Acadia Healthcare Reports Third Quarter 2025 Results
FRANKLIN, Tenn.--( BUSINESS WIRE)--Acadia Healthcare Company, Inc. (“Acadia” or the “Company”) (NASDAQ: ACHC) today announced financial results for the third quarter ended September 30, 2025.
Third Quarter 2025 Results
Full Year Financial Guidance
Revenue Performance by Service Type
Adjusted income attributable to Acadia and Adjusted EBITDA are non-GAAP financial measures. A reconciliation of all non-GAAP financial measures in this press release begins on page 11.
“Acadia delivered solid revenue performance in the third quarter despite a challenging operating environment,” said Chris Hunter, Chief Executive Officer of Acadia. “While we are lowering our full-year EBITDA guidance to reflect incremental volume and rate pressures, we remain encouraged by patient demand and the progress we’re making across key initiatives. In light of these ongoing headwinds, we are taking decisive steps to improve performance and position the business for the future — including targeted efforts to drive volume recovery, a reduction in capital expenditures to accelerate free cash flow generation, and portfolio rationalization to ensure we are focused on the highest-performing markets and service lines. We are executing a focused strategy centered on disciplined growth to expand access to high-quality behavioral healthcare, improve clinical outcomes and drive operational efficiency across our national network.”
Discussion of Results and Updated Guidance
Acadia reported third quarter revenue of $851.6 million, reflecting a 4.4% increase year-over-year. Same-facility revenue grew 3.7%, driven by a 2.3% increase in revenue per patient day and a 1.3% rise in patient days. Same-facility admissions increased 3.3% compared to the prior-year period, underscoring early momentum from targeted referral initiatives. However, patient day growth fell short of expectations due to persistent softness in acute care Medicaid volumes and heightened payor scrutiny around authorizations. In addition, revenue was negatively impacted by elevated levels of bad debt and denials, which are expected to remain a headwind in the fourth quarter.
Adjusted EBITDA for the quarter was $173.0 million, down from $194.3 million in the prior-year period, reflecting the impact of lower volumes, increased startup losses from newly opened facilities, and higher professional and general liability (“PLGL”) expenses. Startup losses from newly opened facilities totaled $13.3 million in the quarter, up from $7.3 million in the third quarter of 2024 due to the significant number of new beds opened in the last 12 months.
In response to these dynamics, Acadia is lowering its full-year 2025 guidance ranges for revenue, adjusted EBITDA, and adjusted earnings per share. The revised outlook incorporates an incremental assumption on PLGL charges of $4.0 million to $6.0 million that are now expected in the fourth quarter, as well as rate pressure stemming from evolving macroeconomic and policy conditions.
While the reimbursement environment remains challenging, Acadia’s investments in quality infrastructure and clinical outcomes position the Company favorably in discussions with payor partners. Several Medicaid supplemental payment programs are currently under review by CMS. However, due to uncertainty surrounding the timing of approvals amid the ongoing government shutdown, these potential contributions of up to $22.0 million in adjusted EBITDA from new supplemental payment programs are not reflected in the updated guidance.
Development Activity
Acadia added 429 new beds during the third quarter, with a total of 908 beds added in the first nine months of 2025:
The 429 beds added during the third quarter are attributable to the Company’s commencement of operations at three previously announced joint venture hospitals: a 96-bed hospital in Danville, Pennsylvania, its second joint venture hospital with Geisinger Health; a 106-bed expansion of a hospital in Austin, Texas, through a joint venture with Ascension Seton; and a 144-bed hospital in St. Paul, Minnesota, through a joint venture with Fairview Health Services.
Joint ventures continue to be an important part of our growth strategy as we partner with marquee healthcare systems to provide critical behavioral care to our patients and communities.
In addition, Acadia added three new comprehensive treatment centers (“CTCs”), extending the Company’s market reach to 177 CTCs across 33 states, treating over 74,000 patients daily in this critical area of care.
Taking Decisive Action to Drive Improved Performance
Acadia is taking decisive steps to strengthen performance and position the Company for long-term success. As announced in September, the Company is reducing its 2026 capital expenditures by at least $300 million compared to 2025 levels, following a comprehensive facility-by-facility review of its development pipeline. This disciplined approach to capital deployment reflects a sharpened focus on high-performing markets and service lines with the most favorable end-market dynamics and is expected to accelerate Acadia’s path to generating positive free cash flow for the full year 2026.
At the same time, Acadia is intensifying efforts to optimize the performance of its expanded footprint. With over 1,700 beds added across 2024 and 2025, and an additional 500 to 700 beds expected in 2026, the Company is executing targeted initiatives to drive volume growth. These efforts include referral source–level action plans at underperforming facilities, enhanced data-driven planning, and dedicated resources to support execution. These initiatives are already yielding results, with same-facility admissions growing 3.3% in the third quarter and referral volumes accelerating meaningfully in the second half of the year.
Acadia’s investments in quality and technology continue to differentiate the Company in a sector historically marked by underinvestment. The Company’s integrated quality dashboard tracks more than 50 key performance indicators in real time, enabling consistent delivery of evidence-based care and supporting constructive engagement with payor partners. These capabilities are increasingly critical in an environment where demonstrated clinical outcomes are becoming a key determinant of reimbursement and access.
Moreover, Acadia’s commitment to quality has helped attract and retain talent, with labor turnover improving for six consecutive quarters and base wage growth stabilizing. As referral volumes rise, these labor trends position the Company to convert demand into admissions more effectively, further supporting its growth trajectory.
Cash and Liquidity
As of September 30, 2025, the Company had $118.7 million in cash and cash equivalents and $786.7 million available under its $1.0 billion revolving credit facility.
2025 Financial Guidance
Acadia today updated its previously announced financial guidance for 2025, as follows:
November Guidance Range
August Guidance Range
Revenue
$3.28 to $3.30 billion
$3.30 to $3.35 billion
Adjusted EBITDA
$650 to $660 million
$675 to $700 million
Adjusted earnings per diluted share
$2.35 to $2.45
$2.45 to $2.65
Interest expense
$135 to $140 million
$130 to $140 million
Tax rate
22.5% to 23.5%
25% to 26%
Depreciation and amortization expense
$190 to $195 million
$185 to $195 million
Stock compensation expense
$33 to $38 million
$40 to $45 million
Operating cash flows
$400 to $425 million
$460 to $485 million
Expansion capital expenditures
$505 to $515 million
$495 to $535 million
Maintenance and IT capital expenditures
$105 to $115 million
$105 to $115 million
Total bed additions
945 to 1,076 beds
950 to 1,000 beds
The Company’s full-year guidance includes the following assumptions:
The Company’s guidance does not include the impact of any future acquisitions, divestitures, transaction, legal and other costs or non-recurring legal settlements expense.
Chief Operating Officer Transition
The Company also announced that Dr. Nasser Khan resigned from his role as Chief Operating Officer, effective November 3, 2025. Dr. Khan will continue to serve as an executive advisor through December 31, 2025. The Company has initiated a search for his replacement, and in the interim, Dr. Khan’s responsibilities are being assumed by other members of executive management.
Conference Call
Acadia will hold a conference call to discuss its third quarter financial results at 8:00 a.m. Central Time/9:00 a.m. Eastern Time on Thursday, November 6, 2025. A live webcast of the conference call will be available at www.acadiahealthcare.com in the “Investors” section of the website. The webcast of the conference call will be available for 30 days.
About Acadia
Acadia is a leading provider of behavioral healthcare services across the United States. As of September 30, 2025, Acadia operated a network of 278 behavioral healthcare facilities with approximately 12,500 beds in 40 states and Puerto Rico. With approximately 25,500 employees serving more than 82,000 patients daily, Acadia is the largest stand-alone behavioral healthcare company in the U.S. Acadia provides behavioral healthcare services to its patients in a variety of settings, including inpatient psychiatric hospitals, specialty treatment facilities, residential treatment centers and outpatient clinics.
Forward-Looking Information
This press release contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), including statements related to our strategy, growth, anticipated operating results for future periods and our share repurchase program. Generally, words such as “may,” “will,” “should,” “could,” “anticipate,” “expect,” “intend,” “estimate,” “plan,” “continue,” and “believe” or the negative of or other variation on these and other similar expressions identify forward-looking statements. These forward-looking statements are made only as of the date of this press release. We do not undertake to update or revise the forward-looking statements, whether as a result of new information, future events or otherwise. Forward-looking statements are based on current expectations and involve risks and uncertainties and our future results could differ significantly from those expressed or implied by our forward-looking statements. Factors that may cause actual results to differ materially include, without limitation, (i) potential difficulties in successfully integrating the operations of acquired facilities or realizing the expected benefits and synergies of our facility expansions, acquisitions, joint ventures and de novo transactions; (ii) Acadia’s ability to add beds, expand services, enhance marketing programs and improve efficiencies at its facilities; (iii) potential reductions in payments received by Acadia from government and commercial payors, including because of the significant changes to Medicaid financing mechanisms introduced by the One Big Beautiful Bill Act (“OBBBA”) enacted on July 4, 2025; (iv) the occurrence of patient incidents, governmental investigations, litigation and adverse regulatory actions, which could adversely affect the price of our common stock and result in substantial payments and incremental regulatory burdens; (v) the risk that Acadia may not generate sufficient cash from operations to service its debt and meet its working capital and capital expenditure requirements; (vi) potential disruptions to our information technology systems or a cybersecurity incident; and (vii) potential operating difficulties, including, without limitation, disruption to the U.S. economy and financial markets, and any effects of the ongoing U.S. government shutdown; reduced admissions and patient volumes, including, without limitation, due to OBBBA’s introduction of work or community engagement requirements in the Medicaid expansion population; increased costs relating to labor, supply chain and other expenditures; changes in competition and client preferences; and general economic or industry conditions that may prevent Acadia from realizing the expected benefits of its business strategies. These factors and others are more fully described in Acadia’s periodic reports and other filings with the SEC.
Share Repurchase Authorization Disclaimer
Acadia’s share repurchase program permits the Company to make repurchases on a discretionary basis as determined by management, subject to market conditions, applicable legal requirements, available liquidity, compliance with the Company's debt agreements, and other appropriate factors. Repurchases under the share repurchase program are to be made through open market or privately negotiated transactions and may be made pursuant to plans entered into in accordance with Rule 10b5-1 and/or Rule 10b-18 of the Exchange Act. The share repurchase program does not have a termination date, does not obligate Acadia to acquire any particular amount of common stock, and may be modified, extended, suspended, or discontinued by the Company’s Board of Directors at any time without prior notice. No assurance can be given that any particular amount of common stock will be repurchased.
Three Months Ended September 30,
Nine Months Ended September 30,
2025
2024
2025
2024
$
851,573
$
815,634
$
2,491,310
$
2,379,725
462,169
428,147
1,359,857
1,265,427
51,478
48,498
147,146
142,236
30,412
29,623
87,286
84,153
11,736
12,389
36,002
36,141
128,787
112,137
377,203
322,900
47,468
37,641
143,495
110,054
36,619
29,924
100,939
86,297
—
—
1,269
—
—
—
3,504
—
—
10,459
1,452
11,459
—
—
(8,715
)
—
42,919
8,249
138,416
17,187
811,588
717,067
2,387,854
2,075,854
39,985
98,567
103,456
303,871
1,668
27,199
18,139
72,916
38,317
71,368
85,317
230,955
(2,071
)
(3,236
)
(10,570
)
(7,958
)
$
36,246
$
68,132
$
74,747
$
222,997
$
0.40
$
0.74
$
0.82
$
2.44
$
0.40
$
0.74
$
0.82
$
2.42
90,414
91,720
90,794
91,571
90,584
92,188
91,255
92,119
September 30,
December 31,
2025
2024
$
118,693
$
76,305
430,838
365,339
198,425
135,848
747,956
577,492
3,091,502
2,853,193
2,286,434
2,264,851
85,176
70,003
27,795
20,964
114,248
118,369
59,630
52,043
$
6,412,741
$
5,956,915
$
24,375
$
76,816
179,939
232,704
166,417
155,426
21,479
25,462
125,713
87,511
517,923
577,919
2,284,773
1,880,093
94,086
83,946
95,464
101,828
130,565
122,298
3,122,811
2,766,084
169,633
117,116
904
918
2,707,719
2,685,464
411,674
387,333
3,120,297
3,073,715
$
6,412,741
$
5,956,915
Nine Months Ended September 30,
2025
2024
$
85,317
$
230,955
143,495
110,054
3,513
3,061
25,257
27,014
3,309
56,133
1,269
—
3,504
—
1,452
11,459
(8,715
)
—
1,907
(3,988
)
(64,958
)
(20,936
)
(17,590
)
(3,334
)
(10,865
)
676
33,584
(404,942
)
5,158
(1,841
)
12,554
8,681
218,191
12,992
(8,165
)
(53,550
)
(478,617
)
(486,891
)
23,151
10,227
(145
)
(2,935
)
(463,776
)
(533,149
)
1,200,000
350,000
875,000
210,000
(1,035,000
)
(15,000
)
(8,125
)
(40,968
)
(670,856
)
—
(18,615
)
(1,518
)
(3,953
)
(824
)
(50,034
)
—
5,000
3,500
(3,877
)
(2,972
)
(1,500
)
—
(67
)
11
287,973
502,229
42,388
(17,928
)
76,305
100,073
$
118,693
$
82,145
$
36,715
$
59,235
(1,193
)
(4,185
)
—
(1,500
)
(27,357
)
—
$
8,165
$
53,550
Three Months Ended September 30,
Nine Months Ended September 30,
2025
2024
% Change
2025
2024
% Change
$
827,824
$
798,350
3.7
%
$
2,438,744
$
2,320,452
5.1
%
811,607
800,845
1.3
%
2,365,184
2,324,011
1.8
%
51,966
50,286
3.3
%
150,376
147,015
2.3
%
15.6
15.9
-1.9
%
15.7
15.8
-0.5
%
$
1,020
$
997
2.3
%
$
1,031
$
998
3.3
%
$
224,702
$
230,614
-2.6
%
$
672,326
$
665,528
1.0
%
$
851,573
$
815,634
4.4
%
$
2,491,310
$
2,379,725
4.7
%
830,165
815,126
1.8
%
2,409,938
2,375,477
1.5
%
54,450
51,513
5.7
%
156,055
151,082
3.3
%
15.2
15.8
-3.6
%
15.4
15.7
-1.8
%
$
1,026
$
1,001
2.5
%
$
1,034
$
1,002
3.2
%
$
210,779
$
230,091
-8.4
%
$
623,537
$
665,052
-6.2
%
Three Months Ended September 30,
Nine Months Ended September 30,
2025
2024
2025
2024
$
36,246
$
68,132
$
74,747
$
222,997
2,071
3,236
10,570
7,958
1,668
27,199
18,139
72,916
36,619
29,924
100,939
86,297
47,468
37,641
143,495
110,054
124,072
166,132
347,890
500,222
6,031
9,467
25,257
27,014
42,919
8,249
138,416
17,187
—
—
1,269
—
—
—
3,504
—
—
10,459
1,452
11,459
—
—
(8,715
)
—
$
173,022
$
194,307
$
509,073
$
555,882
(37,757
)
(35,784
)
(114,464
)
(109,170
)
210,779
230,091
623,537
665,052
(13,923
)
(523
)
(48,789
)
(476
)
$
224,702
$
230,614
$
672,326
$
665,528
Three Months Ended September 30,
Nine Months Ended September 30,
2025
2024
2025
2024
$
36,246
$
68,132
$
74,747
$
222,997
42,919
8,249
138,416
17,187
—
—
1,269
—
—
—
3,504
—
—
10,459
1,452
11,459
—
—
(8,715
)
—
1,668
27,199
18,139
72,916
80,833
114,039
228,812
324,559
16,005
29,960
52,215
79,614
64,828
84,079
176,597
244,945
90,584
92,188
91,255
92,119
$
0.72
$
0.91
$
1.94
$
2.66
Three Months Ended September 30,
Nine Months Ended September 30,
2025
2024
2025
2024
$
38,737
$
3,102
$
123,274
$
5,635
3,206
718
15,446
(1,263
)
976
2,939
(304
)
9,730
—
1,490
—
3,085
$
42,919
$
8,249
$
138,416
$
17,187