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Table of Contents ■ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington , D.C. 20549 FORM 10 - K ANNUAL REPORT PURSUANT TO SECTION 13 OR 15 ( d ) OF THE SECURITIES EXCHANGE ACT OF 1934 FOR THE FISCAL YEAR ENDED DECEMBER 31 , 2020 OR TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 ( d ) OF THE SECURITIES EXCHANGE ACT OF 1934 FOR THE TRANSITION PERIOD FROM ΤΟ Commission File Number 000-27701 Tennessee ( State or other jurisdiction of incorporation or organization ) 500 11th Avenue North , Suite 1000 Nashville , Tennessee ( Address of principal executive offices ) Title of each class Common Stock ( Par Value $ 0.00 ) HEALTHSTREAM , INC . ( Exact name of registrant as specified in its charter ) 62-1443555 ( 615 ) 301-3100 ( Registrant's telephone number , including area code ) Securities Registered Pursuant To Section 12 ( b ) Of The Act : Trading Symbol ( s ) . HSTM Securities Registered Pursuant To Section 12 ( g ) Of The Act : None Indicate by check mark if the registrant is a well - known seasoned issuer , as defined in Rule 405 of the Securities Act . Yes No Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 of 15 ( d ) of the Act . Yes No Indicate by check mark whether the registrant ( 1 ) has filed all reports required to be filed by Section 13 or 15 ( d ) of the Securities Exchange Act of 1934 during the preceding 12 months ( or for such shorter period that the registrant was required to file such reports ) , and ( 2 ) has been subject to such filing requirements for the past 90 days . Yes No ( I.R.S. Employer Identification No. ) Accelerated filer 37203 ( Zip Code ) Non - accelerated filer Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S - T ( § 232.405 of this chapter ) during the preceding 12 months ( or for such shorter period that the registrant was required to submit such files ) . Yes No Indicate by check mark whether the registrant is a large accelerated filer , an accelerated filer , a non - accelerated filer , a smaller reporting company , or an emerging growth company . See the definitions of " large accelerated filer , " " accelerated filer , " " smaller reporting company , " and " emerging growth company " in Rule 12b - 2 of the Exchange Act . Smaller reporting company Name of each exchange on which registered Nasdaq Global Select Market Large accelerated filer > Emerging growth company If an emerging growth company , indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13 ( a ) of the Exchange Act . Indicate by check mark whether the registrant has filed a report on and attestation to its management's assessment of the effectiveness of its internal control over financial reporting under Section 404 ( b ) of the Sarbanes - Oxley Act ( 15 U.S.C. 7262 ( b ) ) by the registered public accounting firm that prepared or issued its audit report . Indicate by check mark whether the registrant is a shell company ( as defined in Rule 12b - 2 of the Act ) . Yes No The aggregate market value of the Common Stock issued and outstanding and held by non - affiliates of the Registrant , based upon the closing sales price for the Common Stock on the Nasdaq Global Select Market on June 30 , 2020 was $ 565.2 million . All executive officers and directors of the registrant have been deemed , solely for the purpose of the foregoing calculation , to be " affiliates " of the registrant . As of February 22 , 2021 , there were 31,493,677 shares of the Registrant's common stock outstanding . DOCUMENTS INCORPORATED BY REFERENCE Portions of the Registrant's definitive Proxy Statement for its 2021 Annual Meeting of Shareholders are incorporated by reference into Part III hereof .