2025		191,587,193
Balance at the end at Dec. 31, 2025	$ 3,878,826	$ 1,916	$ 3,986,353	$ (632)	$ (108,811)

Summary of Significant Accounting Policies - Contract Costs (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Contract Costs
Impairment losses	$ 0.0	$ 0.0	$ 0.0
Incremental costs of obtaining a contract
Contract Costs
Total unamortized costs	32.4	29.0
Amortization related to contract costs	13.0	10.7	7.6
Costs to fulfill a contract
Contract Costs
Total unamortized costs	61.6	53.8
Amortization related to contract costs	$ 16.2	$ 12.3	$ 8.8

Goodwill and Other Intangible Assets

12 Months Ended

Dec. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangible Assets

Goodwill has a balance of $4.0 billion and $3.0 billion as of December 31, 2025 and 2024, respectively.

The following table details the cost basis changes in the carrying amount of goodwill (in thousands):


Balance as of December 31, 2022	$	3,009,558
Goodwill recorded in connection with acquisitions (Note 7)	20,455
Balance as of December 31, 2023	3,030,013
Rollover options deferred tax asset adjustment	(10,014)
Balance as of December 31, 2024	3,019,999
Goodwill recorded in connection with acquisitions (Note 7)	996,819
Total	$	4,016,818

Amortization for definite-lived intangible assets is as follows (in thousands, except useful life):


	Gross Carrying Amount		Accumulated Amortization		Net Carrying Value		Weighted- Average Remaining Useful Life
As of December 31, 2025
Customer relationships	$	1,720,000	$	(539,645)	$	1,180,355	12.0
Purchased developed technology	119,800		(27,045)		92,755		4.6
Tradenames and trademarks	45,100		(25,371)		19,729		3.3
Total	$	1,884,900	$	(592,061)	$	1,292,839
As of December 31, 2024
Customer relationships	$	1,429,400	$	(440,729)	$	988,671	11.1
Purchased developed technology	81,800		(50,875)		30,925		4.2
Tradenames and trademarks	40,700		(21,247)		19,453		4.7
Total	$	1,551,900	$	(512,851)	$	1,039,049

Amortization expense was $118.6 million, $147.9 million, and $159.4 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Estimated future amortization expense is as follows (in thousands):


Year ending, December 31,
2026	$	137,895
2027	137,245
2028	135,295
2029	133,379
2030	123,796
Thereafter	625,229
Total	$	1,292,839

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024	Jun. 10, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Accounts receivable, allowance	$ 6,170	$ 5,885		$ 5,335
Preferred stock, shares par value (in dollars per share)	$ 0.01	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	100,000,000	100,000,000	100,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, shares par value (in dollars per share)	$ 0.01	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	2,500,000,000	2,500,000,000	2,500,000,000
Common stock, shares issued (in shares)	191,587,193	172,108,240
Common stock, shares outstanding (in shares)	191,587,193	172,108,240

Summary of Significant Accounting Policies (Policies)	12 Months Ended
Summary of Significant Accounting Policies (Policies)	Dec. 31, 2025
Accounting Policies [Abstract]
Basis of Financial Statement Presentation	Basis of Financial Statement Presentation The financial statements include the consolidated balance sheets, statements of operations, statements of comprehensive loss, statements of changes in stockholders’ equity, and statements of cash flows of Waystar and its subsidiaries and have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”).
Segment information	Segment information Operating segments are defined as components of an enterprise about which separate financial information is evaluated regularly by the chief operating decision maker in deciding how to allocate resources and assessing performance. We define the term “chief operating decision maker” to be our Chief Executive Officer. Our Chief Executive Officer reviews the financial information presented on an entire company basis for purposes of allocating resources and evaluating our financial performance. Accordingly, we have determined that we operate in a single reportable operating segment.
Use of Estimates	Use of Estimates The preparation of the consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities, the disclosures of contingent assets and liabilities as of the date of the financial statements, and the reported amounts of revenues and expenses during the reporting periods. Significant estimates and assumptions are used for, but are not limited to: (1) revenue recognition, including estimated expected customer life; (2) recoverability of accounts receivable and taxes receivable; (3) impairment assessment of goodwill and long-lived intangible assets; (4) fair value of intangibles acquired in business combinations; (5) litigation reserves; (6) depreciation and amortization; (7) fair value of stock options issued to employees and assumed as part of business combinations; (8) fair value of interest rate swaps; and (9) leases, including incremental borrowing rate. Future events and their effects cannot be predicted with certainty, and accordingly, accounting estimates require the exercise of judgment. We evaluate and update assumptions and estimates on an ongoing basis and may employ outside experts to assist in evaluations. Actual results could differ from the estimates used.
Principals of Consolidation	Principals of Consolidation The accompanying consolidated financial statements include the accounts of Waystar Holding Corp. and its subsidiaries. All material intercompany balances and transactions have been eliminated.
Revenue Recognition	Revenue Recognition We derive revenue primarily from providing access to our solutions for use in the healthcare industry and in doing so generate two types of revenue: (i) subscription revenue and (ii) volume-based revenue, which account for 99% of total revenue for all periods presented. We also derive revenue from implementation fees for our software, as well as hardware sales to facilitate patient payments. We recognize revenue in accordance with Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers (“ASC 606”), through the following five steps: •identification of the contract, or contracts, with a client; •identification of the performance obligations in the contract; •determination of the transaction price; •allocation of the transaction price to the performance obligations in the contract; and •recognition of revenue when, or as, we satisfy a performance obligation Our customers, referred to as clients elsewhere in this report, represent healthcare providers across all types of care settings, including physician practices, clinics, surgical centers, and laboratories, as well as large hospitals and health systems. We account for a contract when it has approval and commitment from both parties, the rights of the parties are identified, payment terms are identified, the contract has commercial substance and collectability of consideration is probable. The length of our contracts vary but are typically two to three years and generally renew automatically for successive one-year terms. Our revenue is reported net of applicable sales and use tax and is recognized as, or when, control of these services or products are transferred to clients, in an amount that reflects the consideration we expect to be entitled to in exchange for the contract’s performance obligations. Revenue from our subscription services as well as from our volume-based services represents a single promise to provide continuous access (i.e., a stand-ready obligation) to our software solutions in the form of a service. Our software products are made available to our clients via a cloud-based, hosted platform where our clients do not have the right or practical ability to take possession of the software. As each day of providing access to the software solutions is substantially the same and the client simultaneously receives and consumes the benefits as services are provided, these services are viewed as a single performance obligation comprised of a series of distinct daily services. Revenue from our subscription services is recognized over time on a ratable basis over the contract term beginning on the date that the service is made available to the client. Volume-based services are priced based on transaction, dollar volume or provider count in a given period. Given the nature of the promise is based on unknown quantities or outcomes of services to be performed over the contract term, the volume-based fee is determined to be variable consideration. The volume-based transaction fees are recognized each day using a time- elapsed output method based on the volume or transaction count at the time the clients’ transactions are processed. Our other services are generally related to implementation activities across all solutions and hardware sales to facilitate patient payments. Implementation services are not considered performance obligations as they do not provide a distinct service to clients without the use of our software solutions. As such, implementation fees related to our solutions are billed upfront and recognized ratably over the contract term. Implementation fees and hardware sales represent less than 1% of total revenue for all periods presented. Our contracts with clients typically include various combinations of our software solutions. Determining whether such software solutions are considered distinct performance obligations that should be accounted for separately versus together requires significant judgment. Specifically, judgment is required to determine whether access to our SaaS solutions is distinct from other services and solutions included in an arrangement. We follow the requirements of ASC 606-10-55-36 through -40, Revenue from Contracts with Customers, Principal Agent Considerations, in determining the gross versus net revenue presentations for our performance obligations in the contract with a client. Revenue recorded where we act in the capacity of a principal is reported on a gross basis equal to the full amount of consideration to which we expect in exchange for the good or service transferred. Revenue recorded where we act in the capacity of an agent is reported on a net basis, exclusive of any consideration provided to the principal party in the transaction. The principal versus agent evaluation is a matter of judgment that depends on the facts and circumstances of the arrangement and is dependent on whether we control the good or service before it is transferred to the client or whether we are acting as an agent of a third party. This evaluation is performed separately for each performance obligation identified. For the majority of our contracts, we are considered the principal in the transaction with the client and recognize revenue gross of any related channel partner fees or costs. We have certain agency arrangements where third parties control the goods or services provided to a client, and we recognize revenue net of any fees owed to these third parties. Payment terms and conditions vary by contract type, although our standard payment terms generally require payment within 30 to 60 days. In instances where the timing of revenue recognition differs from the timing of payment, we have determined our contracts do not generally include a significant financing component. The primary purpose of our invoicing terms is to provide clients with simplified and predictable ways of purchasing our products and services, not to receive financing from our clients or to provide clients with financing.
Contract Costs	Contract Costs Incremental Costs of Obtaining a Contract Incremental costs of obtaining a contract primarily include commissions paid to our internal sales personnel. We consider all such commissions to be both incremental and recoverable since they are only paid when a contract is secured. These capitalized costs are amortized on a straight-line basis over the expected period of benefit, which is determined based on the average customer life, which includes anticipated renewals of contracts. As of December 31, 2025 and 2024, the total unamortized costs reported as deferred costs on our balance sheet amounted to $32.4 million and $29.0 million, respectively, for internal sales commissions. For the years ended December 31, 2025, 2024, and 2023, amortization related to the sales commission asset was $13.0 million, $10.7 million, and $7.6 million, respectively. The aforementioned amortization amounts are included in sales and marketing in our consolidated statements of operations. Costs to Fulfill a Contract We capitalize costs incurred to fulfill contracts that i) relate directly to the contract, ii) are expected to generate resources that will be used to satisfy performance obligations under the contract, and iii) are expected to be recovered through revenue generated under the contract. Costs incurred to implement clients on our solutions (e.g., direct labor) are capitalized and amortized on a straight-line basis over the estimated customer life if we expect to recover those costs. As of December 31, 2025 and 2024, the total unamortized costs reported as deferred costs on our balance sheet amounted to $61.6 million and $53.8 million, respectively, for fulfillment costs. For the years ended December 31, 2025, 2024, and 2023, amortization related to the fulfillment cost asset was $16.2 million, $12.3 million, and $8.8 million, respectively. The aforementioned amortization amounts are included in the costs of revenue in our consolidated statements of operations.
Channel Partners	Channel Partners We account for fees paid to channel partners within sales and marketing expenses in the accompanying statements of operations. For the years ended December 31, 2025, 2024, and 2023, we recorded fees to all channel partners of $77.9 million, $65.3 million and $52.3 million, respectively. As we are primarily responsible for contracting with and fulfilling contracts for the end user, we record revenue gross of related channel partner fees.
Cash and cash equivalents	Cash and cash equivalents We consider highly liquid investments with an original maturity of three months or less to be cash equivalents. We maintain our cash in bank deposit accounts, which, at times, may exceed federally insured limits. We have not experienced any credit losses in such accounts.
Restricted cash	Restricted cash For a fee, we provide lockbox solutions through a banking institution to certain clients. When participating customers’ cash is received from their clients or patients, it is deposited in a lockbox account owned by us and is contractually required to be disbursed to the participating clients the following day. Any funds residing in these accounts are categorized as restricted cash. Our restricted cash balance also consists of cash collected on behalf of healthcare providers from patients that has yet to be remitted to the providers. There is also an associated liability corresponding to cash held for others.
Accounts receivable	Accounts receivable Accounts receivable are primarily generated from billings related to our cloud-based technology and do not bear interest. Unbilled accounts receivable arise when services have been rendered for which revenue has been recognized but the customers have not been billed. Substantially all accounts receivable are from companies in the healthcare service industry. Accounts receivable are net of an allowance for doubtful accounts and are considered past due when they are outstanding beyond agreement terms. We estimate the allowance for doubtful accounts based primarily on an analysis of historical collections experience, review of accounts receivable aging schedules, and specific identification of individual clients management believes to be at risk. If additional amounts become uncollectible, they will be charged to operations when that determination is made. Accounts receivable are written off against the allowance for doubtful accounts once all collection efforts have been exhausted, and recovery is deemed remote. If amounts previously written off are collected, they will be included as a deduction in general and administrative expense when received. Credit is extended based on historical experience with similar clients. Generally, collateral is not required.
Property and equipment	Property and equipment Property and equipment are stated at cost. Depreciation of property and equipment is computed using the straight-line method for financial reporting purposes at rates based on the estimated useful lives and pattern of usage of the assets. The estimated useful lives of the assets are 5 years for computer hardware and office equipment, 7 years for furniture and fixtures, and 40 years for buildings. Purchased computer software is depreciated over the estimated useful life of 3–5 years. Leasehold improvements are amortized over the life of the lease or their estimated useful lives, whichever is shorter. We evaluate the useful lives of these assets and test for impairment whenever events or changes in circumstances occur that could impact the recoverability of these assets. Expenditures for major renewals and betterments that extend the useful lives of property and equipment are capitalized. Expenditures for maintenance and repairs are charged to expense as incurred. Refer to Note 8 for more information on property and equipment.
Software licenses and maintenance contracts	Software licenses and maintenance contracts Software licenses and prepaid software maintenance contracts are accounted for as prepaid expenses and are amortized over the related service period, which is typically 12 months or less. In instances where contracts exceed 12 months, a portion of the contract is recorded as other long-term assets.
Long-Lived Assets	Long-Lived Assets Long-lived assets are amortized over their useful lives. We evaluate the remaining useful life of long-lived assets periodically to determine if events or changes in circumstances warrant a revision to the remaining period of amortization. The carrying amounts of these assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying value of these assets may not be recoverable. We measure the recoverability of these assets by comparing the carrying amount of the asset group to the future undiscounted cash flows the assets are expected to generate. If the undiscounted cash flows used in the test for recoverability are less than the carrying amount of the asset groups, then the carrying amount of such assets is reduced to fair value. Refer to Notes 8, 9, and 10 for more information on long-lived assets.
Goodwill	Goodwill We account for business combinations under the acquisition method of accounting in accordance with ASC 805, Business Combinations, where the total purchase price is allocated to the tangible and identified intangible assets acquired and liabilities assumed based on their estimated fair values. The purchase price is allocated using the information currently available, and may be adjusted, up to one year from acquisition date, after obtaining more information regarding, among other things, asset valuations, liabilities assumed and revisions to preliminary estimates. The purchase price in excess of the fair value of the tangible and identified intangible assets acquired less liabilities assumed is recognized as goodwill. We account for goodwill under the provisions of ASC 350, Intangibles—Goodwill and Other. Goodwill is evaluated for impairment annually on October 1st or whenever there is an impairment indicator. There was no impairment to goodwill during the years ended December 31, 2025, 2024 and 2023, respectively. Refer to Note 9 for more information on goodwill.
Deferred Offering Costs	Deferred Offering Costs We capitalize within other assets certain legal, accounting, and other third-party fees that are directly related to our in-process equity financings, including the planned IPO, until such financings are consummated. After consummation of the equity financing, these costs are recorded as a reduction of the proceeds received as a result of the offering. Should a planned equity financing be abandoned, terminated, or significantly delayed, the deferred offering costs are immediately written off to operating expenses.
Capitalized software development costs	Capitalized software development costs We capitalize internal-use software costs under the provisions of ASC 350 which includes costs incurred in connection with the development of new software solutions and enhancements to existing software solutions that are expected to result in increased functionality. The costs incurred in the preliminary stages of development are expensed as incurred. Once the software has reached the development stage, internal and external costs, if direct and incremental, are capitalized until the software is complete and available for general release. Capitalized software development costs are recorded in property and equipment and are amortized on a straight-line basis over their estimated useful life of two years. We evaluate the useful lives of these assets and test for impairment whenever events or changes in circumstances occur that could impact the recoverability of these assets.
Research and development costs	Research and development costs Research and development (“R&D”) costs consist primarily of personnel and related expenses for employees engaged in research and development activities as well as third-party fees. All such costs are expensed as incurred, except for capitalized software development costs.
Debt Issuance Costs	Debt Issuance Costs Debt issuance costs, net of amortization, are reflected on our balance sheet as a direct reduction in the carrying amount of our long-term debt. In addition, debt issuance costs, net of amortization, related to our revolver debt are included in other assets. Debt issuance costs include fees paid to creditors and third-party fees incurred for the issuance of new debt. Debt issuance costs are amortized over the respective term of the debt instruments using the effective interest method, and amortization charges are included in interest expense.
Derivative instruments	Derivative instruments We hold three interest rate swaps with one maturing on January 31, 2026 and two maturing on March 31, 2027, as well as an interest rate cap maturing on April 30, 2026. We held one interest rate swap that matured on October 31, 2024 and two interest rate swaps that matured on November 30, 2022 designated as cash flow hedges to a portion of our outstanding debt. At inception and on an ongoing basis, we assess whether our swaps qualify for hedge accounting. These interest rate swaps have been deemed highly effective under ASC 815 so they meet the hedge accounting treatment criteria and qualify for hedge accounting. The swaps have been recorded on the balance sheet at fair value as either assets or liabilities and any changes to the fair value are recorded through accumulated other comprehensive income and reclassified into interest expense in the same period in which the hedged transaction is recognized in earnings. Cash flows from interest rate swaps are reported in the same category as the cash flows from the items being hedged.
Fair value of financial instruments	Fair value of financial instruments Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. It also establishes a three-level hierarchy that prioritizes the inputs used to measure fair value. The three levels of the hierarchy are defined as follows: •Level 1—Observable inputs that reflect quoted prices (unadjusted) for identical assets and liabilities in active markets. •Level 2—Include other inputs that are directly or indirectly observable in the marketplace. •Level 3—Unobservable inputs which are supported by little or no market activity. As of December 31, 2025 and 2024, the carrying value of cash equivalents, accounts receivable, accounts payable, accrued liabilities, and other current assets and liabilities approximates fair value due to the short maturities of these instruments. Swaps are Level 2 instruments whose fair value is derived from discounted cash flows adjusted for nonperformance risk.
Investment securities	Investment securities Our short-term investments, which consist of debt securities, are stated at fair value. These debt securities have been categorized as available-for-sale and classified as current assets given their maturity date is 12 months or less. Unrealized holding gains and losses for debt securities, net of applicable deferred taxes, are included in other comprehensive income or loss as a component of stockholders’ equity until realized from a sale or an expected credit loss is recognized. For the purpose of determining realized gross gains and losses for debt securities sold, that are included as a component of interest income/(expense) in the consolidated statements of income, the cost of investment securities sold is based upon specific identification. We recorded $2.1 million of interest income on investment securities for the year ended December 31, 2025, within “Other expense” of our statements of operations. We recorded no interest income on investment securities for the years ended December 31, 2024 and 2023. Under the current expected credit losses model, expected losses on available for sale debt securities are recognized through an allowance for credit losses rather than as reductions in the amortized cost of securities. For debt securities whose fair value is less than their amortized cost, which we do not intend to sell or are not required to sell, we evaluate the expected cash flows to be received as compared to amortized cost and determine if an expected credit loss has occurred. In the event of any expected credit loss, only the amount of impairment associated with the expected credit loss is recognized in income with the remainder, if any, of the loss recognized in other comprehensive income. To the extent we have the intent to sell the debt security, or it is more likely than not we will be required to sell the debt security before recovery of our amortized cost basis, we recognize an impairment loss in income in an amount equal to the full difference between the amortized cost basis and the fair value.
Stock-based compensation	Stock-based compensation We measure and recognize compensation expense for all stock-based payment awards made to employees and members of the Board of Directors based on estimated fair values and when vesting criteria is assessed as probable of being achieved. We utilize the straight-line vesting method to recognize compensation expense for all service-based payment awards. The value of the portion of the award that is ultimately expected to vest is recognized as expense over the requisite service periods in the consolidated statement of operations. Such expense consists of stock-based compensation expense related to stock option grants to employees and directors. See Note 18 for additional information. We estimate the fair value of service condition stock-based payment awards on the date of grant using the Black-Scholes option pricing model (“Black-Scholes”). We estimate the fair value of the performance condition stock-based payment awards that include a market condition on the date of grant using the Monte Carlo pricing model. We account for forfeitures as they occur. Our determination of fair value is affected by an estimate of our stock value as well as assumptions regarding several highly complex and subjective variables. These variables include, but are not limited to, our expected stock price volatility over the term of the awards and the expected term of the awards. We estimate expected stock price volatility using historical data of a peer group of public companies.
Advertising costs	Advertising costs We expense advertising costs as incurred.
Income taxes	Income taxes Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred income tax assets and liabilities of a change in tax rates is recognized in income tax expense in the period that includes the enactment date. A valuation allowance is provided against deferred tax assets if it is more-likely-than-not that some portion or all of the deferred tax assets will not be realized. Any change in the valuation allowance is charged to income tax expense in the period such determination was made. Deferred tax balances are presented as noncurrent liabilities. See Note 11 for additional information. We evaluate tax positions taken or expected to be taken in the course of preparing our tax returns to determine whether the tax positions are more-likely-than-not of being sustained upon examination by the applicable tax authority, based on the technical merits of the tax position, and then recognizing the tax benefit that is more-likely-than-not to be realized. Interest and penalties on material uncertain tax positions are classified as interest expense and operating expense, respectively.
Loss contingencies	Loss contingencies In accordance with ASC 450, Contingencies, estimated losses from contingencies are accrued when both of the following conditions are met: (1) it is probable a loss has been incurred; and (2) the amount of loss can be reasonably estimated. Any legal fees are recognized as incurred
Recently Adopted Accounting Pronouncements and Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Adopted Accounting Pronouncements In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023 - 09, Income Taxes (Topic 740): “Improvements to Income Tax Disclosures,” which requires disaggregated information about a reporting entity’s effective tax rate reconciliation as well as information on income taxes paid. The standard is intended to benefit investors by providing more detailed income tax disclosures that would be useful in making capital allocation decisions. For public business entities, the ASU will be effective for annual periods beginning after December 15, 2024. We adopted ASU 2023-09 during the year ended December 31, 2025 on a full retrospective basis. Refer to Note 11 for further details. In November 2023, the FASB issued ASU 2023 - 07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures.” The standard is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. For public business entities, the ASU was effective for annual periods beginning after December 15, 2023. We adopted ASU 2023-07 on a retrospective basis during the year ended December 31, 2024. Refer to Note 4 for further details. Recently Issued Accounting Pronouncements Not Yet Adopted In December 2025, the FASB issued ASU 2025-11, an update to improve the guidance in Topic 270, Interim Reporting, by improving the navigability of the required interim disclosures and clarifying when that guidance is applicable. For public companies, the update is effective for interim reporting periods within annual reporting periods beginning after December 15, 2027. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements. In November 2025, the FASB issued ASU 2025-09, an update to ASU 2017-12, "Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities." Consistent with the original objective of ASU 2017-12, the objective of this update is to more closely align hedge accounting with the economics of an entity's risk management activity. The amendments included in the five issues addressed in this update are intended to better reflect those strategies in financial reporting by enabling entities to achieve and maintain hedge accounting for highly effective economic hedges of forecasted transactions. For public companies, the new guidance will be effective for annual reporting periods beginning after December 15, 2026, and interim periods within those annual reporting periods. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements. In September 2025, the FASB issued ASU 2025-06, “Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software” to modernize the accounting guidance for the costs to develop software for internal use. The new guidance amends the existing standard that refers to various stages of a software development project to align better with current software development methods, such as agile programming. The new guidance will be effective for all entities for annual periods beginning after December 15, 2027. Early adoption is permitted. The guidance can be applied on a fully prospective basis, a modified basis for in-process projects, or a full retrospective basis. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements. In November 2024, the FASB issued ASU 2024-03, “Income Statement—Reporting Comprehensive Income— Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses.” The standard is intended to benefit investors by providing more detailed information about expenses that is critically important in understanding an entity’s performance, assessing an entity’s prospects for future cash flows, and comparing an entity’s performance over time and with that of other entities. For public companies, this ASU will be effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The amendments in this ASU should be applied either (1) prospectively to financial statements issued for reporting periods after the effective date of this ASU or (2) retrospectively to any or all prior periods presented in the financial statements. We are currently evaluating the effect of the adoption of this amendment on our consolidated financial statements.

Investment Securities

12 Months Ended

Dec. 31, 2025

Investments, Debt and Equity Securities [Abstract]

Investment Securities

Investment SecuritiesThe following table summarizes the unrealized positions for our investment securities classified as available-for-sale fixed-maturity debt securities, disaggregated by class of instrument (in thousands) as of December 31, 2025.


	Amortized Cost		Allowances for Credit Losses		Total Unrealized Gains		Total Unrealized Losses		Fair Value
Available-for-sale fixed-maturity securities
Commercial Paper	$	12,439	$	—	$	—	$	4	$	12,435

U.S. Treasury Bills	7,459		—		1		—		7,460
U.S. Government Agencies	4,982		—		—		—		4,982
Total	$	24,880	$	—	$	1	$	4	$	24,877

We did not own any investment securities as of December 31, 2024.

Property and Equipment, Net

12 Months Ended

Dec. 31, 2025

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

The balances of the major classes of property and equipment are as follows (in thousands):


	December 31,
	2025		2024

Computer hardware	$	44,045	$	39,833
Capitalized internal-use software	53,373		40,281
Purchased computer software	23,188		22,789
Furniture and fixtures	4,184		3,642
Office equipment	271		247
Leasehold improvements	4,994		3,778


Internal-use software in progress	19,110		15,361
	149,165		125,931
Accumulated depreciation	(97,516)		(79,200)
Total	$	51,649	$	46,731

Depreciation of fixed assets, including the amortization of capitalized software, for the years ended December 31, 2025, 2024, and 2023 was $21.9 million, $38.7 million, and $17.1 million, respectively.

We capitalized $16.8 million, $16.4 million, and $15.0 million in software development costs for the years ended December 31, 2025, 2024, and 2023, respectively. Amortization of capitalized software was $10.6 million, $10.2 million, and $6.8 million for the years ended December 31, 2025, 2024, and 2023, respectively. The net book value of capitalized software development costs was $35.9 million and $29.6 million as of December 31, 2025 and 2024, respectively. We expect to recognize $35.9 million of amortization of capitalized software in future periods.

There were no impairments of property and equipment for the years ended December 31, 2025, 2024, and 2023. Due to the relocation of one of our offices, we reduced the useful life of the related finance lease and leasehold improvement assets which represented $17.9 million of incremental depreciation in the year ended December 31, 2024. The aforementioned assets have been fully depreciated and disposed of as of December 31, 2024.

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies We may be subject to legal proceedings, claims, asserted or unasserted, and litigation arising in the ordinary course of business. We do not, however, currently expect that the ultimate costs to resolve any pending matter will have a material effect on our consolidated financial position, results of operations, or cash flows.

Goodwill and Other Intangible Assets - Estimated Future Amortization Expense (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Estimated future amortization expense
2026	$ 137,895
2027	137,245
2028	135,295
2029	133,379
2030	123,796
Thereafter	625,229
Net Carrying Value	$ 1,292,839	$ 1,039,049

Common and Preferred Stock	12 Months Ended
Common and Preferred Stock	Dec. 31, 2025
Stockholders' Equity Note [Abstract]
Common and Preferred Stock	Common and Preferred Stock Prior to the IPO, we authorized the issuance of 225,000,000 shares of common stock, par value 0.01 per share and 2,000,000 shares of Class A common stock, par value $0.01 per share. There were 121,243,101 common stock shares issued and outstanding as of December 31, 2023. There were 436,801 Class A common stock shares issued and outstanding as of December 31, 2023. Both common stock and Class A common stock had the same dividend and liquidation rights. However, each share of common stock was entitled to one vote and each share of the Class A common stock was not entitled to a vote. In connection with the IPO, our amended and restated certificate of incorporation became effective on June 10, 2024, which authorizes the issuance of 2,500,000,000 shares of common stock, par value 0.01 per share, and 100,000,000 shares of preferred stock, par value $0.01 per share. The shares of preferred stock have rights and preferences, including voting rights, designated from time to time by the Board of Directors. In connection with the amendment and restatement of the Company’s certificate of incorporation effective on the IPO date, the Class A common stock shares were automatically reclassified as, and became, one share of common stock. There were 191,587,193 and 172,108,240 common stock shares issued and outstanding as of December 31, 2025 and 2024, respectively. There were no shares of preferred stock issued and outstanding as of both December 31, 2025 and 2024.

- Definition

The entire disclosure for equity.

+ References

+ Details

Income Taxes - Deferred Tax Assets and Deferred Tax Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Deferred tax assets:
Accrued bonus	$ 7,985	$ 5,148
Stock based compensation	16,538	30,022
Accrued revenue, expenses, deferrals and other	3,614	2,607
Deferred revenue	3,857	2,129
Interest Expense	105,123	105,353
Interest Rate Swap	186	0
Other	19	4
Capitalized Research and Development Expenditures	6,171	20,557
Right-of-use Liability	4,484	4,703
Depreciation of property and equipment	0	1,755
Net operating loss	18,603	15,599
Valuation Allowance	(2,610)	(1,056)	$ (197)
Total deferred tax assets	168,973	187,648
Deferred tax liabilities:
Depreciation of property and equipment	4,493	0
Transaction Costs	36	26
Amortization	346,194	262,026
Other prepaid expenses	2,920	2,270
Right-of-use Asset	3,230	2,717
Interest Rate Swap	0	283
Deferred costs	23,420	20,849
Total deferred liabilities	380,293	288,171
Net deferred tax liability	(211,320)	(100,523)
State
Deferred tax assets:
Tax credits	827	827
Federal
Deferred tax assets:
Tax credits	$ 4,176	$ 0

Business - Initial Public Offering and Secondary Offerings (Details) - USD ($) $ / shares in Units, $ in Thousands					1 Months Ended	12 Months Ended
	Sep. 10, 2025	May 15, 2025	Feb. 24, 2025	Jul. 05, 2024	Jun. 30, 2024	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Jun. 06, 2024
Business
Deferred offering costs capitalized						$ 0	$ 0
Payment of offering costs						0	3,407	$ 0
First Lien Term Loan Facility
Business
Outstanding principal							$ 909,100	$ 110,900
IPO
Business
Number of shares issued (in shares)					45,000,000
Shares issued price per share (in dollars per share)					$ 21.50
Proceeds from exercise of common stock options					$ 914,300
Underwriters discounts and commission expense					53,200
Deferred offering costs capitalized					$ 8,800				$ 8,800
Over Allotment Option
Business
Number of shares issued (in shares)				5,059,010	6,750,000
Proceeds from exercise of common stock options				$ 102,800
Underwriters discounts and commission expense				$ 6,000
Secondary Offering \| Institutional Investors
Business
Payment of offering costs						$ 4,600
First Secondary Offering \| Institutional Investors
Business
Number of shares issued (in shares)			23,000,000
Second Secondary Offering \| Institutional Investors
Business
Number of shares issued (in shares)		14,375,000
Third Secondary Offering \| Institutional Investors
Business
Number of shares issued (in shares)	18,000,000

Goodwill and Other Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Changes in the Carrying Amount of Goodwill

The following table details the cost basis changes in the carrying amount of goodwill (in thousands):


Balance as of December 31, 2022	$	3,009,558
Goodwill recorded in connection with acquisitions (Note 7)	20,455
Balance as of December 31, 2023	3,030,013
Rollover options deferred tax asset adjustment	(10,014)
Balance as of December 31, 2024	3,019,999
Goodwill recorded in connection with acquisitions (Note 7)	996,819
Total	$	4,016,818

Schedule of Amortization for Definite-lived Intangible Assets

Amortization for definite-lived intangible assets is as follows (in thousands, except useful life):


	Gross Carrying Amount		Accumulated Amortization		Net Carrying Value		Weighted- Average Remaining Useful Life
As of December 31, 2025
Customer relationships	$	1,720,000	$	(539,645)	$	1,180,355	12.0
Purchased developed technology	119,800		(27,045)		92,755		4.6
Tradenames and trademarks	45,100		(25,371)		19,729		3.3
Total	$	1,884,900	$	(592,061)	$	1,292,839
As of December 31, 2024
Customer relationships	$	1,429,400	$	(440,729)	$	988,671	11.1
Purchased developed technology	81,800		(50,875)		30,925		4.2
Tradenames and trademarks	40,700		(21,247)		19,453		4.7
Total	$	1,551,900	$	(512,851)	$	1,039,049

Schedule of Estimated Future Amortization Expense

Estimated future amortization expense is as follows (in thousands):


Year ending, December 31,
2026	$	137,895
2027	137,245
2028	135,295
2029	133,379
2030	123,796
Thereafter	625,229
Total	$	1,292,839

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 24
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482548/350-20-55-24

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
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Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Section 50
-Paragraph 1
-Subparagraph (c)
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Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
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Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (f)
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Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-URI https://asc.fasb.org/1943274/2147482573/350-20-50-1A

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482573/350-20-50-2

+ Details

Revenue Recognition (Tables)

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Schedule of Revenues Disaggregated by Revenue Type and the Timing of Revenue Recognition

The following table presents revenues disaggregated by revenue type and the timing of revenue recognition (in thousands):


		Years ended December 31,
	Recognition		2025		2024		2023
Subscription revenue	Over time		$	558,408	$	457,975	$	401,013
Volume-based revenue	Over time		534,755		479,913		386,276
Implementation services and other revenue	Various		6,115		5,661		3,721
Total revenues			$	1,099,278	$	943,549	$	791,010

Schedule of Activity Impacting Deferred Revenue Balances

The following table presents activity impacting deferred revenue balances (in thousands):


	Years ended December 31,
	2025		2024		2023
Beginning balance	$	16,266	$	17,108	$	16,454
Revenue recognized (a)	(21,330)		(10,917)		(9,900)
Additional amounts deferred	16,672		10,075		10,554
Deferred revenue assumed as part of acquisitions (see Note 7)	61,743		—		—
Ending balance	$	73,351	$	16,266	$	17,108

(a) For the year ended December 31, 2025, $10.8 million of revenue was recognized from the acquired Iodine deferred revenue (see Note 7).

Debt - Maturity of Long-Term Principal Payments (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Debt Disclosure [Abstract]
2026	$ 14,194
2027	14,194
2028	14,194
2029	1,438,664
Total	$ 1,481,246

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References

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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
-SubTopic 10
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+ Details

Business - Reverse Stock Split (Details)	May 15, 2024
Business
Reverse stock split ratio	0.605
Reverse stock split ratio before amended	0.62
Class A common stock
Business
Reverse stock split ratio	0.605

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Retirement Plans	12 Months Ended
Retirement Plans	Dec. 31, 2025
Retirement Benefits [Abstract]
Retirement Plans	Retirement Plans We maintain qualified 401(k) plans which cover substantially all employees meeting certain eligibility requirements. Participants may contribute a portion of their compensation to the plans, up to the maximum amount permitted under Section 401(k) of the Internal Revenue Code. Under these plans, we contribute various percentages of employees’ salaries to the plans. Total expenses included in operating expenses in the accompanying consolidated statement of operations related to the plans were $5.4 million, $4.7 million and $4.1 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Leases - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Leases
Finance lease right-of-use assets	$ 0	$ 0
Incremental depreciation of finance lease right-of-use asset		14,900
Additional operating lease cost		1,200
Payment for lease termination	15,000
Loss on lease termination	$ 838	$ 0	$ 0
Minimum
Leases
Remaining lease term of operating lease	1 year
Maximum
Leases
Remaining lease term of operating lease	5 years

Other Accrued Expenses (Tables)

12 Months Ended

Dec. 31, 2025

Accrued Liabilities, Current [Abstract]

Schedule of Other Accrued Expenses

Other accrued expenses consist of the following (in thousands):


	Year ended December 31,
	2025		2024
Accrued income taxes	$	4,957	$	4,111
Other taxes payable	2,882		3,915
Accrued severance	920		—
Retirement plan payable	307		497
Accrued self insurance claims	1,160		1,064
Accrued interest	655		597

ESPP payable	1,721		—
Other	10,388		5,746
Total	$	22,990	$	15,930

Goodwill and Other Intangible Assets - Amortization for Definite-lived Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Goodwill and other intangible assets
Gross Carrying Amount	$ 1,884,900	$ 1,551,900
Accumulated Amortization	(592,061)	(512,851)
Net Carrying Value	1,292,839	1,039,049
Customer relationships
Goodwill and other intangible assets
Gross Carrying Amount	1,720,000	1,429,400
Accumulated Amortization	(539,645)	(440,729)
Net Carrying Value	$ 1,180,355	$ 988,671
Weighted- Average Remaining Useful Life	12 years	11 years 1 month 6 days
Purchased developed technology
Goodwill and other intangible assets
Gross Carrying Amount	$ 119,800	$ 81,800
Accumulated Amortization	(27,045)	(50,875)
Net Carrying Value	$ 92,755	$ 30,925
Weighted- Average Remaining Useful Life	4 years 7 months 6 days	4 years 2 months 12 days
Tradenames and trademarks
Goodwill and other intangible assets
Gross Carrying Amount	$ 45,100	$ 40,700
Accumulated Amortization	(25,371)	(21,247)
Net Carrying Value	$ 19,729	$ 19,453
Weighted- Average Remaining Useful Life	3 years 3 months 18 days	4 years 8 months 12 days

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Stock-based Compensation - PSUs, Valuation Assumption (Details) - PSU	12 Months Ended
	Dec. 31, 2025
Stock-based compensation
Risk free interest rate (as a percent)	3.92%
Expected dividend yield (as a percent)	0.00%
Expected term of stock award	4 years
Expected volatility in stock price (as a percent)	40.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Common and Preferred Stock (Details)		12 Months Ended
Common and Preferred Stock (Details)	Jun. 10, 2024 $ / shares shares	Dec. 31, 2023 instrument $ / shares shares	Dec. 31, 2025 $ / shares shares	Dec. 31, 2024 $ / shares shares
Business
Shares authorized (in shares)	2,500,000,000		2,500,000,000	2,500,000,000
Common stock, par value (in dollars per share) \| $ / shares	$ 0.01		$ 0.01	$ 0.01
Shares issued (in shares)			191,587,193	172,108,240
Shares outstanding (in shares)			191,587,193	172,108,240
Preferred stock, shares authorized (in shares)	100,000,000		100,000,000	100,000,000
Preferred stock, shares par value (in dollars per share) \| $ / shares	$ 0.01		$ 0.01	$ 0.01
Preferred stock, shares issued (in shares)			0	0
Preferred stock, shares outstanding (in shares)			0	0
No class common stock
Business
Shares authorized (in shares)		225,000,000
Common stock, par value (in dollars per share) \| $ / shares		$ 0.01
Shares issued (in shares)		121,243,101
Shares outstanding (in shares)		121,243,101
Class A common stock
Business
Shares authorized (in shares)		2,000,000
Common stock, par value (in dollars per share) \| $ / shares		$ 0.01
Shares issued (in shares)		436,801
Shares outstanding (in shares)		436,801
Number of votes entitled \| instrument		1
Number of common stock reclassified (in shares)	1

Income/ (Loss) Per Share

12 Months Ended

Dec. 31, 2025

Earnings Per Share [Abstract]

Income/ (Loss) Per Share

A reconciliation of the numerators and the denominators of the basic and diluted per share computations are as follows:


	Years ended December 31,
	2025		2024		2023
Basic income/(loss) per share:
Net income/(loss)	$	112,089	$	(19,125)	$	(51,334)
Net income/(loss) attributable to common shares	$	112,089	$	(19,125)	$	(51,334)
Weighted average common stock outstanding–(voting)	177,926,745		149,915,839		121,238,629
Weighted average common stock outstanding–(non-voting)	—		—		436,801
Basic weighted average common stock outstanding	177,926,745		149,915,839		121,675,430
Basic income/(loss) per share	$	0.63	$	(0.13)	$	(0.42)

Diluted income/(loss) per share:
Net income/(loss)	$	112,089	$	(19,125)	$	(51,334)
Net income/(loss) attributable to common shares	$	112,089	$	(19,125)	$	(51,334)
Dilutive effect of stock options – (voting)	5,846,245		—		—
Dilutive effect of RSUs – (voting)	1,003,061		—		—
Dilutive effect of ESPP – (voting)	7,233		—		—
Weighted average common stock outstanding–(voting)	184,783,284		149,915,839		121,238,629
Weighted average common stock outstanding–(non-voting)	—		—		436,801
Diluted weighted average common stock outstanding	184,783,285		149,915,839		121,675,430
Diluted income/(loss) per share	$	0.61	$	(0.13)	$	(0.42)

Because of their anti-dilutive effect, 1,385,208, 5,761,255, and 5,213,559 common share equivalents comprised of time-based stock options and RSUs, have been excluded from the diluted earnings per share calculation for the years ended December 31, 2025, 2024, and 2023, respectively.

Summary of Significant Accounting Policies - Investment Securities (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Realized gain (loss) on investment securities	$ 2.1	$ 0.0	$ 0.0

Income Taxes - Income Tax Expense/(Benefit) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Current tax expense:
Federal	$ 3,695	$ 44,082	$ 36,277
State	10,757	11,633	12,888
Total current tax expense	14,452	55,715	49,165
Deferred tax (benefit):
Federal	42,064	(53,032)	(53,382)
State	3,158	(6,103)	(8,283)
Total deferred tax benefit	45,222	(59,135)	(61,665)
Income tax benefit	$ 59,674	$ (3,420)	$ (12,500)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References

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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Leases - Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$ 6,634	$ 5,423	$ 5,400
Financing cash flows for financing leases	16,336	1,572	1,547
Right-of-use assets obtained in exchange for new lease liabilities:
Operating leases	$ 6,154	$ 4,642	$ 2,284

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Unrecognized Tax Benefits [Roll Forward]
Beginning balance	$ 4,335	$ 3,094
Additions based on tax positions related to the current year	0	1,265
Reductions based on tax positions related to the current year	0	(24)
Reductions for tax positions in prior years	(279)	0
Ending balance	$ 4,056	$ 4,335

Insider Trading Policies and Procedures	12 Months Ended
Insider Trading Policies and Procedures	Dec. 31, 2025
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Stock-based Compensation

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Stock-based Compensation

Equity incentive plans

On October 22, 2019, the Board of Directors approved the Waystar Holding Corp. 2019 Stock Incentive Plan. Under this plan, we can issue up to 9.9 million options or other equity awards. The granted awards contain service criteria, performance criteria, market conditions, or a combination thereof for vesting and have a 10-year contractual term. Options with a service condition generally vest over 5 years with 20% vesting in equal vesting installments. Options with a performance condition and a market condition vest based upon a change in control, initial public offering, or a sponsor distribution or deemed return if the investors have achieved specified levels of return on investment. In addition, as part of a change in control in 2019, 2.2 million fully vested rollover options remain outstanding.

The Board of Directors approved the Waystar Holding Corp. 2024 Equity Incentive Plan (the “2024 Equity Incentive Plan”), effective as of June 6, 2024, the date of pricing of our IPO. Under this plan, we can issue non-qualified stock options, incentive stock options, stock appreciation rights, restricted shares of our Common Stock, restricted stock units, performance based stock units, and other equity-based awards tied to the value of our shares. Under this plan, we can issue up to 10 million options and other equity awards, subject to annual increases as outlined under the plan. The number of shares available to be issued automatically increases on the first day of each fiscal year beginning in 2025 by a number of shares equal to the lesser of the positive difference, if any, between 5% of the outstanding common stock on the last day of the immediately preceding fiscal year, minus the plan share reserve on the last day of the immediately preceding fiscal year or such lesser number of shares as may be determined by the Board of Directors. Options with a service condition generally vest over 5 years with 20% vesting in equal vesting installments. The restricted stock units (“RSUs”) under the 2024 Equity Incentive Plan generally vest over 4 or 5 years with 25% or 20% vesting, respectively, in equal vesting installments. The performance-based stock units (“PSUs”) under the 2024 Equity Incentive Plan vest between 0% and 200% based on our total shareholder return (“TSR”) relative to a designated peer group as defined in the respective agreement over a four-year performance period. As of December 31, 2025, 5.2 million shares were available for future grants under this plan.

The Board of Directors approved the Waystar Holding Corp. 2024 Employee Stock Purchase Plan (the “ESPP”), effective as of June 6, 2024, the date of pricing of our IPO. A total of 3,250,000 shares of common stock are initially reserved for the ESPP. The number of shares available to be issued for the ESPP will automatically increase each fiscal year beginning in 2025 by a number of shares equal to the lesser of the positive difference, if any, between 1% of the outstanding common stock on the last day of the immediately preceding fiscal year and the number of shares of common stock available for the issuance of shares pursuant to the plan on the last day of the immediately preceding fiscal year or such lesser number of shares as may be determined by the Board of Directors. The number of shares available to be issued for the ESPP will not exceed 27,000,000 as outlined in the plan agreement. Our employees contribute funds via payroll deductions during the offering periods, which are used to buy Waystar common shares at a discount of up to 15% of the purchase price at the purchase date. Offerings to purchase shares are granted twice annually on or about June 30 and December 31. During the year ended December 31, 2025, 37,323 of common shares have been issued as part of the ESPP. For the year ended December 31, 2025 expense of $0.5 million has been recorded which represents the 15% discount given to the employees under the ESPP. Zero expense was recorded in connection with the ESPP for the years ended December 31, 2024 and 2023.

Stock Options

We utilize the Black-Scholes option pricing model to estimate the fair value of the service condition options under all plans and the Monte Carlo pricing model to estimate the fair value of the performance condition options under the 2019 Waystar Holding Corp. Plan. We value both types of options at the grant date using the following assumptions:

•Risk-free interest rate—reflects the average rate on the United States Treasury bond with maturity equal to the expected term of the option;

•Expected dividend yield—as we do not currently pay dividends or expect to pay dividends in the near future, the expected dividend yield is zero;

•Expected term of stock award—under the 2024 Equity Incentive Plan, we utilized the simplified method due to the lack of historical experience activity for our Company. The simplified method calculates the expected term as the mid-point between the vesting date and the contractual expiration date of the award. Under the 2019 Waystar Holding Corp. Plan, it is based on historical experience that is modified based on expected future changes; and

•Expected volatility in stock price—reflects the historical volatility of comparable public companies over the expected term of the stock option.

The weighted average grant date fair value of options granted during the years ended December 31, 2025, 2024, and 2023 was $18.69, $12.89, and $19.66 per share, respectively. As of December 31, 2025, we had 6.6 million fully vested options with a weighted average exercise price of $15.06 per share, an aggregate intrinsic value of $117.9 million and an average remaining contractual term of 4.0 years. The total fair value of options vested for the years ended December 31, 2025, 2024, and 2023 were $17.7 million, $9.5 million, and $8.5 million, respectively.

In June 2024, we determined the vesting of all our performance condition options became probable as a result of the IPO (see Note 1). Therefore, we recognized an additional $33.1 million of stock-based compensation for the year ended December 31, 2024 as the implicit service period for the awards established at the grant date had elapsed. As of December 31, 2025, there is no remaining unrecognized compensation expense related to the performance condition options issued under the 2019 Waystar Holding Corp. Plan.

Information pertaining to option activity under all plans (including rollover options) during the years ending December 31, 2025, 2024, and 2023 is as follows:


	Number of options	Weighted average exercise price per share		Weighted average remaining contractual life
Outstanding December 31, 2024	16,511,128	$	17.57	5.8
Granted	132,065	36.94
Exercised	(2,317,930)	10.63
Forfeited	(333,090)	25.95
Outstanding December 31, 2025	13,992,173	18.71		5.1


	Number of options	Weighted average exercise price per share		Weighted average remaining contractual life
Outstanding December 31, 2023	13,032,541	$	15.20	5.7
Granted	4,003,703	24.20
Exercised	(392,016)	4.53
Forfeited	(133,100)	22.28
Outstanding December 31, 2024	16,511,128	17.57		5.8


	Number of options	Weighted average exercise price per share		Weighted average remaining contractual life
Outstanding December 31, 2022	13,123,170	$	15.10	6.6
Granted	208,725	37.20
Exercised	(39,204)	21.51
Forfeited	(260,150)	23.70
Outstanding December 31, 2023	13,032,541	15.20		5.7

The following is a summary of the significant assumptions used in estimating the fair value of options granted the years ended December 31, 2025, 2024, and 2023:


	Years ended December 31,
	2025		2024		2023
Risk free interest rate	3.95	%	3.76%–4.59%		3.51%–4.55%
Expected dividend yield	—	%	—	%	—	%
Expected term of stock award	6.2		5.0–6.5		1.2–5.0
Expected volatility in stock price	46.24	%	49.62%–51.89%		51.64%–55.00%

The aggregate intrinsic value of options exercised (the difference between the fair market value of our stock on the date of exercise and the exercise price) was approximately $66.1 million, $7.3 million and $0.4 million for the years ended December 31, 2025, 2024, and 2023, respectively.

We expect to incur compensation expense of approximately $35.2 million over a weighted average of 3.1 years for all unvested time-based awards outstanding as of December 31, 2025.

RSUs

The RSUs granted on June 10, 2024 in conjunction with the IPO were valued at the IPO price. Subsequent RSU grants are valued using our common stock price as of the grant date based on the publicly traded value per NASDAQ, and are expensed on a straight-line basis over the applicable vesting period. All vesting is contingent on continued service.

The following tables summarize RSU activity during the years ended December 31, 2025 and 2024, respectively. There was no RSU activity prior to the initial grant of RSUs on June 10, 2024.


	Number of shares	Weighted average grant date fair value
Outstanding December 31, 2024	2,089,241	$21.91
Granted	2,698,171	37.43
Vested	(483,491)	21.92
Forfeited	(83,763)	30.67
Outstanding December 31, 2025	4,220,158	31.65


	Number of shares	Weighted average grant date fair value
Outstanding December 31, 2023	—	$	—
Granted	2,107,499	21.90
Vested	—	—
Forfeited	(18,258)	21.50
Outstanding December 31, 2024	2,089,241	21.91

We expect to incur compensation expense of $117.0 million over a weighted average of 4.3 years for all unvested RSUs outstanding on December 31, 2025.

PSUs

We utilize the Monte Carlo pricing model to estimate the fair value of the market-based condition PSUs at the grant date under the 2024 Equity Incentive Plan. The Monte Carlo model incorporates assumptions regarding expected volatility, correlation between performance of our stock price and that of publicly traded peer companies, expected dividend yields and the risk-free interest rate. The Monte Carlo pricing model simulates potential future stock price paths yielding a grant date fair value that reflects the likelihood of varying outcomes. These awards are expensed on a straight-line basis over the applicable vesting period utilizing the fair value at the grant date.


	Years ended December 31,
	2025		2024	2023
Risk free interest rate	3.92	%	N/A	N/A
Expected dividend yield	0	%	N/A	N/A
Expected term of stock award	4.0		N/A	N/A
Expected volatility in stock price	40.00	%	N/A	N/A

The following table summarizes PSU activity during the year ended December 31, 2025.


	Number of shares	Weighted average grant date fair value
Outstanding December 31, 2024	—	$	—
Granted	396,197	61.67
Vested	—	—
Forfeited	—	—
Outstanding December 31, 2025	396,197	61.67

Stock-based Compensation

We recorded stock-based compensation expense of $42.1 million, $54.4 million, and $8.8 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Stock-based compensation expense was recorded in the following cost and expense categories in the consolidated statements of operations:


	Years ended December 31,
	2025		2024		2023
Cost of revenue	$	1,514	$	2,403	$	645
General and administrative	25,678		31,288		5,034
Sales and marketing	8,562		12,440		1,866
Research and development	6,315		8,306		1,303
Total	42,069		54,437		8,848

Debt

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Debt

On October 22, 2019, we entered into a first lien credit agreement (the “First Lien Credit Agreement”), which initially provided for a first lien term loan balance of $825.0 million and a Revolving Credit Facility of $125 million. From then through 2023, we entered into various amendments that increased the first lien term loan balance to be $1,730.0 million outstanding and the Revolving Credit Facility borrowing capacity to $342.5 million as of December 31, 2023. We refer to the term loan facilities under the First Lien Credit Agreement as the “First Lien Credit Facility” and the revolving credit facility under the First Lien Credit Agreement as the “Revolving Credit Facility.”

On October 22, 2019, we entered into a second lien credit agreement (the “Second Lien Credit Agreement”), which initially provided a second lien term loan of $255.0 million. From then through 2023, we entered into various amendments that increased the second lien term loan balance to $448.0 million as of December 31, 2023 with a maturity date of October 21, 2027. We refer to the term loan facilities under the Second Lien Credit Agreement as the “Second Lien Credit Facility.”

On February 9, 2024, we executed the Eighth Amendment to the First Lien Credit Agreement whereby we extended the maturity date of the First Lien Credit Facility to October 22, 2029, and refinanced the outstanding balance of the facility resulting in a new outstanding loan balance of $2.2 billion ("February 2024 First Lien Refinancing"). We utilized proceeds from the amended First Lien Credit Facility to paydown the remaining principal and interest on the Second Lien Credit Facility ("February 2024 Second Lien Paydown").

In connection with the closing of the IPO in June 2024 (see Note 1)", we repaid $909.1 million outstanding principal and $2.8 million accrued interest on our First Lien Credit Facility ("June 2024 First Lien Paydown"). On June 27, 2024, we entered into the Ninth Amendment to the First Lien Credit Agreement whereby the outstanding balance was repriced bearing an interest rate of 2.75% per annum above the SOFR rate with a minimum base of 0.00% ("June 2024 First Lien Repricing"). The Ninth Amendment did not effectuate changes to any other terms of the agreement.

In connection with the underwriters' exercise of the overallotment option in July 2024 (see Note 1), we repaid $110.9 million outstanding principal and $0.4 million accrued interest on our First Lien Credit Facility ("July 2024 First Lien Paydown"). On September 6, 2024, we utilized the $10.0 million drawn on the Receivables Facility to paydown $10.0 million outstanding principal on our First Lien Credit Facility ("September 2024 First Lien Paydown").

On December 30, 2024, we entered into the Tenth Amendment to the First Lien Credit Agreement whereby the outstanding balance was repriced bearing an interest rate of 2.25% per annum above the SOFR rate with a minimum base of 0.00% ("December 2024 First Lien Repricing"). Additionally with the Tenth Amendment, the Revolving Credit Facility's borrowing capacity was increased to $400.0 million bearing an interest rate of 1.75% per annum above the SOFR rate with a minimum base of 0.00% ("December 2024 Revolving Credit Facility Repricing").

On August 12, 2025, we executed the Eleventh Amendment on the First Lien Credit Agreement whereby the outstanding balance was repriced bearing an interest rate of 2.00% per annum above the SOFR rate with a minimum base of 0.00% ("August 2025 First Lien Repricing"). There was no change in the outstanding loan balance before repricing and after repricing and the maturity date was not impacted by the amendment.

On October 1, 2025, we entered into the Twelfth Amendment to the First Lien Credit Agreement to increase our First Lien Credit Facility by $250.0 million ("October 2025 First Lien Refinancing"). Additionally, the amendment increased the maximum borrowing capacity under the Revolving Credit Facility from $400.0 million to $500.0 million and decreased the

interest rate under the Revolving Credit Facility from 1.75% per annum above SOFR to 1.50% per annum above SOFR ("October 2025 Revolving Credit Facility Repricing"). We drew $30.0 million on the Revolving Credit Facility to help fund the Iodine acquisition (see Note 7), and subsequently repaid the $30.0 million during the year ended December 31, 2025.

Debt instruments consist primarily of term notes, revolving lines of credit, and a Receivables Facility as follows (in thousands):


	December 31,
	2025		2024
First lien term loan facility outstanding debt	$	1,401,246	$	1,163,545


Receivables facility outstanding debt	80,000		80,000
Total outstanding debt	1,481,246		1,243,545
Unamortized debt issuance costs	(8,343)		(11,255)
Current portion of long-term debt	(14,194)		(11,668)
Total long-term debt, net	$	1,458,709	$	1,220,622

The maturity of long-term principal payments (excluding debt discount) at December 31, 2025 is as follows (in thousands):


2026	$	14,194
2027	14,194
2028	14,194
2029	1,438,664


	$	1,481,246

As of December 31, 2025 and 2024, there is no outstanding balance on our Revolving Credit Facility. The interest rate under the Revolving Credit Facility is 1.50% per annum above the SOFR rate with a minimum base of 0.00%. The SOFR is adjusted each thirty-day period to the thirty-day SOFR rate. At December 31, 2025, the effective interest rate for the Revolving Credit Facility is 5.19%.

The interest rate under the amended First Lien Credit Facility is 2.00% per annum above the SOFR rate with a minimum base of 0.00%. The SOFR is adjusted each thirty-day period to the thirty-day SOFR rate. Interest under the First Lien Credit Facility is paid monthly in arrears. As of December 31, 2025, the effective interest rate for First Lien Credit Facility is 5.69%.

Principal on the First Lien Credit Facility is payable in 20 equal quarterly installments with the remaining balance to be paid on October 22, 2029. As of December 31, 2025, there are 15 payments remaining. The First Lien Credit Agreement contains certain covenants which, among other things, restrict our ability to incur additional indebtedness. We were in compliance with such debt covenants as of December 31, 2025.

Debt Issuance Costs

In connection with the August 2025 First Lien Repricing, we recorded $0.7 million in third-party fees that were expensed immediately, which were recorded in general and administrative expense in our consolidated statements of operations. Also related to the August 2025 First Lien Repricing, we recorded a loss on extinguishment of $0.7 million for the year ended December 31, 2025. In connection with the October 2025 First Lien Refinancing, we capitalized $0.1 million of third-party fees with the new debt. Additionally, we recorded $1.4 million in third-party fees that were expensed immediately, which were recorded in general and administrative expense in our consolidated statements of operations. In connection with the October 2025 First Lien Refinancing, we recorded a loss on extinguishment of $0.1 million for the year ended December 31, 2025. In connection with the October 2025 Revolving Credit Facility Repricing, we capitalized credit fees and third-party fees totaling $0.2 million.

In connection with the February 2024 First Lien Refinancing, we capitalized creditor fees of $2.8 million and $1.4 million of third-party fees in connection with the issuance of new debt. Additionally, we recorded $10.3 million in third party fees that were expensed immediately, which were recorded in general and administrative expense in our consolidated statements

of operations. As part of the February 2024 Second Lien Paydown, we recorded a loss on extinguishment of $8.0 million for the year ended December 31, 2024. As part of the February 2024 First Lien Refinancing, we recorded a loss on extinguishment $0.9 million for the year ended December 31, 2024. In connection with the June 2024 First Lien Paydown, we recorded a loss on extinguishment of $9.8 million for the year ended December 31, 2024. As part of the June 2024 First Lien Repricing, we recorded $2.5 million in third-party fees that were expensed immediately, which were recorded in general and administrative expenses in our consolidated statements of operations. We recorded a loss on extinguishment of $0.3 million for the year ended December 31, 2024 related to the June 2024 First Lien Repricing. We also recorded a loss on extinguishment of $1.2 million and $0.1 million in connection with the July 2024 First Lien Paydown and September 2024 First Lien Paydown, respectively, for the year ended December 31, 2024. As part of the December 2024 First Lien Repricing we recorded $1.2 million in third party fees that were expensed immediately, which were recorded in general and administrative expenses in our consolidated statements of operations, and a loss on extinguishment of $0.3 million for the year ended December 31, 2024.

For the year ended December 31, 2023, we expensed previously capitalized fees and other debt issuance costs totaling $0.4 million related to a paydown on the Second Lien Credit Facility.

Losses on extinguishment were recorded within interest expense in our consolidated statements of operations.

We had unamortized debt issuance costs of $8.3 million and $11.3 million as of December 31, 2025 and 2024, respectively.

In connection with the Revolving Credit Facility, unamortized debt issuance costs were $1.7 million and $2.1 million as of December 31, 2025 and 2024, respectively.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

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+ Details

Derivative Financial Instruments - Effect of Derivative Instruments Designated as Hedging Instruments (Details) - Interest rate swap - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Derivative financial instruments
Total interest Expense on Consolidated Statements of Operations	$ (77,542)	$ (146,270)	$ (155,325)
Derivatives—Cash Flow Hedging Relationships
Derivative financial instruments
Amount of Gain or (Loss) Recognized in AOCI/AOCL on Derivative	(1,511)	(14,921)	30,327
Amount of Gain or (Loss) Reclassified from AOCI/AOCL into Income	$ 2,324	$ 29,175	$ 5,244

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Leases - Components of Lease Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Finance lease cost
Amortization of right-of-use assets	$ 0	$ 15,993	$ 1,586
Interest on lease liabilities	531	751	797
Operating lease cost	4,832	5,004	3,780
Variable lease cost	46	412	360
Short-term lease	797	634	781
Total lease cost	$ 6,206	$ 22,794	$ 7,304

Accounts Receivable Securitization (Details) - USD ($) $ in Thousands		12 Months Ended
	Aug. 13, 2021	Dec. 31, 2025	Dec. 31, 2024
Accounts Receivable Securitization
Outstanding amount		$ 1,481,246	$ 1,243,545
Line of Credit \| Receivables facility
Accounts Receivable Securitization
Term of receivables facility	3 years
Maximum borrowing capacity	$ 50,000	80,000
Outstanding amount		$ 80,000	$ 80,000
Interest rate (as a percent)		1.61%
Minimum base rate (as a percent)		0.00%
Basis spread on variable rate, adjustment period		30 days
Effective interest rate (as a percent)		5.30%

Leases - Lease Liability Maturities (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Operating Leases
2026	$ 6,794
2027	4,584
2028	4,270
2029	2,849
2030	1,283
Thereafter	0
Total future minimum lease payments	19,780
Less: Interest	1,757
Total	18,023
Finance Leases
2026	0
2027	0
2028	0
2029	0
2030	0
Thereafter	0
Total future minimum lease payments	0
Less: Interest	0
Total	$ 0

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2025
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions As of December 31, 2025 and 2024, we had $64.8 million and $35.6 million, respectively, of outstanding debt as part of the First Lien Credit Facility from Bain Affiliated Funds and CPPIB Credit Investments III Inc., affiliates of Bain Capital LP and Canada Pension Plan Investment Board (“Affiliated Debtholders”). Interest expense associated with and paid to Affiliated Debtholders was $3.5 million, $4.5 million and $7.6 million for the years ended December 31, 2025, 2024, and 2023, respectively. Canada Pension Plan Investment Board has an ownership interest in us and a significant interest in the landlord that leases us office space under an operating lease agreement in Houston, Texas. For the years ended December 31, 2024 and 2023, we expensed $0.2 million and $0.3 million, respectively, for this office space lease in general and administrative expense. They did not have a significant interest in any of our vendors for the year ended December 31, 2025. Bain Capital LP has an ownership interest in us and a significant interest in some clients for whom we provide software solutions. For the years ended December 31, 2025, 2024, and 2023, we earned $2.5 million from four customers, $1.9 million from five customers and $1.5 million from four customers, respectively. They also have an ownership interest in us and a significant interest in some vendors that provides us with software solutions. For the years ended December 31, 2025, 2024, and 2023, we expensed $2.8 million from three vendors, $2.1 million from two vendors and $0.4 million from two vendors, respectively, for software services from these vendors in cost of revenue expense. After the Iodine acquisition (see Note 7), Advent has an ownership interest in us and a significant interest in some clients for whom we provide software solutions. For the year ended December 31, 2025, we earned $0.7 million from two customers subsequent to the acquisition. They also have ownership in us and a significant interest in one vendor that provides us with software solutions. For the year ended December 31, 2025, we expensed $0.1 million for software services from this vendor in cost of revenue expenses subsequent to the acquisition.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

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-Paragraph 5
-Publisher FASB
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
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-Subparagraph (c)
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Consolidated Statements of Comprehensive Income/(Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Statement of Comprehensive Income [Abstract]
Net income/(loss)	$ 112,089	$ (19,125)	$ (51,334)
Other comprehensive income/(loss), before tax:
Interest rate swaps and cap	(1,996)	(19,728)	(18,651)
Available-for-sale securities	(3)	0	0
Income tax effect:
Interest rate swaps and cap	485	4,807	4,615
Available-for-sale securities	1	0	0
Other comprehensive income/(loss), net of tax	(1,513)	(14,921)	(14,036)
Comprehensive income/(loss), net of tax	$ 110,576	$ (34,046)	$ (65,370)

Segments - Schedule of Reconciliation of Revenue to Consolidated Net Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Segments
Total Revenue	$ 1,099,278	$ 943,549	$ 791,010
Less:
Research & development	54,623	48,775	35,332
Sales and marketing	178,017	156,935	124,437
General and administrative	128,623	111,753	62,924
Depreciation	21,900	38,700	17,100
Income tax expense/(benefit)	59,674	(3,420)	(12,500)
Net income/(loss)	112,089	(19,125)	(51,334)
Reportable Segment
Segments
Total Revenue	1,099,278	943,549	791,010
Less:
Materials and connectivity	244,993	225,333	173,077
Labor and associated expenses	103,169	90,397	76,690
Research & development	54,623	48,775	35,332
Sales and marketing	178,017	156,935	124,437
General and administrative	128,623	111,753	62,924
Depreciation	21,938	38,744	17,062
Amortization	118,610	147,887	159,405
Interest and non-operating expenses, net	77,542	146,270	205,917
Income tax expense/(benefit)	59,674	(3,420)	(12,500)
Net income/(loss)	$ 112,089	$ (19,125)	$ (51,334)

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Current assets
Cash and cash equivalents	$ 61,355	$ 182,133
Restricted cash	15,454	22,449
Investment securities	24,877	0
Accounts receivable, net of allowance of $6,170 as of December 31, 2025 and $5,885 as of December 31, 2024	177,037	145,235
Income tax receivable	6,437	2,838
Prepaid expenses	20,078	14,414
Other current assets	3,174	3,972
Total current assets	308,412	371,041
Property, plant and equipment, net	51,649	46,731
Operating lease right-of-use assets, net	12,972	10,820
Intangible assets, net	1,292,839	1,039,049
Goodwill	4,016,818	3,019,999
Deferred costs	93,951	82,815
Other long-term assets	8,459	6,549
Total assets	5,785,100	4,577,004
Current liabilities
Accounts payable	50,949	47,365
Accrued compensation	40,942	31,589
Aggregated funds payable	15,104	22,059
Other accrued expenses	22,990	15,930
Deferred revenue	67,855	10,527
Current portion of long-term debt	14,194	11,668
Current portion of operating lease liabilities	6,029	5,591
Current portion of finance lease liabilities	0	904
Total current liabilities	218,063	145,633
Long-term liabilities
Deferred tax liability	211,320	100,523
Total long-term debt, net	1,458,709	1,220,622
Operating lease liabilities, net of current portion	11,994	13,133
Finance lease liabilities, net of current portion	0	11,290
Deferred revenue - long-term	5,496	5,739
Other long-term liabilities	692	278
Total liabilities	1,906,274	1,497,218
Commitments and contingencies (Note 21)
Stockholders’ equity
Preferred stock 0.01 par value - 100,000,000 shares authorized as of December 31, 2025 and December 31, 2024, respectively; zero shares issued and outstanding as of December 31, 2025 and December 31, 2024, respectively	0	0
Common stock 0.01 par value - 2,500,000,000 shares authorized as of December 31, 2025 and December 31, 2024, respectively; 191,587,193 and 172,108,240 shares issued and outstanding as of December 31, 2025 and December 31, 2024, respectively	1,916	1,722
Additional paid-in capital	3,986,353	3,298,083
Accumulated other comprehensive income (loss)	(632)	881
Accumulated deficit	(108,811)	(220,900)
Total stockholders’ equity	3,878,826	3,079,786
Total liabilities and stockholders’ equity	5,785,100	4,577,004
Nonrelated Party
Current liabilities
Current portion of long-term debt	13,537	11,311
Long-term liabilities
Total long-term debt, net	1,394,523	1,185,411
Related Party
Current liabilities
Current portion of long-term debt	657	357
Long-term liabilities
Total long-term debt, net	$ 64,186	$ 35,211

Leases

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Leases

We determine whether a contract is or contains a lease at inception. At the lease commencement date, we record a liability for the lease obligation and a corresponding asset representing the right to use the underlying asset over the lease term. Leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet and are recognized in expense using a straight-line basis for all asset classes. Variable lease payments are expensed as incurred, which primarily include maintenance costs, services provided by the lessor, and other charges reimbursed to the lessor.

We lease office space and data center facilities with remaining lease terms ranging from one year to five years, some of which contain renewal options. The exercise of these options is at our sole discretion.

Certain of our leases contain lease and non-lease components. For leases held on or after January 1, 2022, we have elected the practical expedient under ASC 842-10-15-37 for all asset classes which allows companies to account for lease and non-lease components as a single lease component.

Our leases do not contain an implicit rate of return; therefore, an incremental borrowing rate was determined. We assessed which rate would be most reflective of a reasonable rate we would be able to borrow based on credit rating and lease term.

Finance lease right-of-use assets were zero as of both December 31, 2025 and 2024. Due to the relocation of one of our offices (see Note 8), we reduced the useful life of the related finance lease right-of-use asset, which represented $14.9 million of incremental depreciation (excluding accelerated depreciation on leasehold improvements) for the year ended December 31, 2024. We also reduced the useful life of the related operating lease right-of-use asset, which represented $1.2 million of additional operating lease cost for the year ended December 31, 2024. Subsequently during the year ended December 31, 2025, we reached a settlement agreement to terminate the prior lease of the aforementioned

office that was relocated. The total settlement was $15.0 million and resulted in a loss on lease termination totaling $0.8 million, which is recorded in general and administrative expense within our consolidated statements of operations for the year ended December 31, 2025.

The following table presents components of lease expense for the years ended December 31, 2025, 2024, and 2023, respectively (in thousands):


	Years ended December 31,
	2025		2024		2023
Finance lease cost
Amortization of right-of-use assets	$	—	$	15,993	$	1,586
Interest on lease liabilities	531		751		797
Operating lease cost	4,832		5,004		3,780
Variable lease cost	46		412		360
Short-term lease	797		634		781
Total lease cost	$	6,206	$	22,794	$	7,304

Maturities of lease liabilities as of December 31, 2025 are as follows (in thousands):


	Operating Leases		Finance Leases
2026	$	6,794	$	—
2027	4,584		—
2028	4,270		—
2029	2,849		—
2030	1,283		—
Thereafter	—		—
Total future minimum lease payments	19,780		—
Less: Interest	1,757		—
Total	$	18,023	$	—

Supplemental cash flow information related to leases for the years ended December 31, 2025, 2024, and 2023 are as follows (in thousands):


	Years ended December 31,
	2025		2024		2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	6,634	$	5,423	$	5,400
Financing cash flows for financing leases	16,336		1,572		1,547
Right-of-use assets obtained in exchange for new lease liabilities:
Operating leases	$	6,154	$	4,642	$	2,284

Supplemental balance sheet information related to leases as of December 31, 2025 and 2024 are as follows:


	Year ending December 31,
	2025	2024
Weighted average remaining lease term (years):
Operating leases	3.5	4.1
Financing leases	0	9.1
Weighted average discount rate:
Operating leases	5.0	4.7
Financing leases	—	5.9

Leases

The following table presents components of lease expense for the years ended December 31, 2025, 2024, and 2023, respectively (in thousands):


	Years ended December 31,
	2025		2024		2023
Finance lease cost
Amortization of right-of-use assets	$	—	$	15,993	$	1,586
Interest on lease liabilities	531		751		797
Operating lease cost	4,832		5,004		3,780
Variable lease cost	46		412		360
Short-term lease	797		634		781
Total lease cost	$	6,206	$	22,794	$	7,304

Maturities of lease liabilities as of December 31, 2025 are as follows (in thousands):


	Operating Leases		Finance Leases
2026	$	6,794	$	—
2027	4,584		—
2028	4,270		—
2029	2,849		—
2030	1,283		—
Thereafter	—		—
Total future minimum lease payments	19,780		—
Less: Interest	1,757		—
Total	$	18,023	$	—

Supplemental cash flow information related to leases for the years ended December 31, 2025, 2024, and 2023 are as follows (in thousands):


	Years ended December 31,
	2025		2024		2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	6,634	$	5,423	$	5,400
Financing cash flows for financing leases	16,336		1,572		1,547
Right-of-use assets obtained in exchange for new lease liabilities:
Operating leases	$	6,154	$	4,642	$	2,284

Supplemental balance sheet information related to leases as of December 31, 2025 and 2024 are as follows:


	Year ending December 31,
	2025	2024
Weighted average remaining lease term (years):
Operating leases	3.5	4.1
Financing leases	0	9.1
Weighted average discount rate:
Operating leases	5.0	4.7
Financing leases	—	5.9

Stock-based Compensation - RSUs Activity (Details) - RSUs - $ / shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Number of shares
Outstanding, Beginning balance (in shares)	2,089,241	0
Granted (in shares)	2,698,171	2,107,499
Vested (in shares)	(483,491)	0
Forfeited (in shares)	(83,763)	(18,258)
Outstanding, Ending balance (in shares)	4,220,158	2,089,241
Weighted average grant date fair value
Outstanding, Beginning balance (in dollars per share)	$ 21.91	$ 0
Granted (in dollars per share)	37.43	21.90
Vested (in dollars per share)	21.92	0
Forfeited (in dollars per share)	30.67	21.50
Outstanding, Ending balance (in dollars per share)	$ 31.65	$ 21.91

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Operating Loss Carryforwards
Unrecognized tax benefits	$ 4,000	$ 4,300
Interest and penalties	400	200	$ 0
Valuation allowance	2,610	$ 1,056	$ 197
State credits
Operating Loss Carryforwards
Valuation allowance	200
State net operating loss
Operating Loss Carryforwards
Valuation allowance	1,000
Federal
Operating Loss Carryforwards
Operating loss carryforwards	4,300
Valuation allowance on tax credits	1,400
State
Operating Loss Carryforwards
Operating loss carryforwards	$ 14,400

Stock-based Compensation - Equity Incentive Plans, Additional Information (Details) - USD ($) $ in Thousands			12 Months Ended
	Jun. 06, 2024	Oct. 22, 2019	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Stock-based compensation
Number of shares outstanding (in shares)			13,992,173	16,511,128	13,032,541	13,123,170
Stock-based compensation expense			$ 42,069	$ 54,437	$ 8,848
ESPP
Stock-based compensation
Stock-based compensation expense			$ 500	$ 0	$ 0
2019 Waystar Holding Plan
Stock-based compensation
Maximum shares issuable (in shares)		9,900,000
Contractual term		10 years
Number of shares outstanding (in shares)		2,200,000
2019 Waystar Holding Plan \| Stock Options
Stock-based compensation
Vesting period		5 years
Vesting percentage		20.00%
2024 Equity Incentive Plan
Stock-based compensation
Maximum shares issuable (in shares)	10,000,000
Percentage of outstanding common stock	5.00%
Shares available for future grant (in shares)			5,200,000
2024 Equity Incentive Plan \| Stock Options
Stock-based compensation
Vesting period	5 years
Vesting percentage	20.00%
2024 Equity Incentive Plan \| RSUs \| Share-Based Payment Arrangement, Tranche One
Stock-based compensation
Vesting period	4 years
Vesting percentage	25.00%
2024 Equity Incentive Plan \| RSUs \| Share-Based Payment Arrangement, Tranche Two
Stock-based compensation
Vesting period	5 years
Vesting percentage	20.00%
2024 Equity Incentive Plan \| PSUs
Stock-based compensation
Performance period	4 years
2024 Equity Incentive Plan \| PSUs \| Minimum
Stock-based compensation
Vesting percentage	0.00%
2024 Equity Incentive Plan \| PSUs \| Maximum
Stock-based compensation
Vesting percentage	200.00%
2024 Employee Stock Purchase Plan
Stock-based compensation
Percentage of outstanding common stock	1.00%
Common stock, capital shares reserved for future issuance (in shares)	3,250,000
Common stock issued under employee stock purchase plan (in shares)			37,323
2024 Employee Stock Purchase Plan \| Maximum
Stock-based compensation
Shares available for future grant (in shares)	27,000,000
2024 Employee Stock Purchase Plan \| ESPP
Stock-based compensation
ESPP discount rate (as a percent)	15.00%

Fair Value Measurements and Disclosures

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Fair Value Measurements and Disclosures

The following table presents the fair value hierarchy for financial assets and liabilities measured at fair value on a recurring basis (in thousands):


	Balance Sheet Classification	Carrying Value		Level 1		Level 2		Level 3
December 31, 2025
Available-for-sale fixed-maturity securities
Commercial paper	Investment securities	$	12,439	$	—	$	12,439	$	—

U.S. Treasury Bills	Investment securities	$	7,459	$	—	$	7,459	$	—
U.S. Government Agencies	Investment securities	$	4,982	$	—	$	4,982	$	—
Money market funds	Cash and cash equivalents	$	25,292	$	25,292	$	—	$	—
Other financial assets:
Interest rate cap	Other current assets	$	274	$	—	$	274	$	—
Other financial liabilities:
Interest rate swaps	Other accrued expenses	$	621	$	—	$	621	$	—
Interest rate swaps	Other long-term liabilities	$	414	$	—	$	414	$	—
December 31, 2024
Other financial assets:
Interest rate swaps	Other current assets	$	1,127	$	—	$	1,127	$	—
Interest rate swaps	Other long-term assets	$	22	$	—	$	22	$	—

The fair values of our interest rate swaps are based on the sum of all future net present value cash flows. The future cash flows are derived based on the terms of our interest rate swaps, as well as considering published discount factors, and projected SOFR curve. The fair value of long-term debt was determined using the present value of future cash flows based on the borrowing rates currently available for debt with similar terms and maturities. The carrying value of our First Lien Credit Facility was $1,401.2 million and $1,163.5 million compared to a fair value of $1,408.3 million and $1,169.4 million as of December 31, 2025 and 2024, respectively. As of December 31, 2025, there is no balance for our second lien term loan facility given the paydown outlined below in Note 13. There were no transfers in or out of Level 3 during the periods presented.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (bbb)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 107
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-107

Reference 3: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 100
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-100

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(3)
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Section 50
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Section 50
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-Subparagraph (h)
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Section 50
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 940
-SubTopic 820
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478119/940-820-50-1

+ Details

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2025
Auditor Information [Abstract]
Auditor Name	KPMG LLP
Auditor Location	Indianapolis, Indiana
Auditor Firm ID	185

Fair Value Measurements and Disclosures - Fair Value Hierarchy for Financial Assets and Liabilities Measured at Fair Value (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Fair Value Measurements and Disclosures
Investment securities	$ 24,877	$ 0
Commercial paper
Fair Value Measurements and Disclosures
Investment securities	12,435
U.S. Treasury Bills
Fair Value Measurements and Disclosures
Investment securities	7,460
U.S. Government Agencies
Fair Value Measurements and Disclosures
Investment securities	4,982
Carrying Value \| Interest rate cap
Fair Value Measurements and Disclosures
Derivative assets, current	274
Carrying Value \| Interest rate swaps
Fair Value Measurements and Disclosures
Derivative assets, current		1,127
Derivative liability, current	621
Derivative liabilities, noncurrent	414
Derivative assets, noncurrent		22
Carrying Value \| Money market funds
Fair Value Measurements and Disclosures
Cash and cash equivalents	25,292
Carrying Value \| Commercial paper
Fair Value Measurements and Disclosures
Investment securities	12,439
Carrying Value \| U.S. Treasury Bills
Fair Value Measurements and Disclosures
Investment securities	7,459
Carrying Value \| U.S. Government Agencies
Fair Value Measurements and Disclosures
Investment securities	4,982
Fair Value \| Level 1 \| Interest rate cap
Fair Value Measurements and Disclosures
Derivative assets, current	0
Fair Value \| Level 1 \| Interest rate swaps
Fair Value Measurements and Disclosures
Derivative assets, current		0
Derivative liability, current	0
Derivative liabilities, noncurrent	0
Derivative assets, noncurrent		0
Fair Value \| Level 1 \| Money market funds
Fair Value Measurements and Disclosures
Cash and cash equivalents	25,292
Fair Value \| Level 1 \| Commercial paper
Fair Value Measurements and Disclosures
Investment securities	0
Fair Value \| Level 1 \| U.S. Treasury Bills
Fair Value Measurements and Disclosures
Investment securities	0
Fair Value \| Level 1 \| U.S. Government Agencies
Fair Value Measurements and Disclosures
Investment securities	0
Fair Value \| Level 2 \| Interest rate cap
Fair Value Measurements and Disclosures
Derivative assets, current	274
Fair Value \| Level 2 \| Interest rate swaps
Fair Value Measurements and Disclosures
Derivative assets, current		1,127
Derivative liability, current	621
Derivative liabilities, noncurrent	414
Derivative assets, noncurrent		22
Fair Value \| Level 2 \| Money market funds
Fair Value Measurements and Disclosures
Cash and cash equivalents	0
Fair Value \| Level 2 \| Commercial paper
Fair Value Measurements and Disclosures
Investment securities	12,439
Fair Value \| Level 2 \| U.S. Treasury Bills
Fair Value Measurements and Disclosures
Investment securities	7,459
Fair Value \| Level 2 \| U.S. Government Agencies
Fair Value Measurements and Disclosures
Investment securities	4,982
Fair Value \| Level 3 \| Interest rate cap
Fair Value Measurements and Disclosures
Derivative assets, current	0
Fair Value \| Level 3 \| Interest rate swaps
Fair Value Measurements and Disclosures
Derivative assets, current		0
Derivative liability, current	0
Derivative liabilities, noncurrent	0
Derivative assets, noncurrent		$ 0
Fair Value \| Level 3 \| Money market funds
Fair Value Measurements and Disclosures
Cash and cash equivalents	0
Fair Value \| Level 3 \| Commercial paper
Fair Value Measurements and Disclosures
Investment securities	0
Fair Value \| Level 3 \| U.S. Treasury Bills
Fair Value Measurements and Disclosures
Investment securities	0
Fair Value \| Level 3 \| U.S. Government Agencies
Fair Value Measurements and Disclosures
Investment securities	$ 0

Income/ (Loss) Per Share (Tables)

12 Months Ended

Dec. 31, 2025

Earnings Per Share [Abstract]

Schedule of Reconciliation of the Numerators and the Denominators of the Basic and Diluted Per Share

A reconciliation of the numerators and the denominators of the basic and diluted per share computations are as follows:


	Years ended December 31,
	2025		2024		2023
Basic income/(loss) per share:
Net income/(loss)	$	112,089	$	(19,125)	$	(51,334)
Net income/(loss) attributable to common shares	$	112,089	$	(19,125)	$	(51,334)
Weighted average common stock outstanding–(voting)	177,926,745		149,915,839		121,238,629
Weighted average common stock outstanding–(non-voting)	—		—		436,801
Basic weighted average common stock outstanding	177,926,745		149,915,839		121,675,430
Basic income/(loss) per share	$	0.63	$	(0.13)	$	(0.42)

Diluted income/(loss) per share:
Net income/(loss)	$	112,089	$	(19,125)	$	(51,334)
Net income/(loss) attributable to common shares	$	112,089	$	(19,125)	$	(51,334)
Dilutive effect of stock options – (voting)	5,846,245		—		—
Dilutive effect of RSUs – (voting)	1,003,061		—		—
Dilutive effect of ESPP – (voting)	7,233		—		—
Weighted average common stock outstanding–(voting)	184,783,284		149,915,839		121,238,629
Weighted average common stock outstanding–(non-voting)	—		—		436,801
Diluted weighted average common stock outstanding	184,783,285		149,915,839		121,675,430
Diluted income/(loss) per share	$	0.61	$	(0.13)	$	(0.42)

Summary of Significant Accounting Policies - Accounts Receivable (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Changes in the allowance for doubtful accounts
Beginning balance	$ (5,885)	$ (5,335)
Provision for losses on receivables	(3,320)	(2,669)	$ (2,419)
Write-offs	4,001	2,792
Recoveries	(966)	(673)
Ending Balance	$ (6,170)	$ (5,885)	$ (5,335)

Stock-based Compensation - PSUs Activity (Details) - PSU	12 Months Ended
	Dec. 31, 2025 $ / shares shares
Number of shares
Outstanding, Beginning balance (in shares) \| shares	0
Granted (in shares) \| shares	396,197
Vested (in shares) \| shares	0
Forfeited (in shares) \| shares	0
Outstanding, Ending balance (in shares) \| shares	396,197
Weighted average grant date fair value
Outstanding, Beginning balance (in dollars per share) \| $ / shares	$ 0
Granted (in dollars per share) \| $ / shares	61.67
Vested (in dollars per share) \| $ / shares	0
Forfeited (in dollars per share) \| $ / shares	0
Outstanding, Ending balance (in dollars per share) \| $ / shares	$ 61.67

Goodwill and Other Intangible Assets - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	$ 4,016,818	$ 3,019,999	$ 3,030,013	$ 3,009,558
Amortization expense	$ 118,600	$ 147,900	$ 159,400

- Definition

The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Subparagraph (b)
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Reference 2: http://www.xbrl.org/2003/role/exampleRef
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Reference 6: http://www.xbrl.org/2003/role/exampleRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (d)
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-URI https://asc.fasb.org/1943274/2147476148/220-40-50-6

Debt (Tables)

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Schedule of Debt Instruments

Debt instruments consist primarily of term notes, revolving lines of credit, and a Receivables Facility as follows (in thousands):


	December 31,
	2025		2024
First lien term loan facility outstanding debt	$	1,401,246	$	1,163,545


Receivables facility outstanding debt	80,000		80,000
Total outstanding debt	1,481,246		1,243,545
Unamortized debt issuance costs	(8,343)		(11,255)
Current portion of long-term debt	(14,194)		(11,668)
Total long-term debt, net	$	1,458,709	$	1,220,622

Schedule of Maturity of Long-Term Principal Payments (Excluding Debt Discount)

The maturity of long-term principal payments (excluding debt discount) at December 31, 2025 is as follows (in thousands):


2026	$	14,194
2027	14,194
2028	14,194
2029	1,438,664


	$	1,481,246

Revenue Recognition

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Revenue Recognition

Disaggregation of Revenue

The following table presents revenues disaggregated by revenue type and the timing of revenue recognition (in thousands):


		Years ended December 31,
	Recognition		2025		2024		2023
Subscription revenue	Over time		$	558,408	$	457,975	$	401,013
Volume-based revenue	Over time		534,755		479,913		386,276
Implementation services and other revenue	Various		6,115		5,661		3,721
Total revenues			$	1,099,278	$	943,549	$	791,010

Contract Liabilities

We derive our revenue from contracts with clients primarily through subscription fees and volume-based fees. Our payment terms with the client generally comprise an initial payment for implementation services, which includes client enrollment and the setup of contracted solutions on our platform. These implementation fees are due upon contract execution. Additionally, subscription fees are earned on an ongoing basis, which are invoiced monthly.

Client payments received in advance of fulfilling the corresponding performance obligations are recorded as contract liabilities. Implementation fees are recognized over the customer life, with any unrecognized amounts deferred as contract liabilities. These amounts are reported as deferred revenue on our consolidated balance sheet.

The following table presents activity impacting deferred revenue balances (in thousands):


	Years ended December 31,
	2025		2024		2023
Beginning balance	$	16,266	$	17,108	$	16,454
Revenue recognized (a)	(21,330)		(10,917)		(9,900)
Additional amounts deferred	16,672		10,075		10,554
Deferred revenue assumed as part of acquisitions (see Note 7)	61,743		—		—
Ending balance	$	73,351	$	16,266	$	17,108

(a) For the year ended December 31, 2025, $10.8 million of revenue was recognized from the acquired Iodine deferred revenue (see Note 7).

Transaction Price Allocated to Remaining Performance Obligations

As of December 31, 2025, the transaction price related to unsatisfied performance obligations that are expected to be recognized for the next 12 months and greater than 12 months was $78.6 million and $37.8 million, respectively. Included in the aforementioned amounts to be recognized is the impact from the Iodine acquisition (see Note 7), which was $26.4 million to be recognized for the next 12 months and $23.5 million to be recognized in greater than 12 months.

The transaction price allocated to performance obligations that are unsatisfied (or partially unsatisfied) for executed contracts does not include revenue related to performance obligations that are part of a contract with an original expected duration of one year or less. Additionally, the balance does not include variable consideration that is allocated entirely to wholly unsatisfied promises that form part of a single performance obligation comprised of a series of distinct daily services.

Remaining performance obligation estimates are subject to change and are affected by several factors, including terminations and changes in the timing and scope of contracts, arising from contract modifications.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
-Section 50
-Paragraph 7
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-URI https://asc.fasb.org/1943274/2147479806/606-10-50-7

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Cash flows from operating activities
Net income/(loss)	$ 112,089	$ (19,125)	$ (51,334)
Adjustments to reconcile net income/(loss) to net cash provided by operating activities
Depreciation and amortization	140,548	186,631	176,467
Stock-based compensation	42,069	54,437	8,848
Provision for bad debt expense	3,320	2,669	2,419
Loss on extinguishment of debt	821	20,611	393
Loss on lease termination	838	0	0
Deferred income taxes	45,222	(59,135)	(61,665)
Amortization of debt discount and issuance costs	2,697	3,946	10,471
Other	154	(99)	485
Changes in:
Accounts receivable	(7,324)	(21,816)	(16,714)
Income tax refundable	(16,993)	3,973	(2,459)
Prepaid expenses and other current assets	(1,947)	(2,322)	(9,705)
Deferred costs	(10,866)	(16,497)	(14,189)
Other long-term assets	(2,376)	(472)	(1,664)
Accounts payable and accrued expenses	8,932	18,228	11,920
Deferred revenue	(4,658)	(842)	(167)
Operating lease right-of-use assets and lease liabilities	(2,853)	(419)	(1,691)
Other long-term liabilities	0	0	45
Net cash provided by operating activities	309,673	169,768	51,460
Cash flows from investing activities
Purchase of property and equipment and capitalization of internally developed software costs	(26,481)	(27,268)	(21,517)
Acquisitions, net of cash and cash equivalents acquired	(629,535)	0	(40,000)
Purchase of investment securities	(231,324)	0	0
Proceeds from sale of investment securities	206,444	0	0
Net cash used in investing activities	(680,896)	(27,268)	(61,517)
Cash flows from financing activities
Change in aggregated funds liability	(6,955)	12,399	2,105
Proceeds from equity offering, net of underwriting discounts	0	1,017,074	0
Payments of third-party IPO issuance costs	0	(3,407)	0
Repurchase of shares	0	(844)	(688)
Proceeds from issuance of common stock from employee equity plans	25,779	1,683	425
Proceeds from issuances of debt, net of creditor fees	390,140	576,060	20,000
Payments on debt	(152,440)	(1,584,080)	(37,983)
Third-party fees paid in connection with issuance of new debt	(42)	(1,410)	(219)
Finance lease liabilities paid	(13,032)	(821)	(791)
Net cash provided by (used in) financing activities	243,450	16,654	(17,151)
Increase/(decrease) in cash and cash equivalents during the period	(127,773)	159,154	(27,208)
Cash and cash equivalents and restricted cash–beginning of period	204,582	45,428	72,636
Cash and cash equivalents and restricted cash–end of period	76,809	204,582	45,428
Supplemental disclosures of cash flow information
Interest paid	81,666	122,771	193,003
Cash taxes paid (refunds received), net	32,418	51,100	51,449
Non-cash investing and financing activities
Fixed asset purchases in accounts payable	280	283	1,091
Unpaid third-party IPO issuance costs	0	15	0
Common stock issued in connection to acquisitions (see Note 7)	620,835	0	0
Balance sheet
Cash and cash equivalents	61,355	182,133	35,580
Restricted cash	15,454	22,449	9,848
Total	$ 76,809	$ 204,582	$ 45,428

Property and Equipment, Net - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Abstract]
Capitalization of software development costs	$ 16.8	$ 16.4	$ 15.0
Amortization of capitalized software	10.6	10.2	6.8
Net book value of capitalized software development costs	35.9	29.6
Expected amortization of capitalized software	35.9
Impairments of property and equipment	0.0	0.0	0.0
Property and equipment, net
Depreciation	$ 21.9	38.7	$ 17.1
Finance Lease and Leasehold Improvements
Property and equipment, net
Depreciation		$ 17.9

Accounts Receivable Securitization	12 Months Ended
Accounts Receivable Securitization	Dec. 31, 2025
Transfers and Servicing [Abstract]
Accounts Receivable Securitization	Accounts Receivable Securitization On August 13, 2021, we entered into a receivables financing agreement with a counterparty as the lender, which provided for a three-year receivables facility with an initial limit of $50.0 million ("Receivables Facility"). As of both December 31, 2025 and 2024, we had $80.0 million outstanding on the Receivables Facility with a limit of $80.0 million. Pursuant to the Receivables Facility, we sell and/or contribute current and future receivables to Waystar RC, LLC as the Special Purpose Entity (“SPE”). The SPE, in turn, pledges its interests in the receivables to the counterparty, which either makes loans or issues letters of credit on behalf of the SPE. All receivables remain on our balance sheet as they continue to be the property of our consolidated entities under the securitization. The interest rate under the Receivables Facility is 1.61% per annum above the SOFR rate with a minimum base of 0%. The SOFR is adjusted each thirty-day period to the thirty-day SOFR rate. Interest under the Receivables Facility is paid monthly in arrears. As of December 31, 2025, the effective interest rate for the Receivables Facility is 5.30%. All principal under the Receivables Facility is due on October 31, 2026. The Receivables Facility contains certain covenants which, among other things, require we maintain certain collection thresholds with respect to our accounts receivable. We were in compliance with all such debt covenants during the periods presented.

- Definition

The entire disclosure for a transferor's continuing involvement in financial assets that it has transferred in a securitization or asset-backed financing arrangement, the nature of any restrictions on assets reported by an entity in its statement of financial position that relate to a transferred financial asset (including the carrying amounts of such assets), how servicing assets and servicing liabilities are reported, and (for securitization or asset-backed financing arrangements accounted for as sales) when a transferor has continuing involvement with the transferred financial assets and transfers of financial assets accounted for as secured borrowings, how the transfer of financial assets affects an entity's financial position, financial performance, and cash flows.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org/1943274/2147480591/815-20-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (a)(5)(ii)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481326/860-20-50-4

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 860
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481326/860-20-50-4

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 860
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 4D
-Subparagraph (c)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481326/860-20-50-4D

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 860
-SubTopic 30
-Name Accounting Standards Codification
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-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481420/860-30-50-7

Reference 20: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 860
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-Name Accounting Standards Codification
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-Paragraph 2
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481229/860-50-50-2

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Topic 860
-SubTopic 50
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
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Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Topic 860
-SubTopic 50
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481229/860-50-50-4

+ Details

Leases (Tables)

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Schedule of Components of Lease Expense

The following table presents components of lease expense for the years ended December 31, 2025, 2024, and 2023, respectively (in thousands):


	Years ended December 31,
	2025		2024		2023
Finance lease cost
Amortization of right-of-use assets	$	—	$	15,993	$	1,586
Interest on lease liabilities	531		751		797
Operating lease cost	4,832		5,004		3,780
Variable lease cost	46		412		360
Short-term lease	797		634		781
Total lease cost	$	6,206	$	22,794	$	7,304

Schedule of Maturity of Operating Leases

Maturities of lease liabilities as of December 31, 2025 are as follows (in thousands):


	Operating Leases		Finance Leases
2026	$	6,794	$	—
2027	4,584		—
2028	4,270		—
2029	2,849		—
2030	1,283		—
Thereafter	—		—
Total future minimum lease payments	19,780		—
Less: Interest	1,757		—
Total	$	18,023	$	—

Schedule of Maturity of Finance Leases

Maturities of lease liabilities as of December 31, 2025 are as follows (in thousands):


	Operating Leases		Finance Leases
2026	$	6,794	$	—
2027	4,584		—
2028	4,270		—
2029	2,849		—
2030	1,283		—
Thereafter	—		—
Total future minimum lease payments	19,780		—
Less: Interest	1,757		—
Total	$	18,023	$	—

Schedule of Supplemental Cash Flow Information Related to Leases

Supplemental cash flow information related to leases for the years ended December 31, 2025, 2024, and 2023 are as follows (in thousands):


	Years ended December 31,
	2025		2024		2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	6,634	$	5,423	$	5,400
Financing cash flows for financing leases	16,336		1,572		1,547
Right-of-use assets obtained in exchange for new lease liabilities:
Operating leases	$	6,154	$	4,642	$	2,284

Schedule of Supplemental Balance Sheet Information

Supplemental balance sheet information related to leases as of December 31, 2025 and 2024 are as follows:


	Year ending December 31,
	2025	2024
Weighted average remaining lease term (years):
Operating leases	3.5	4.1
Financing leases	0	9.1
Weighted average discount rate:
Operating leases	5.0	4.7
Financing leases	—	5.9

Derivative Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2025

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Interest Rate Swap Agreements Designated as a Hedging Instrument

As of December 31, 2025, we have the following interest rate swap or cap agreements designated as a hedging instrument:


Effective Dates	Floating Rate Debt			Fixed Rates
May 31, 2023 through January 31, 2026	$	506.7	million	3.87	%
April 1, 2025 through January 30, 2026	$	80.0	million	3.59	%
October 1, 2025 through April 30, 2026	$	127.0	million	3.50	%
January 31, 2026 through March 31, 2027	$	275.0	million	3.59	%
January 31, 2026 through March 31, 2027	$	275.0	million	3.27	%

As of December 31, 2024, we had the following interest rate swap agreement designated as a hedging instrument:


Effective Dates	Floating Rate Debt			Fixed Rates
May 31, 2023 through January 31, 2026	$	506.7	million	3.87	%

Schedule of Effect of Derivative Instruments Designated as Hedging Instruments on the Accompanying Consolidated Financial Statements

The effect of derivative instruments designated as hedging instruments on the accompanying consolidated financial statements is as follows (in thousands):


Derivatives—Cash Flow Hedging Relationships	Amount of Gain or (Loss) Recognized in AOCI/AOCL on Derivative		Location of Gain or (Loss) Reclassified from AOCI/AOCL into Income	Amount of Gain or (Loss) Reclassified from AOCI/AOCL into Income		Total interest Expense on Consolidated Statements of Operations
Interest rate swaps:
Year Ended December 31, 2025	$	(1,511)	Interest expense	$	2,324	$	(77,542)
Year Ended December 31, 2024	$	(14,921)	Interest expense	$	29,175	$	(146,270)
Year Ended December 31, 2023	$	30,327	Interest expense	$	5,244	$	(155,325)

Fair Value Measurements and Disclosures - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Fair Value Measurements and Disclosures
Transfers in or out of Level 3	$ 0.0
Line of Credit \| First Lien Credit Facility \| Carrying Value
Fair Value Measurements and Disclosures
Long-term debt	1,401.2	$ 1,163.5
Line of Credit \| First Lien Credit Facility \| Fair Value
Fair Value Measurements and Disclosures
Long-term debt	$ 1,408.3	$ 1,169.4

- Definition

The fair value amount of long-term debt whether such amount is presented as a separate caption or as a parenthetical disclosure. Additionally, this element may be used in connection with the fair value disclosures required in the footnote disclosures to the financial statements. The element may be used in both the balance sheet and disclosure in the same submission.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (bbb)(2)(i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (bbb)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (bbb)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 4: http://www.xbrl.org/2003/role/exampleRef
-Name Accounting Standards Codification
-Section 55
-Paragraph 10
-SubTopic 10
-Topic 825
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482881/825-10-55-10

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 28
-Subparagraph (c)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-28

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 11
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-11

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 11
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-11

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482907/825-10-50-10

Reference 9: http://www.xbrl.org/2003/role/exampleRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 12
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482881/825-10-55-12

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

+ Details

Debt - Additional Information (Details) $ in Thousands									1 Months Ended			12 Months Ended
Debt - Additional Information (Details) $ in Thousands	Oct. 01, 2025 USD ($)	Sep. 30, 2025 USD ($)	Aug. 12, 2025	Dec. 30, 2024 USD ($)	Sep. 06, 2024 USD ($)	Jun. 27, 2024	Feb. 09, 2024 USD ($)	Oct. 22, 2019 USD ($)	Aug. 31, 2025 USD ($)	Jul. 31, 2024 USD ($)	Jun. 30, 2024 USD ($)	Dec. 31, 2025 USD ($) installment	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Aug. 13, 2021 USD ($)
Debt
Interest paid												$ 81,666	$ 122,771	$ 193,003
Outstanding amount												1,481,246	1,243,545
Loss on extinguishment of debt												821	20,611	393
Unamortized debt issuance costs												8,343	11,255
Line of Credit \| Second Lien Credit Agreement
Debt
Debt costs expensed														400
Line of Credit \| February 2024 First Lien Refinancing
Debt
Debt costs expensed							$ 10,300
Loss on extinguishment of debt													900
Line of Credit \| February 2024 First Lien Refinancing, Creditor Fees
Debt
Capitalized debt issuance costs							2,800
Line of Credit \| February 2024 First Lien Refinancing, Third Party Fees
Debt
Capitalized debt issuance costs							1,400
Line of Credit \| June 2024 First Lien Repricing
Debt
Minimum base rate (as a percent)						0.00%
Interest rate (as a percent)						2.75%
Debt costs expensed													2,500
Loss on extinguishment of debt													300
Line of Credit \| August 2025 First Lien Repricing
Debt
Minimum base rate (as a percent)			0.00%
Interest rate (as a percent)			2.00%
Debt costs expensed									$ 700
Loss on extinguishment of debt												700
Line of Credit \| October 2025 First Lien Refinancing
Debt
Debt costs expensed	$ 1,400
Loss on extinguishment of debt												$ 100
Capitalized debt issuance costs	100
Line of Credit \| October 2025 Revolving Credit Facility Repricing
Debt
Capitalized debt issuance costs	200
Line of Credit \| February 2024 Second Lien Paydown
Debt
Loss on extinguishment of debt													8,000
Line of Credit \| Term Loan
Debt
Minimum base rate (as a percent)												0.00%
Interest rate (as a percent)												2.00%
Effective interest rate (as a percent)												5.69%
Number of quarterly installments \| installment												20
Number of remaining payments \| installment												15
Line of Credit \| Term Loan \| First Lien Credit Agreement
Debt
Maximum borrowing capacity								$ 825,000						342,500
Line of credit facility														1,730,000
Line of Credit \| Term Loan \| Second Lien Credit Agreement
Debt
Maximum borrowing capacity														$ 448,000
Line of credit facility								255,000
Line of Credit \| Term Loan \| February 2024 First Lien Refinancing
Debt
Line of credit facility							$ 2,200,000
Line of Credit \| Term Loan \| June 2024 First Lien Paydown
Debt
Repayments of credit facility											$ 909,100
Interest paid											$ 2,800
Loss on extinguishment of debt													9,800
Line of Credit \| Term Loan \| July 2024 First Lien Paydown
Debt
Repayments of credit facility										$ 110,900
Interest paid										$ 400
Loss on extinguishment of debt													1,200
Line of Credit \| Term Loan \| September 2024 First Lien Paydown
Debt
Repayments of credit facility					$ 10,000
Loss on extinguishment of debt													100
Line of Credit \| Term Loan \| December 2024 First Lien Repricing
Debt
Minimum base rate (as a percent)				0.00%
Interest rate (as a percent)				2.25%
Debt costs expensed													1,200
Loss on extinguishment of debt													300
Line of Credit \| Term Loan \| October 2025 First Lien Refinancing
Debt
Maximum borrowing capacity	250,000
Line of Credit \| Revolving Credit Facility
Debt
Repayments of credit facility												$ 30,000
Minimum base rate (as a percent)												0.00%
Interest rate (as a percent)												1.50%
Proceeds from credit facility	30,000
Outstanding amount												$ 0	0
Effective interest rate (as a percent)												5.19%
Unamortized debt issuance costs on line of credit												$ 1,700	2,100
Line of Credit \| Revolving Credit Facility \| First Lien Credit Agreement
Debt
Maximum borrowing capacity								$ 125,000
Line of Credit \| Revolving Credit Facility \| December 2024 Revolving Credit Facility Repricing
Debt
Maximum borrowing capacity				$ 400,000
Minimum base rate (as a percent)				0.00%
Interest rate (as a percent)				1.75%
Line of Credit \| Revolving Credit Facility \| October 2025 Revolving Credit Facility Repricing
Debt
Maximum borrowing capacity	$ 500,000	$ 400,000
Interest rate (as a percent)	1.50%	1.75%
Line of Credit \| Receivables Facility
Debt
Maximum borrowing capacity												$ 80,000			$ 50,000
Minimum base rate (as a percent)												0.00%
Interest rate (as a percent)												1.61%
Proceeds from credit facility					$ 10,000
Outstanding amount												$ 80,000	$ 80,000
Effective interest rate (as a percent)												5.30%

Consolidated Statements of Comprehensive Income/(Loss) (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Statement of Comprehensive Income [Abstract]
Amounts reclassified out of accumulated other comprehensive income (loss) into net interest expense	$ 4,446	$ 29,175	$ 31,386
Income tax effects of amounts reclassified out of accumulated other comprehensive income (loss)	$ (1,094)	$ (7,084)	$ (7,620)

Related Party Transactions (Details) $ in Thousands	12 Months Ended
Related Party Transactions (Details) $ in Thousands	Dec. 31, 2025 USD ($) client vendor	Dec. 31, 2024 USD ($) client vendor	Dec. 31, 2023 USD ($) client vendor
Related party transactions
Outstanding amount	$ 1,481,246	$ 1,243,545
General and administrative	128,623	111,753	$ 62,924
Total revenues	1,099,278	943,549	791,010
Cost of revenue (exclusive of depreciation and amortization expenses)	348,162	315,730	249,767
Line of Credit \| First Lien Term Loan Facility
Related party transactions
Outstanding amount	1,401,246	1,163,545
Affiliated Entity
Related party transactions
General and administrative		200	300
Affiliated Entity \| Bain Capital LP
Related party transactions
Total revenues	$ 2,500	$ 1,900	$ 1,500
Number of clients from whom revenue is earned \| client	4	5	4
Cost of revenue (exclusive of depreciation and amortization expenses)	$ 2,800	$ 2,100	$ 400
Number of vendors \| vendor	3	2	2
Affiliated Entity \| Advent
Related party transactions
Total revenues	$ 700
Number of clients from whom revenue is earned \| client	2
Cost of revenue (exclusive of depreciation and amortization expenses)	$ 100
Number of vendors \| vendor	1
Affiliated Entity \| Line of Credit \| First Lien Term Loan Facility
Related party transactions
Outstanding amount	$ 64,800	$ 35,600

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2025
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On February 13, 2026, we executed an amendment to our Receivables Facility that increased the credit available to us from $80.0 million to $100.0 million and extended the maturity date from October 31, 2026 to February 13, 2029. Additionally, the amendment decreased the interest rate on the Receivables Facility from 1.61% per annum above the SOFR rate to 1.10% per annum above the SOFR rate.

Other Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Accrued Liabilities, Current [Abstract]
Accrued income taxes	$ 4,957	$ 4,111
Other taxes payable	2,882	3,915
Accrued severance	920	0
Retirement plan payable	307	497
Accrued self insurance claims	1,160	1,064
Accrued interest	655	597
ESPP payable	1,721	0
Other	10,388	5,746
Total	$ 22,990	$ 15,930

Summary of Significant Accounting Policies - Capitalized Software Development Costs (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Property and equipment, net
Impairments of capitalized software development costs	$ 0.0	$ 0.0	$ 0.0
Capitalized software development costs
Property and equipment, net
Estimated useful life	2 years

Retirement Plans (Details) - USD ($) $ in Millions	12 Months Ended
Retirement Plans (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Retirement Benefits [Abstract]
Total Plan expense	$ 5.4	$ 4.7	$ 4.1

Summary of Significant Accounting Policies - Software Licenses and Maintenance Contracts (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024
Prepaid expenses
Goodwill and other intangible assets
Total unamortized costs	$ 9.2	$ 7.2
Other long-term assets
Goodwill and other intangible assets
Total unamortized costs	$ 0.8	$ 0.1

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Income Taxes

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Income Taxes

Income tax expense/(benefit) consisted of the following for the years ended December 31, 2025, 2024, and 2023 (in thousands):


	Years ended December 31,
	2025		2024		2023
Current tax expense:
Federal	$	3,695	$	44,082	$	36,277
State	10,757		11,633		12,888
Total current tax expense	14,452		55,715		49,165
Provisions for uncertain tax expense
Deferred tax (benefit):
Federal	42,064		(53,032)		(53,382)
State	3,158		(6,103)		(8,283)
Total deferred tax benefit	45,222		(59,135)		(61,665)
Income tax benefit	$	59,674	$	(3,420)	$	(12,500)

The reconciliation between the statutory income tax rate and the effective income tax rate for the years ended December 31, 2025, 2024, and 2023 are as follows:


	Years ended December 31,
	2025				2024				2023
Book Income	$	171,763			$	(22,545)			$	(63,834)
U.S. Federal Tax At Statutory Rate	36,071		21	%	(4,735)		21	%	(13,309)		21	%
State & local income tax, net of federal tax effect (a)	11,459		7	%	2,836		(13)	%	2,893		(5)	%



Effects of changes in tax laws	—		0	%	—		0	%	—		0	%
Tax Credits
Purchased Tax Credits	(976)		(1)	%	—		0	%	—		0	%
Research and development tax credit	(1,711)		(1)	%	(2,108)		9	%	(1,885)		3	%



Nontaxable or nondeductible items
Stock based compensation	8,214		5	%	(942)		4	%	—		0	%
Nondeductible compensation	4,663		3	%	—		0	%	—		0	%
Transaction Costs	1,561		1	%	—		0	%	—		0	%

Change in Uncertain Tax Liability	(279)		0	%	1,241		(6)	%	281		0	%
Other, net	672		0	%	288		(1)	%	(480)		1	%
Effective Tax Rate	$	59,674	35	%	$	(3,420)	15	%	$	(12,500)	20	%

(a) During the year ended December 31, 2025, local taxes in Louisville, KY and state taxes in Pennsylvania, Tennessee, California, Minnesota, and New York comprised greater than 50% of the effect in this category.

The tax effects of temporary differences that gave rise to significant portions of the deferred tax assets and deferred tax liabilities at December 31, 2025 and 2024 are as follows (in thousands):


	December 31,
	2025		2024
Deferred tax assets:
State tax credits	$	827	$	827
Federal tax credits	4,176		—
Accrued bonus	7,985		5,148
Stock based compensation	16,538		30,022
Accrued revenue, expenses, deferrals and other	3,614		2,607
Deferred revenue	3,857		2,129
Interest Expense	105,123		105,353
Interest Rate Swap	186		—
Other	19		4
Capitalized Research and Development Expenditures	6,171		20,557
Right-of-use Liability	4,484		4,703

Depreciation of property and equipment	—		1,755
Net operating loss	18,603		15,599
Valuation Allowance	(2,610)		(1,056)
Total deferred tax assets	$	168,973	$	187,648
Deferred tax liabilities:
Depreciation of property and equipment	4,493		—
Transaction Costs	36		26
Amortization	346,194		262,026
Other prepaid expenses	2,920		2,270
Right-of-use Asset	3,230		2,717

Interest Rate Swap	—		283

Deferred costs	23,420		20,849

Total deferred liabilities	380,293		288,171
Net deferred tax liability	$	(211,320)	$	(100,523)

The following is a reconciliation of beginning and ending unrecognized tax benefits, including associated interest and penalties for the years ended December 31, 2025 and 2024 (in thousands):


	December 31,
	2025		2024
Beginning balance	$	4,335	$	3,094
Additions based on tax positions related to the current year	—		1,265
Reductions based on tax positions related to the current year	—		(24)

Reductions for tax positions in prior years	(279)		—
Ending balance	$	4,056	$	4,335

The following presents the cash paid for income taxes for the years ended December 31, 2025, 2024, and 2023 (in thousands):


	Years ended December 31,
	2025		2024			2023
Federal (a)	$	18,971	$	41,500		$	34,095

Aggregated state and local jurisdictions	9,352		8,997			12,555

Disaggregated state and local jurisdictions
California	1,820		—		(b)	—		(b)
Louisville, KY	1,579		—		(b)	3,460
Net cash paid for income taxes	$	31,721	$	50,497		$	50,110

(a) Includes amounts paid to purchase transferable tax credits of $15 million during the year ended December 31, 2025

(b) Jurisdiction below the threshold for the period presented

As of December 31, 2025 and 2024, the amount of unrecognized tax benefits that would impact the effective tax rate if recognized was $4.0 million and $4.3 million, respectively. During the years ended December 31, 2025, 2024, and 2023, we recognized $0.4 million, $0.2 million, and $0 million expense for interest and penalties related to unrecognized tax benefits. The above unrecognized tax benefits are recorded as an increase in the deferred tax liability in the accompanying balance sheet. Years 2021 to 2024 remain open to examination by federal, state, or local tax authorities.

As of December 31, 2025, we had net operating loss (“NOL”) carryforwards, consisting of approximately $4.3 million of tax effected Federal NOLs that expire beginning in 2032 and $14.4 million of tax effected state NOLs net of federal benefit that expire beginning in 2029, limited under provisions of Internal Revenue Code Section 382.

The following table details the changes in the valuation allowance for the years ended December 31, 2025 and 2024 (in thousands):


	Valuation Allowance
December 31, 2025
Beginning balance	$	1,056
Increase/(decrease)	130
Acquisitions	1,424
Ending balance	2,610
December 31, 2024
Beginning balance	$	197
Increase/(decrease)	859
Ending balance	$	1,056

As of December 31, 2025, we have a partial valuation allowance on our state credits of $0.2 million as well as a partial valuation allowance on certain state net operating loss carryforwards of $1.0 million. As part of the Iodine acquisition, we recorded a partial valuation allowance on federal credits of $1.4 million.

- Definition

The entire disclosure for income tax.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 740
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477617/942-740-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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-Publisher FASB
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+ Details

Summary of Significant Accounting Policies - Property and Equipment (Details)	Dec. 31, 2025
Computer hardware
Property and equipment, net
Estimated useful life	5 years
Office equipment
Property and equipment, net
Estimated useful life	5 years
Furniture and fixtures
Property and equipment, net
Estimated useful life	7 years
Building
Property and equipment, net
Estimated useful life	40 years
Purchased computer software \| Minimum
Property and equipment, net
Estimated useful life	3 years
Purchased computer software \| Maximum
Property and equipment, net
Estimated useful life	5 years
Leasehold improvements
Property and equipment, net
Property, Plant, and Equipment, Useful Life, Term, Description [Extensible Enumeration]	Useful Life, Shorter of Lease Term or Asset Utility [Member]

Segments (Tables)

12 Months Ended

Dec. 31, 2025

Segment Reporting [Abstract]

Schedule of Reconciliation of Revenue to Consolidated Net Income


	Years ended December 31,
($in thousands)	2025		2024		2023
Total Revenue	$	1,099,278	$	943,549	$	791,010
Less:
Materials and connectivity	244,993		225,333		173,077
Labor and associated expenses	103,169		90,397		76,690
Research & development	54,623		48,775		35,332
Sales and marketing	178,017		156,935		124,437
General and administrative	128,623		111,753		62,924
Depreciation	21,938		38,744		17,062
Amortization	118,610		147,887		159,405
Interest and non-operating expenses, net	77,542		146,270		205,917
Income tax expense/(benefit)	59,674		(3,420)		(12,500)
Segment net income/(loss)	$	112,089	$	(19,125)	$	(51,334)
Consolidated net income/(loss)	$	112,089	$	(19,125)	$	(51,334)

Summary of Significant Accounting Policies - Derivative Instruments (Details) - derivative_instrument	Dec. 31, 2025	Oct. 30, 2024	Nov. 29, 2022
Interest Rate Swap
Derivative financial instruments
Number of derivative instruments held	3	1	2
Interest Rate Swap Maturing on January 31, 2026
Derivative financial instruments
Number of derivative instruments held	1
Interest Rate Swap Maturing on March 31, 2027
Derivative financial instruments
Number of derivative instruments held	2

Revenue Recognition - Transaction Price Allocated to Remaining Performance Obligations (Details) $ in Millions	Dec. 31, 2025 USD ($)
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2026-01-01
Revenue Recognition
Period of revenue recognition related to unsatisfied performance obligations	12 months
Revenue to be recognized for unsatisfied performance obligations	$ 78.6
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2026-01-01 \| Iodine Acquisition
Revenue Recognition
Period of revenue recognition related to unsatisfied performance obligations	12 months
Revenue to be recognized for unsatisfied performance obligations	$ 26.4
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2027-01-01
Revenue Recognition
Period of revenue recognition related to unsatisfied performance obligations	12 months
Revenue to be recognized for unsatisfied performance obligations	$ 37.8
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2027-01-01 \| Iodine Acquisition
Revenue Recognition
Period of revenue recognition related to unsatisfied performance obligations	12 months
Revenue to be recognized for unsatisfied performance obligations	$ 23.5

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Schedule of Changes in the Allowance for Doubtful Accounts

Changes in the allowance for doubtful accounts are as follows (in thousands):


	December 31,
	2025		2024
Beginning balance	$	(5,885)	$	(5,335)
Provision for losses on receivables	(3,320)		(2,669)
Write-offs	4,001		2,792
Recoveries	(966)		(673)
Ending balance	$	(6,170)	$	(5,885)

Derivative Financial Instruments - Interest Rate Swaps Designated as Hedging Instruments (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024
May 31, 2023 through January 31, 2026
Derivative financial instruments
Floating Rate Debt	$ 506.7	$ 506.7
Fixed Rates	3.87%	3.87%
April 1, 2025 through January 30, 2026
Derivative financial instruments
Floating Rate Debt	$ 80.0
Fixed Rates	3.59%
October 1, 2025 through April 30, 2026
Derivative financial instruments
Floating Rate Debt	$ 127.0
Fixed Rates	3.50%
January 31, 2026 through March 31, 2027
Derivative financial instruments
Floating Rate Debt	$ 275.0
Fixed Rates	3.59%
January 31, 2026 through March 31, 2027
Derivative financial instruments
Floating Rate Debt	$ 275.0
Fixed Rates	3.27%

Investment Securities (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Debt Securities, Available-for-Sale [Line Items]
Amortized Cost	$ 24,880
Allowances for Credit Losses	0
Total Unrealized Gains	1
Total Unrealized Losses	4
Investment securities	24,877	$ 0
Commercial Paper
Debt Securities, Available-for-Sale [Line Items]
Amortized Cost	12,439
Allowances for Credit Losses	0
Total Unrealized Gains	0
Total Unrealized Losses	4
Investment securities	12,435
U.S. Treasury Bills
Debt Securities, Available-for-Sale [Line Items]
Amortized Cost	7,459
Allowances for Credit Losses	0
Total Unrealized Gains	1
Total Unrealized Losses	0
Investment securities	7,460
U.S. Government Agencies
Debt Securities, Available-for-Sale [Line Items]
Amortized Cost	4,982
Allowances for Credit Losses	0
Total Unrealized Gains	0
Total Unrealized Losses	0
Investment securities	$ 4,982

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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-Name Accounting Standards Codification
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
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-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 2
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147481800/320-10-50-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
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-Paragraph 2
-Subparagraph (d)
-Publisher FASB
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-3

+ Details

Property and Equipment, Net - Balance of Major Classes of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Property and equipment, net
Property and equipment, gross	$ 149,165	$ 125,931
Accumulated depreciation	(97,516)	(79,200)
Total	51,649	46,731
Computer hardware
Property and equipment, net
Property and equipment, gross	44,045	39,833
Capitalized internal-use software
Property and equipment, net
Property and equipment, gross	53,373	40,281
Purchased computer software
Property and equipment, net
Property and equipment, gross	23,188	22,789
Furniture and fixtures
Property and equipment, net
Property and equipment, gross	4,184	3,642
Office equipment
Property and equipment, net
Property and equipment, gross	271	247
Leasehold improvements
Property and equipment, net
Property and equipment, gross	4,994	3,778
Internal-use software in progress
Property and equipment, net
Property and equipment, gross	$ 19,110	$ 15,361

Stock-based Compensation - RSUs, Additional Information (Details) - RSUs $ in Millions	12 Months Ended
	Dec. 31, 2025 USD ($)
Stock-based compensation
Compensation expense	$ 117.0
Expected compensation expense, weighted average period	4 years 3 months 18 days

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Summary of Significant Accounting Policies - Revenue Recognition (Details)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Summary of Significant Accounting Policies
Revenue contract renewal term	1 year
Implementation fees and hardware sales
Summary of Significant Accounting Policies
Percentage to total revenues	1.00%	1.00%	1.00%
Minimum
Summary of Significant Accounting Policies
Revenue contract term	2 years
Maximum
Summary of Significant Accounting Policies
Revenue contract term	3 years

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 275
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-Section 50
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Reference 7: http://www.xbrl.org/2003/role/exampleRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 954
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-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478785/954-310-50-2

+ Details

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
Cybersecurity Risk Management and Strategy Disclosure	Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	We have developed a cybersecurity risk management program intended to assess risks from cybersecurity threats and manage those risks. Our cybersecurity risk management program is an important component of, and integrated with, our overall enterprise risk management framework, which addresses legal, compliance, operational, and financial risks, alongside cybersecurity risks. Through this integration, we aim to optimize resource allocation, improve risk identification, and strengthen our cybersecurity governance. Our cybersecurity risk management program is based on the National Institute of Standards and Technology Cybersecurity Framework (NIST CSF 2.0) and is aimed to assess, identify, and manage risks from cybersecurity threats. This does not imply that we meet any particular technical standards, specifications, or requirements, only that we use the NIST CSF 2.0 framework as a guide to help us identify, assess, and manage cybersecurity risks relevant to our business. The processes comprising our cybersecurity risk management program include risk assessments, vulnerability scanning and penetration testing, threat intelligence monitoring, and employee training and awareness programs. We have also implemented and maintain an incident response process designed to respond to and manage cybersecurity incidents. To protect our information systems from cybersecurity threats, we employ technical processes as a crucial component of our multi-layered cybersecurity risk management program. These processes include firewalls, intrusion detection and prevention systems, access controls, endpoint protection, data encryption, vulnerability management, security information event management, data loss prevention, security assessments, and penetration testing. As part of our cybersecurity risk management program, we undergo assessments and audits by external and independent auditors. These include evaluations against the HITRUST Common Security Framework (CSF), where we have achieved the HITRUST Risk-based, 2-year (R2) Certification—the highest level of HITRUST assurance. Additionally, we undergo audits in accordance with the SSAE 18 framework, specifically the System and Organization Controls 2 (SOC 2) Type 2 audit, which is designed for service organizations to demonstrate effective controls over security, availability, and confidentiality. Our program also includes independent assessments to validate compliance with the Payment Card Industry Data Security Standard (PCI DSS), for which we maintain PCI certification. The results of these audits and assessments are reported to our Board of Directors where deemed appropriate. . Our cybersecurity team, which is led by our Digital Information & Cybersecurity Officer (DISO), implements and maintains our cybersecurity risk management program and is dedicated to mitigating risks and protecting the confidentiality, integrity, and availability of our systems and data. Our cybersecurity team’s functions include security operations, vulnerability management, security engineering and architecture, risk management, compliance and audit support, threat intelligence, security awareness training, and policy development. Our cybersecurity team is also responsible for developing and executing the incident response plan. Because we rely on third-party vendors, including for information technology services, we have processes to oversee and identify risks from cybersecurity threats associated with key third-party vendors, based on our assessment of their criticality to our operations and respective risk profile. These processes may include vendor screening and due diligence, contractual requirements, security assessments and audits, incident response planning requirements, and ongoing monitoring. We are not aware of any risks from cybersecurity threats, including as a result of previously identified cybersecurity incidents, that have materially affected or are reasonably likely to materially affect us, including our business strategy, results of operations, or financial condition. As discussed more fully under Item 1A “Risk Factors,” there is a risk that we could experience a security incident and a compromise of our information technology systems and data. There is no assurance that our cybersecurity program will in all cases prevent such security incidents. We also maintain cybersecurity insurance that we regularly review to assess for appropriate coverage.
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	We have developed a cybersecurity risk management program intended to assess risks from cybersecurity threats and manage those risks. Our cybersecurity risk management program is an important component of, and integrated with, our overall enterprise risk management framework, which addresses legal, compliance, operational, and financial risks, alongside cybersecurity risks. Through this integration, we aim to optimize resource allocation, improve risk identification, and strengthen our cybersecurity governance. Our cybersecurity risk management program is based on the National Institute of Standards and Technology Cybersecurity Framework (NIST CSF 2.0) and is aimed to assess, identify, and manage risks from cybersecurity threats. This does not imply that we meet any particular technical standards, specifications, or requirements, only that we use the NIST CSF 2.0 framework as a guide to help us identify, assess, and manage cybersecurity risks relevant to our business. The processes comprising our cybersecurity risk management program include risk assessments, vulnerability scanning and penetration testing, threat intelligence monitoring, and employee training and awareness programs. We have also implemented and maintain an incident response process designed to respond to and manage cybersecurity incidents. To protect our information systems from cybersecurity threats, we employ technical processes as a crucial component of our multi-layered cybersecurity risk management program. These processes include firewalls, intrusion detection and prevention systems, access controls, endpoint protection, data encryption, vulnerability management, security information event management, data loss prevention, security assessments, and penetration testing. As part of our cybersecurity risk management program, we undergo assessments and audits by external and independent auditors. These include evaluations against the HITRUST Common Security Framework (CSF), where we have achieved the HITRUST Risk-based, 2-year (R2) Certification—the highest level of HITRUST assurance. Additionally, we undergo audits in accordance with the SSAE 18 framework, specifically the System and Organization Controls 2 (SOC 2) Type 2 audit, which is designed for service organizations to demonstrate effective controls over security, availability, and confidentiality. Our program also includes independent assessments to validate compliance with the Payment Card Industry Data Security Standard (PCI DSS), for which we maintain PCI certification. The results of these audits and assessments are reported to our Board of Directors where deemed appropriate. . Our cybersecurity team, which is led by our Digital Information & Cybersecurity Officer (DISO), implements and maintains our cybersecurity risk management program and is dedicated to mitigating risks and protecting the confidentiality, integrity, and availability of our systems and data. Our cybersecurity team’s functions include security operations, vulnerability management, security engineering and architecture, risk management, compliance and audit support, threat intelligence, security awareness training, and policy development. Our cybersecurity team is also responsible for developing and executing the incident response plan. Because we rely on third-party vendors, including for information technology services, we have processes to oversee and identify risks from cybersecurity threats associated with key third-party vendors, based on our assessment of their criticality to our operations and respective risk profile. These processes may include vendor screening and due diligence, contractual requirements, security assessments and audits, incident response planning requirements, and ongoing monitoring. We are not aware of any risks from cybersecurity threats, including as a result of previously identified cybersecurity incidents, that have materially affected or are reasonably likely to materially affect us, including our business strategy, results of operations, or financial condition.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Board of Directors Oversight [Text Block]	Our Board of Directors plays an active role in overseeing our cybersecurity risk management program. The Board of Directors or the Audit, Compliance, and Risk Committee receives a quarterly update on cybersecurity-related topics. The Board of Directors receives materials every quarter and presentations on alternating quarters from our Chief Technology Officer (CTO) on topics including significant cyberattacks and emerging threats, cybersecurity program performance, results of risk assessments, incident response updates, cybersecurity strategy, and cybersecurity program maturity. We have also established procedures for informing the Board of Directors of certain cybersecurity incidents outside of these scheduled briefings.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	The Board of Directors or the Audit, Compliance, and Risk Committee
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	Our Board of Directors plays an active role in overseeing our cybersecurity risk management program. The Board of Directors or the Audit, Compliance, and Risk Committee receives a quarterly update on cybersecurity-related topics. The Board of Directors receives materials every quarter and presentations on alternating quarters from our Chief Technology Officer (CTO) on topics including significant cyberattacks and emerging threats, cybersecurity program performance, results of risk assessments, incident response updates, cybersecurity strategy, and cybersecurity program maturity. We have also established procedures for informing the Board of Directors of certain cybersecurity incidents outside of these scheduled briefings
Cybersecurity Risk Role of Management [Text Block]	Our DISO is responsible for developing and implementing our cybersecurity program and holds certifications including ISO/IEC 27001:2002 Certified Information Security Executive, Cyber Security Executive Certification from Cornell University, Risk & Compliance Executive Certification from William & Mary University, and Healthcare Risk & Compliance Certification from American College of Medical Practice Executives (ACMPE). Our DISO’s responsibilities include managing cybersecurity risk, leading the cybersecurity team, staying informed about threats, reporting on cybersecurity performance, promoting a culture of security, and compliance and audit support. Our DISO regularly updates senior management and the Board of Directors on the performance of the cybersecurity program and the state of cybersecurity risk. Our DISO reports directly to our CTO who provides executive leadership and support for the overall technology and cybersecurity strategy. Our management team takes steps to stay informed about and monitor efforts to prevent, detect, mitigate, and remediate cybersecurity risks and incidents through various means, which may include briefings from internal security personnel; threat intelligence and other information obtained from governmental, public or private sources, including external consultants engaged by us; and alerts and reports produced by security tools deployed in our IT environment. To promote strong governance and oversight in managing cybersecurity risk, we have established a Cyber Risk Council, which is composed of our CTO, DISO, Chief Privacy Officer, Chief Financial Officer, Chief Legal Officer, and representatives of our technology and cybersecurity teams. The Cyber Risk Council is responsible for overseeing cybersecurity risk, monitoring performance of the cybersecurity risk management program, providing strategic guidance, and direction of the cybersecurity risk management program, among other oversight and monitoring functions.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	Cyber Risk Council
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	we have established a Cyber Risk Council, which is composed of our CTO, DISO, Chief Privacy Officer, Chief Financial Officer, Chief Legal Officer, and representatives of our technology and cybersecurity teams. The Cyber Risk Council is responsible for overseeing cybersecurity risk, monitoring performance of the cybersecurity risk management program, providing strategic guidance, and direction of the cybersecurity risk management program, among other oversight and monitoring functions
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	Our DISO regularly updates senior management and the Board of Directors on the performance of the cybersecurity program and the state of cybersecurity risk. Our DISO reports directly to our CTO who provides executive leadership and support for the overall technology and cybersecurity strategy. Our management team takes steps to stay informed about and monitor efforts to prevent, detect, mitigate, and remediate cybersecurity risks and incidents through various means, which may include briefings from internal security personnel; threat intelligence and other information obtained from governmental, public or private sources, including external consultants engaged by us; and alerts and reports produced by security tools deployed in our IT environment.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense/(Benefit)

Income tax expense/(benefit) consisted of the following for the years ended December 31, 2025, 2024, and 2023 (in thousands):


	Years ended December 31,
	2025		2024		2023
Current tax expense:
Federal	$	3,695	$	44,082	$	36,277
State	10,757		11,633		12,888
Total current tax expense	14,452		55,715		49,165
Provisions for uncertain tax expense
Deferred tax (benefit):
Federal	42,064		(53,032)		(53,382)
State	3,158		(6,103)		(8,283)
Total deferred tax benefit	45,222		(59,135)		(61,665)
Income tax benefit	$	59,674	$	(3,420)	$	(12,500)

Schedule of Reconciliation Between Statutory Income Tax Rate and Effective Income Tax Rate

The reconciliation between the statutory income tax rate and the effective income tax rate for the years ended December 31, 2025, 2024, and 2023 are as follows:


	Years ended December 31,
	2025				2024				2023
Book Income	$	171,763			$	(22,545)			$	(63,834)
U.S. Federal Tax At Statutory Rate	36,071		21	%	(4,735)		21	%	(13,309)		21	%
State & local income tax, net of federal tax effect (a)	11,459		7	%	2,836		(13)	%	2,893		(5)	%



Effects of changes in tax laws	—		0	%	—		0	%	—		0	%
Tax Credits
Purchased Tax Credits	(976)		(1)	%	—		0	%	—		0	%
Research and development tax credit	(1,711)		(1)	%	(2,108)		9	%	(1,885)		3	%



Nontaxable or nondeductible items
Stock based compensation	8,214		5	%	(942)		4	%	—		0	%
Nondeductible compensation	4,663		3	%	—		0	%	—		0	%
Transaction Costs	1,561		1	%	—		0	%	—		0	%

Change in Uncertain Tax Liability	(279)		0	%	1,241		(6)	%	281		0	%
Other, net	672		0	%	288		(1)	%	(480)		1	%
Effective Tax Rate	$	59,674	35	%	$	(3,420)	15	%	$	(12,500)	20	%

Schedule of Deferred Tax Assets and Deferred Tax Liabilities

The tax effects of temporary differences that gave rise to significant portions of the deferred tax assets and deferred tax liabilities at December 31, 2025 and 2024 are as follows (in thousands):


	December 31,
	2025		2024
Deferred tax assets:
State tax credits	$	827	$	827
Federal tax credits	4,176		—
Accrued bonus	7,985		5,148
Stock based compensation	16,538		30,022
Accrued revenue, expenses, deferrals and other	3,614		2,607
Deferred revenue	3,857		2,129
Interest Expense	105,123		105,353
Interest Rate Swap	186		—
Other	19		4
Capitalized Research and Development Expenditures	6,171		20,557
Right-of-use Liability	4,484		4,703

Depreciation of property and equipment	—		1,755
Net operating loss	18,603		15,599
Valuation Allowance	(2,610)		(1,056)
Total deferred tax assets	$	168,973	$	187,648
Deferred tax liabilities:
Depreciation of property and equipment	4,493		—
Transaction Costs	36		26
Amortization	346,194		262,026
Other prepaid expenses	2,920		2,270
Right-of-use Asset	3,230		2,717

Interest Rate Swap	—		283

Deferred costs	23,420		20,849

Total deferred liabilities	380,293		288,171
Net deferred tax liability	$	(211,320)	$	(100,523)

Schedule of Reconciliation of Unrecognized Tax Benefits

The following is a reconciliation of beginning and ending unrecognized tax benefits, including associated interest and penalties for the years ended December 31, 2025 and 2024 (in thousands):


	December 31,
	2025		2024
Beginning balance	$	4,335	$	3,094
Additions based on tax positions related to the current year	—		1,265
Reductions based on tax positions related to the current year	—		(24)

Reductions for tax positions in prior years	(279)		—
Ending balance	$	4,056	$	4,335

Schedule of Cash Paid for Income Taxes

The following presents the cash paid for income taxes for the years ended December 31, 2025, 2024, and 2023 (in thousands):


	Years ended December 31,
	2025		2024			2023
Federal (a)	$	18,971	$	41,500		$	34,095

Aggregated state and local jurisdictions	9,352		8,997			12,555

Disaggregated state and local jurisdictions
California	1,820		—		(b)	—		(b)
Louisville, KY	1,579		—		(b)	3,460
Net cash paid for income taxes	$	31,721	$	50,497		$	50,110

(a) Includes amounts paid to purchase transferable tax credits of $15 million during the year ended December 31, 2025

(b) Jurisdiction below the threshold for the period presented

Schedule of Changes in Valuation Allowance

The following table details the changes in the valuation allowance for the years ended December 31, 2025 and 2024 (in thousands):


	Valuation Allowance
December 31, 2025
Beginning balance	$	1,056
Increase/(decrease)	130
Acquisitions	1,424
Ending balance	2,610
December 31, 2024
Beginning balance	$	197
Increase/(decrease)	859
Ending balance	$	1,056