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BILLION TO ONE Q2 2026 Business Update August 5 , 2026
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This presentation contains certain “forward-looking statementsˮ within the meaning of applicable securities laws. These statements relate to future events and results of BillionToOne, Inc. (the “Company,ˮ “we,ˮ “us,ˮ or “ourˮ) and involve known and unknown risks, uncertainties and other factors that may cause the actual results, levels of activity, performance or achievements of the Company or its industry to be materially different from those expressed or implied by any forward-looking statements. In some cases, forward-looking statements can be identified by terminology such as “may,ˮ “will,ˮ “could,ˮ “would,ˮ “should,ˮ “to,ˮ “target,ˮ “expect,ˮ “plan,ˮ “anticipate,ˮ “intend,ˮ “believe,ˮ “estimate,ˮ “predict,ˮ “potentialˮ or other comparable terminology. All statements other than statements of historical fact could be deemed forward-looking, including, but not limited to: our 2026 financial guidance, any projections of market opportunities; any statements regarding expectations for future reimbursement opportunities and product performance; any statements regarding the Companyʼs long-term expectations; and the Companyʼs goals and general business and market conditions. The forward-looking statements are based on our beliefs, assumptions and expectations of future performance, taking into account the information currently available to us. These statements are only predictions based upon our current expectations about future events. Forward-looking statements are subject to known and unknown risks, uncertainties and other factors that may cause our actual results, performance or achievements to be materially different from those expressed or implied by such forward-looking statements including but not limited to: our limited operating history and rapid growth; our dependence on sales of our molecular diagnostic tests for our revenue and success; risks relating to the government and other third-party payors failing to provide coverage and adequate payment for our existing and future tests; risks related to our ability to successfully obtain reimbursement from the Medicare program and state Medicaid programs; risks related to our billing and claim processing; risks related to the inherent variability of the insurance coverage and reimbursement landscape; the loss of key members of our senior management team or our inability to attract and retain highly skilled scientists, technicians, clinicians, and sales representatives; risks of damage to or interoperability of our existing laboratory facilities; risks related to our tests in development, including clinical effectiveness or commercial market acceptance; the commercial success of our recently launched tests; risks related to our products meeting the expectations of patients and customers; risks related to international trade policies, including tariffs, sanctions and trade barriers; risks related to legal proceedings, regulatory investigations and inquiries and other legal matters; and risks related to effectively protecting our proprietary technologies. We discuss these and other risks and uncertainties in greater detail under the captions “Risk Factorsˮ and “Managementʼs Discussion and Analysis of Financial Condition and Results of Operationsˮ in filings we make with the Securities and Exchange Commission from time to time. Though we have attempted to identify important factors that could cause actual results to differ materially from those contained in forward-looking statements, there may be other factors that cause results not to be as anticipated, estimated or intended. The assumptions used in the preparation of this presentation, although considered reasonable by us at the time of preparation, may prove to be incorrect. You are cautioned that the information is based on assumptions as to many factors and that actual results may vary from the results projected and such variations may be material. Accordingly, you should not place undue reliance on any forward-looking statements contained herein. We do not undertake to update any forward-looking statements, except in accordance with applicable securities laws. Certain information contained in this presentation relate to or are based on studies, publications, surveys and other data obtained from third-party sources and our own internal estimates and research. While we believe these third-party studies, publications, surveys and other data to be reliable as of the date of this presentation, we have not independently verified, and makes no representations as to the adequacy, fairness, accuracy or completeness of, any information obtained from third-party sources. In addition, no independent source has evaluated the reasonableness or accuracy of our internal estimates or research and no reliance should be made on any information or statements made in this presentation relating to or based on such internal estimates and research. This presentation includes certain non-GAAP financial measures as defined by the SEC rules. These non-GAAP financial measures are in addition to, and not as a substitute for or superior to measures of financial performance prepared in accordance with U.S. GAAP. There are a number of limitations related to the use of these non-GAAP financial measures versus their nearest GAAP equivalents. For example, other companies may calculate non-GAAP financial measures differently or may use other measures to evaluate their performance, all of which could reduce the usefulness of our non-GAAP financial measures as tools for comparison. As required by Regulation G, we have provided a reconciliation of those measures to the most directly comparable GAAP measures, which is available in the appendix. Disclaimer & Forward Looking Statement
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Scalable Rapid Growth Zero to $438M ARR* in 6 years $100B TAM US** Patented QCT™ technology enabling single-molecule sensitivity Category-defining products in prenatal and oncology Culture of fiscal discipline & efficient operations incorporating AI GAAP profitability & positive cash flows with accumulated deficit 10% that of public competitors 70%+ gross margin Significant opportunity for further ASP growth and COGS-per-test reductions smNGS single-molecule next-generation sequencing; QCT™: Quantitative Counting Templates™; ARR annualized revenue run-rate; TAM total addressable market; ASP average sales price * Q2 2026 revenue of $109.4M annualized. Calculated as Q2 multiplied by 4. ** Our estimated US annual market opportunity includes important assumptions, including the number of eligible patients, frequency of testing and ASPs. See our public filings with the SEC for more information regarding our total addressable market calculations and assumptions. Revolutionary smNGS Platform & Products Superior Gross Margin Profile GAAP Profitability Our 4 Pillars of Differentiation 3
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Scalable Rapid Growth • Consistent test volume growth to 196K, up 35% YoY • Achieved revenue of $109.4M, $438M ARR. Represents YoY growth of 64% in Q2. • Successful launch and reception of Unity Confirm • Launching Expanded Fetal Risk Screen with 130 genes • Launching Northstar Origin add-on for updated Northstar Select • Northstar Response publication in Journal of Liquid Biopsy, to support MolDX coverage • Achieved $5.5M in GAAP operating income, reflecting a 5% GAAP operating margin and a 15% adjusted EBITDA margin • Strong balance sheet with $549M cash • ASP growth to $551 per test, 21% YoY increase $20 lower QoQ due to lower true-up) • COGS increased 3% YoY to $161/test due to mix-shift, i.e., faster growth of oncology • Gross margin of 70.5% Revolutionary smNGS Platform & Products Superior Gross Margin Profile GAAP Profitability Summary of Q2 Achievements4
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Revolutionary smNGS Platform & Products
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CONFIDENTIAL & PROPRIETARY6 Pillar 1 — Platform & Product Prenatal ● Launched as a specialized follow-on to high-risk pregnancies identified on Unity Aneuploidy; captures and sequences intact circulating fetal cells, providing 100% fetal fraction ● Strong provider reception with current providers ordering it on 50% of eligible high-risk Unity Aneuploidy patients "This is going to be such an incredible option for my patients who don't want invasive diagnostic testing." Ob/Gyn ● Continuing to enroll patients in the largest prospective circulating fetal cell-based study. ● Opening doors to “no-seeˮ health systems, with significant long-term positive impact expected, especially after future readouts from the study. Unity Confirm: Strong adoption to-date LAUNCHED May 28
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CONFIDENTIAL & PROPRIETARY7 ● Expands the Unity Fetal Risk Screen offering to 130-genes, the largest NIPT panel for recessive conditions, leapfrogging competitive offerings. ● Increases the available market size significantly, as 50% of all providers prefer large panels ● Screens for prevalent, actionable conditions selected from ACOG, ACMG, RUSP guidelines ● Reinforces Unity's position as the leader in cfDNA testing for recessive conditions Unity Fetal Risk Screen: Panel Expansion Pillar 1 — Platform & Product Prenatal COMING Aug 17
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CONFIDENTIAL & PROPRIETARY Peer-reviewed study validates Northstar Response for monitoring IO & IO-combination therapy Published in The Journal of Liquid Biopsy, in collaboration with Allegheny Health Network AHN. ● 142 patients with 750+ samples, two prospective cohorts, 12 tumor types ● Molecular progression strongly predicted worse survival PFS HR 5.8; OS HR 4.1) and was a stronger predictor than imaging. ● Extremely strong predictive power when combined with imaging (13.8 landmark hazard ratio) ● Enables categorization of radiographically stable disease patients to responders and non-responders ● 1% QC failure rate (vs. 1530% with tumor-informed assays) Pillar 1 — Platform & Product Oncology8 Image source: Anees, M et al. J Liq Biopsy. 2026 Jun 24;13100477. doi: 10.1016/j.jlb.2026.100477. PUBLISHED Jun 24
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CONFIDENTIAL & PROPRIETARY Northstar Select Panel Update Problem: 3% of patients have cancer of unknown primary CUP) and do not have effective therapy options without a diagnosis. Up to 10% of patients in community oncology settings without access to detailed pathology work-ups may have uncertain diagnosis. Solution: Add-on tissue-of-origin feature with 91% top-3 and 86% top-1 accuracy. QCT-based molecular counting of methylation enables significantly better categorization of tissue types. Pillar 1 — Platform & Product Oncology9 Problem: There are recent and upcoming FDA approvals for new targeted therapies. Solution: Updating the panel to 102-genes to cover all recent & upcoming FDA approvals, including highly sensitive detection of MTAP copy number loss, present in 15% of patients with highly promising ongoing clinical trials (presented at Cancer Genomics Conference). LAUNCHING September 1 LAUNCHING September 1 Northstar Origin Add-on POLD1 PIK3R1 MTAP NRG1
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Scalable Rapid Growth
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Total test volume grew 35% YoY. Pillar 2 — Scalable Rapid Growth11 Test Volume Delivered Quarterly 196K • Total test volumes grew 35% Yo Y and 8000 tests sequentially. • We have continued our strong sequential growth adding 70 reps in H1, higher than the plan, due to the strength of the hiring pipeline. While this impacted the short-term sales productivity, this is expected to lead to faster growth exiting the year and into the early part of the next year. * Delivered and billable tests in Q2 2026. 35%
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CONFIDENTIAL & PROPRIETARY Record-speed Epic Aura integration 12 Pillar 2 — Scalable Rapid Growth ● Launched Epic Aura* platform in 5 months, a record speed for any laboratory to launch on Epic — opens up access to Health Systems ● Completed first Epic Aura health system integration in 2 weeks, from start to first test order ● Aura removes barrier to health system adoption, but it will still take time to integrate, as it requires IT teams at health systems to slot our integration into their roadmap, which is often 24 quarters in the future. * Epic and Aura are trademarks of Epic Systems Corporation
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CONFIDENTIAL & PROPRIETARY Laboratory expansion for oncology 13 Pillar 2 — Scalable Rapid Growth ● Signed lease for an oncology production lab, 62K sq ft, directly across from existing prenatal production lab in Union City, CA ● Build-out underway, with production expected by Dec. 2027 ● Expected to enable an oncology test capacity of 5000 tests per day over time Lab 2.0 (CA) Oncology Lab 3.0 (CA) Prenatal Lab 4.0 (TX) PrenatalLab 3.5 (CA) Oncology Opening Dec 2027 Opening Q1 2028
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CONFIDENTIAL & PROPRIETARY Oncology GAAP Revenue Quarterly Pillar 2 — Scalable Rapid Growth Prenatal GAAP Revenue Quarterly 14 Percentage growth rates represent growth from Q2 2025 to Q2 2026 $95.8M* $13.7M * Includes revenue associated with clinical trial services 176%56%
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Rapid revenue growth: zero to $438M* ARR in ~6 years. Pillar 2 — Scalable Rapid Growth Total GAAP Revenue Quarterly *Q2 2026 revenue of $109.4M annualized as of June 30, 2026. Calculated as Q2 2026 revenue multiplied by 4. Percentage growth rates represent growth from Q2 2025 to Q2 2026 • 64% YoY revenue growth driven by rapid YoY increases both in tests delivered 35%) and ASP 21%. • Total revenues grew 8% QoQ excluding true-up revenue 15 $109.4M 64%
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Superior Gross Margin Profile
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• Overall ASP increased 21% YoY to $551, but declined $20 QoQ due to very high true-up revenue of $49 per test in Q1 vs $14 per test in Q2. • We held $10M of claims in Q2 for in-network implementation of our codes by national payors. • Excluding true-up revenue, overall ASP increased $15 per test QoQ, due to record number of payor contracts signed in Q2. Overall ASP* * Overall ASP is the weighted average ASP across all of our prenatal and oncology products. It is computed by dividing revenue for our prenatal and oncology tests by the number of tests that are delivered and billable. The number of tests that are delivered and billable in a given period represents that number of billable tests for which we deliver a result to the ordering provider in such period. In this chart we show overall ASP both including and excluding true-up revenue. 17 Pillar 3 — Superior Gross Margin Profile $551 21% Overall ASP grew (excluding true-up).
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Overall COGS per test was $161 in Q2. Pillar 3 — Superior Gross Margin Profile Overall COGS Per Test Quarterly ● The overall COGS-per-test increased to $161 in Q2 from $152 in Q1 (and from $156 a year ago), primarily due to a shift in the test volume mix towards oncology. ● Prenatal COGS was approximately constant QoQ despite Unity Confirm launch, and we have continued to achieve significant COGS reductions, over 10% QoQ, in oncology. ● We expect our overall COGS to slightly rise over time as our faster oncology growth continues. $161 18 3%
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70.5% gross margin: stable despite faster growth of oncology. Pillar 3 — Superior Gross Margin Profile Gross Margin Quarterly 19 • GM was relatively consistent, 70.5%, despite the faster growth of oncology, which has lower margins at its current state. GM is higher by 5 pp YoY due to higher ASPs. • The slight differences in GM in the last 4 quarters are almost entirely attributable to quarterly true-up differences 70% excluding true-up). 5% 70.5%
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GAAP Profitability
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CONFIDENTIAL & PROPRIETARYQ2 2026 Financials21 Actual Q2 2025 Actual Q1 2026 Actual Q2 2026 Yo Y Growth Commentary Total Tests Delivered 145,000 188,000 196,000 35% Overall ASP per test (excluding true-up) $440 $522 $537 22% True-up (per test) $15 $49 $14 Overall ASP per test $455 $571 $551 21% Revenue - Total Prenatal $61.6 $97 .7 $95.8 56% ● Prenatal total revenues of $95.8M in Q226 $383M ARR Revenue - Total Oncology $4.9 $10.7 $13.7 176% ● Oncology revenues achieving $55M ARR, and 2.8x YoY Total Revenue $66.6 $108.4 $109.4 64% ● Total revenues of $109.4M $438M ARR Gross Margin % Total 65.3% 73.0% 70.5% 5 pp ● Overall GM increased 5 pp Yo Y and decreased 2.5 pp QoQ Operating Profit Loss $1.6 $17 .8 $5.5 ● 5% positive operating margin. GAAP profitable & cash-flow positive for Q2 Adjusted EBITDA $2.9 $26.0 $16.1 466% ● 15% Adjusted EBITDA margin Ending Cash Balance $189.0 $537.5 $548.6 190%
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CONFIDENTIAL & PROPRIETARY $72M $153M Reiterating guidance of $450-$465M revenue & GAAP profitability Guidance22 Projections Actuals $305M $450M $465M Projections vs Actuals Historical Guidance Previous vs Current Jan 2026 Guidance 85% CAGR Mar 2026 Guidance $430M$445M May & Aug 2026 Guidance
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Summary To build a category-defining company and enter the S&P 500 LONG-TERM GOAL We are transforming healthcare: one molecule at a time, one patient at a time. 23 Strong gross margin profile with 70.5% GM Launching 130-gene Fetal Risk Screen Launching Northstar Origin add-on to updated Northstar Select Continued profitability achieving 5% GAAP operating margin and 15% Adj. EBITDA margin 64% YoY revenue growth leading to $438M annualized revenue run-rate
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Thank you.
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CONFIDENTIAL & PROPRIETARY25 Appendix EBITDA Reconciliation Q2 2025 Q1 2026 Q2 2026 Net Income Loss $0.2M $18.0M $8.1M Provision for Income Taxes $0.0M $0.5M $0.5M Interest Income $1.5M $4.6M $4.7M Interest Expense $0.0M $0.0M $0.0M Depreciation and Amortization $1.7M $1.7M $1.8M EBITDA $0.1M $15.6M $4.7M Note: Numbers may not add due to rounding
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CONFIDENTIAL & PROPRIETARY26 Appendix Adjusted EBITDA Reconciliation Q2 2025 Q1 2026 Q2 2026 Net Income Loss $0.2M $18.0M $8.1M Provision for Income Taxes $0.0M $0.5M $0.5M Interest Income $1.5M $4.6M $4.7M Interest Expense $0.0M $0.0M $0.0M Depreciation and Amortization $1.7M $1.7M $1.8M Stock-Based Compensation Expense $2.7M $6.5M $8.2M Change In Fair Value of Term Loan $0.0M $4.3M $3.0M Change In Fair Value of Warrant Liabilities $0.0M $0.4M $0.3M Adjusted EBITDA $2.9M $26.0M $16.1M Note: Numbers may not add due to rounding