0001558370-22-016892 | 10-Q | XBRL Viewer

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Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2022	Nov. 04, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
Document Transition Report	false
Entity File Number	001-38546
Entity Registrant Name	NEURONETICS, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	33-1051425
Entity Address, Address Line One	3222 Phoenixville Pike
Entity Address, City or Town	Malvern
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19355
City Area Code	610
Local Phone Number	640-4202
Title of 12(b) Security	Common Stock ($0.01 par value)
Trading Symbol	STIM
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		27,221,490
Entity Central Index Key	0001227636
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Amendment Flag	false
Entity Ex Transition Period	false

Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 73,698	$ 94,141
Accounts receivable, net	11,963	7,706
Inventory	8,573	6,563
Current portion of net investments in sales-type leases	1,874	2,198
Current portion of prepaid commission expense	1,871	1,559
Current portion of note receivables	80	74
Prepaid expenses and other current assets	3,037	3,090
Total current assets	101,096	115,331
Property and equipment, net	2,109	1,220
Operating lease right-of-use assets	3,459	3,884
Net investments in sales-type leases	1,617	1,697
Prepaid commission expense	7,305	6,763
Long-term note receivable	94	10,110
Other assets	3,555	2,218
Total Assets	119,235	141,223
Current liabilities:
Accounts payable	2,350	4,299
Accrued expenses	11,493	8,233
Deferred revenue	1,732	2,501
Current portion of operating lease liabilities	818	670
Current portion of long-term debt, net	8,750
Total current liabilities	25,143	15,703
Long-term debt, net	27,009	35,335
Deferred revenue	981	1,471
Operating lease liabilities	3,111	3,539
Total Liabilities	56,244	56,048
Commitments and contingencies (Note 17)
Stockholders' Equity:
Preferred stock, $0.01 par value: 10,000 shares authorized; no shares issued or outstanding on September 30, 2022, and December 31, 2021
Common stock, $0.01 par value: 200,000 shares authorized; 27,060 and 26,395 shares issued and outstanding on September 30, 2022, and December 31, 2021, respectively	270	264
Additional paid-in capital	400,323	393,644
Accumulated deficit	(337,602)	(308,733)
Total Stockholders' Equity	62,991	85,175
Total Liabilities and Stockholders' Equity	$ 119,235	$ 141,223

Balance Sheets (Parenthetical) - $ / shares shares in Thousands	Sep. 30, 2022	Dec. 31, 2021
Balance Sheets
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	10,000	10,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	200,000	200,000
Common stock, shares issued	27,060	26,395
Common stock, shares outstanding	27,060	26,395

Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statements of Operations
Revenues	$ 16,498	$ 13,799	$ 47,008	$ 40,290
Cost of revenues	3,570	3,144	11,093	8,115
Gross Profit	12,928	10,655	35,915	32,175
Operating expenses:
Sales and marketing	11,643	9,827	37,977	27,431
General and administrative	6,391	6,435	19,125	19,220
Research and development	2,348	1,575	6,197	6,179
Total operating expenses	20,382	17,837	63,299	52,830
Loss from Operations	(7,454)	(7,182)	(27,384)	(20,655)
Other (income) expense:
Interest expense	1,061	993	3,039	2,955
Other income, net	(906)	(24)	(1,554)	(53)
Net Loss	$ (7,609)	$ (8,151)	$ (28,869)	$ (23,557)
Net loss per share of common stock outstanding, basic	$ (0.28)	$ (0.31)	$ (1.08)	$ (0.94)
Net loss per share of common stock outstanding, diluted	$ (0.28)	$ (0.31)	$ (1.08)	$ (0.94)
Weighted-average common shares outstanding, basic	26,965	26,301	26,797	25,179
Weighted-average common shares outstanding, diluted	26,965	26,301	26,797	25,179

Statements of Changes in Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Total
Beginning balance at Dec. 31, 2020	$ 191	$ 302,842	$ (277,540)	$ 25,493
Beginning balance, shares at Dec. 31, 2020	19,114
Share-based awards and options exercises	$ 11	1,581		1,592
Share-based awards and options exercises, shares	1,076
Issuance of common stock	$ 56	80,515		80,571
Issuance of common stock (in shares)	5,566
Share-based compensation expense		2,196		2,196
Net Loss			(7,881)	(7,881)
Ending balance at Mar. 31, 2021	$ 258	387,134	(285,421)	101,971
Ending balance, shares at Mar. 31, 2021	25,756
Beginning balance at Dec. 31, 2020	$ 191	302,842	(277,540)	25,493
Beginning balance, shares at Dec. 31, 2020	19,114
Net Loss				(23,557)
Ending balance at Sep. 30, 2021	$ 263	391,910	(301,097)	91,076
Ending balance, shares at Sep. 30, 2021	26,335
Beginning balance at Mar. 31, 2021	$ 258	387,134	(285,421)	101,971
Beginning balance, shares at Mar. 31, 2021	25,756
Share-based awards and options exercises	$ 4	707		711
Share-based awards and options exercises, shares	411
Share-based compensation expense		2,009		2,009
Net Loss			(7,525)	(7,525)
Ending balance at Jun. 30, 2021	$ 262	389,850	(292,946)	97,166
Ending balance, shares at Jun. 30, 2021	26,167
Share-based awards and options exercises	$ 1	99		100
Share-based awards and options exercises, shares	168
Share-based compensation expense		1,961		1,961
Net Loss			(8,151)	(8,151)
Ending balance at Sep. 30, 2021	$ 263	391,910	(301,097)	91,076
Ending balance, shares at Sep. 30, 2021	26,335
Beginning balance at Dec. 31, 2021	$ 264	393,644	(308,733)	85,175
Beginning balance, shares at Dec. 31, 2021	26,395
Share-based awards and options exercises	$ 3	6		9
Share-based awards and options exercises, shares	322
Share-based compensation expense		2,252		2,252
Net Loss			(10,838)	(10,838)
Ending balance at Mar. 31, 2022	$ 267	395,902	(319,571)	76,598
Ending balance, shares at Mar. 31, 2022	26,717
Beginning balance at Dec. 31, 2021	$ 264	393,644	(308,733)	85,175
Beginning balance, shares at Dec. 31, 2021	26,395
Net Loss				(28,869)
Ending balance at Sep. 30, 2022	$ 270	400,323	(337,602)	62,991
Ending balance, shares at Sep. 30, 2022	27,060
Beginning balance at Mar. 31, 2022	$ 267	395,902	(319,571)	76,598
Beginning balance, shares at Mar. 31, 2022	26,717
Share-based awards and options exercises	$ 1	42		43
Share-based awards and options exercises, shares	139
Share-based compensation expense		2,203		2,203
Net Loss			(10,422)	(10,422)
Ending balance at Jun. 30, 2022	$ 268	398,147	(329,993)	68,422
Ending balance, shares at Jun. 30, 2022	26,856
Share-based awards and options exercises	$ 2	(2)
Share-based awards and options exercises, shares	204
Share-based compensation expense		2,178		2,178
Net Loss			(7,609)	(7,609)
Ending balance at Sep. 30, 2022	$ 270	$ 400,323	$ (337,602)	$ 62,991
Ending balance, shares at Sep. 30, 2022	27,060

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

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Statements of Changes in Stockholders' Equity (Parenthetical) $ in Thousands	3 Months Ended
	Mar. 31, 2021 USD ($)
Statements of Changes in Stockholders' Equity (Deficit)
Issuance of common stock, issuance costs	$ 401

Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended		12 Months Ended
Statements of Cash Flows - USD ($) $ in Thousands	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Cash Flows from Operating Activities:
Net loss	$ (28,869)	$ (23,557)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	1,044	768
Share-based compensation	6,633	6,166
Non-cash interest expense	513	484
Cost of rental units purchased by customers	92	137
Changes in certain assets and liabilities:
Accounts receivable, net	(4,257)	(3,097)
Inventory	(2,299)	(1,870)
Net investments in sales-type leases	381	341
Prepaid commission expense	(854)	(602)
Prepaid expenses and other assets	176	(453)
Accounts payable	(2,199)	(840)
Accrued expenses	3,260	(405)
Deferred revenue	(1,260)	(531)
Net Cash Used in Operating Activities	(27,639)	(23,459)	$ (28,000)
Cash Flows from Investing Activities:
Purchases of property and equipment and capitalized software	(2,766)	(1,552)
Repayment (Issuance) of promissory note	10,000
Repayment (Issuance) of promissory note		(7,486)
Net Cash provided by (used in) Investing Activities	7,234	(9,038)
Cash Flows from Financing Activities:
Payments of debt issuance costs	(90)
Proceeds from exercises of stock options	52	2,403
Proceeds from the issuance of common stock		80,972
Payments of common stock offering issuance costs		(401)
Net Cash (used in) Provided by Financing Activities	(38)	82,974
Net (Decrease) Increase in Cash and Cash Equivalents	(20,443)	50,477
Cash and Cash Equivalents, Beginning of Period	94,141	48,957	48,957
Cash and Cash Equivalents, End of Period	73,698	99,434	$ 94,141
Supplemental disclosure of cash flow information:
Cash paid for interest	2,525	2,471
Transfer of Inventory to PP&E	285	235
Supplemental disclosure of non-cash investing and financing activities:
Purchases of property and equipment and capitalized software in accounts payable and accrued expenses	$ 251	398
Reduction of accounts receivable in long-term note receivable		$ 2,514

Description of Business

9 Months Ended

Sep. 30, 2022

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Description of Business

1. DESCRIPTION OF BUSINESS

Neuronetics, Inc., or the Company, is a commercial stage medical technology company focused on designing, developing and marketing products that improve the quality of life for patients who suffer from neurohealth disorders. The Company’s first commercial product, the NeuroStar Advanced Therapy System, is a non-invasive and non-systemic office-based treatment that uses transcranial magnetic stimulation, or TMS, to create a pulsed, MRI-strength magnetic field that induces electrical currents designed to stimulate specific areas of the brain associated with mood. The system was cleared in 2008 by the United States Food and Drug Administration, or the FDA, to treat adult patients with major depressive disorder, or MDD, who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode. Our NeuroStar Advanced Therapy system was also cleared in 2022 by the FDA to treat people suffering from obsessive-compulsive disorder as well as for the treatment of comorbid anxiety symptoms for adults with MDD suffering from anxiety symptoms (“anxious depression”). NeuroStar Advanced Therapy is also available in other parts of the world, including Japan, where it is listed under Japan’s national health insurance. The Company intends to continue to pursue development of its NeuroStar Advanced Therapy System for additional indications.

COVID-19

The Company is continuing to monitor the impact of the COVID-19 pandemic on all aspects of its business and geographies, including how it will continue to impact the Company’s customers, supply chain, employees and other business partners. While the Company experienced significant disruptions in March 2020 through the end of September 30, 2022 from the COVID-19 pandemic, it is unable to predict the full impact that the pandemic may have on its financial condition, results of operations and cash flows due to numerous uncertainties. These uncertainties include the scope, severity and duration of the ongoing pandemic, the actions taken to contain the pandemic or mitigate its impact and the direct and indirect economic effects of the pandemic, vaccination rates, effectiveness of treatments, and containment measures, among others. The pandemic has significantly adversely impacted global economic activity and has contributed to significant volatility and negative pressure in financial markets, and may contribute to periods of economic uncertainty in the future.

Liquidity

As of September 30, 2022, the Company had cash and cash equivalents of $73.7 million and an accumulated deficit of $337.6 million. The Company incurred negative cash flows from operating activities of $27.6 million for the nine months ended September 30, 2022 and $28.0 million for the year ended December 31, 2021. The Company has incurred operating losses since its inception, and management anticipates that its operating losses will continue in the near term as the Company continues to invest in sales, marketing and product development activities. The Company’s primary sources of capital to date have been proceeds from its initial public offering (“IPO”) of common stock, private placements of its convertible preferred securities, borrowings under its credit facility, proceeds from its secondary public offering of common stock and revenues from sales of its products. As of September 30, 2022, the Company had $35.0 million of borrowings outstanding under its credit facility, which has a final maturity in February 2025. Management believes that the Company’s cash and cash equivalents as of September 30, 2022, and anticipated revenues from sales of its products are sufficient to fund the Company’s operations for at least the next 12 months from the issuance of these financial statements.

Basis of Presentation

9 Months Ended

Sep. 30, 2022

Accounting Policies [Abstract]

Basis of Presentation

2. BASIS OF PRESENTATION

The accompanying financial statements have been prepared in accordance with United States generally accepted accounting principles, or GAAP. Any reference in these notes to applicable guidance is meant to refer to GAAP as found in the Accounting Standards Codification, or ASC, and Accounting Standards Updates, or ASUs, promulgated by the Financial Accounting Standards Board, or FASB.

Interim Financial Statements

The accompanying unaudited interim financial statements have been prepared from the books and records of the Company in accordance with GAAP for interim financial information and Rule 10-01 of Regulation S-X promulgated by the United States Securities and Exchange Commission, or SEC, which permit reduced disclosures for interim periods. All adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the accompanying balance sheets and statements of operations and stockholders’ equity and cash flows have been made. Although these interim financial statements do not include all of the information and footnotes required for complete annual financial statements, management believes the disclosures are adequate to make the information presented not misleading. Unaudited interim results of operations and cash flows for the three and nine months ended September 30, 2022 are not necessarily indicative of the results that may be expected for the full year. Unaudited interim financial statements and footnotes should be read in conjunction with the audited financial statements and footnotes included in the Company’s Form 10-K filed with the SEC on March 8, 2022, wherein a more complete discussion of significant accounting policies and certain other information can be found.

Use of Estimates

The preparation of financial statements in accordance with GAAP and the rules and regulations of the SEC requires the use of estimates and assumptions, based on judgments considered reasonable, which affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. The Company bases its estimates and assumptions on historical experience, known trends and events and various other factors that management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Although management believes its estimates and assumptions are reasonable when made, they are based upon information available at the time they are made. Management evaluates the estimates and assumptions on an ongoing basis and, if necessary, makes adjustments. Due to the risks and uncertainties involved in the Company’s business and evolving market conditions, including those related to the COVID-19 pandemic, and given the subjective element of the estimates and assumptions made, actual results may differ materially from estimated results.

Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2022

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

3. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

The Company’s complete summary of significant accounting policies can be found in “Note 3. Summary of Significant Accounting Policies” in the audited financial statements included in the Company’s Form 10-K filed with the SEC on March 8, 2022.

Recent Accounting Pronouncements

9 Months Ended

Sep. 30, 2022

New Accounting Pronouncements And Changes In Accounting Principles [Abstract]

Recent Accounting Pronouncements

4. RECENT ACCOUNTING PRONOUNCEMENTS

New Accounting Standards Not Yet Adopted by the Company

In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“Topic 326”). This ASU provides guidance for recognizing credit losses on financial instruments based on an estimate of current expected credit losses model. The FASB subsequently issued ASU 2019-04, to clarify and address certain items related to the amendments in Topic 326.

ASU 2019-05, Financial Instruments - Credit Losses (Topic 326): Targeted Transition Relief, was issued to provide entities that have certain instruments within the scope of ASC 326 with an option to irrevocably elect the fair value option under ASC 825-10, Financial Instruments - Overall, applied on an instrument-by-instrument basis for eligible instruments. ASU 2019-10, Topic 326, Topic 815, and Topic 842 amends the mandatory effective date for Topic 326.

These ASUs are effective for fiscal years beginning after December 15, 2022 for entities that are eligible to be defined by the SEC as a smaller reporting company. The Company is a smaller reporting company. Although the impact upon adoption will depend on the financial instruments held by the Company at that time, the Company does not anticipate a significant impact on its financial statements based on the instruments currently held and its historical trend of bad debt expense relating to trade accounts receivable.

Other than the items noted above, there have been no new accounting pronouncements not yet effective or adopted in the current year that we believe have a significant impact, or potential significant impact, to our unaudited interim financial statements.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

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

Fair Value Measurement and Financial Instruments

9 Months Ended

Sep. 30, 2022

Fair Value Disclosures [Abstract]

Fair Value Measurement and Financial Instruments

5. FAIR VALUE MEASUREMENT AND FINANCIAL INSTRUMENTS

The carrying values of cash equivalents, accounts receivable, prepaids and other current assets, and accounts payable on the Company’s balance sheets approximated their fair values as of September 30, 2022 and December 31, 2021 due to their short-term nature. The carrying values of the Company’s credit facility approximated its fair value as of September 30, 2022 and December 31, 2021 due to its variable interest rate. The carrying value of the Company’s note receivable approximated its fair value as of December 31, 2021 due to its variable interest rate.

Certain of the Company’s financial instruments are measured at fair value using a three-level hierarchy that prioritizes the inputs used to measure fair value. This hierarchy maximizes the use of observable inputs and minimizes the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows:

Level 1:

Inputs are quoted prices for identical instruments in active markets.

Level 2:

Inputs are quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; or model-derived valuations whose inputs are observable or whose significant value drivers are observable.

Level 3:

Inputs are unobservable and reflect the Company’s own assumptions, based on the best information available, including the Company’s own data.

The following tables set forth the carrying amounts and fair values of the Company’s financial instruments as of September 30, 2022 and December 31, 2021 (in thousands):

September 30, 2022

Fair Value Measurement Based on

Quoted

Significant

Prices In

other

Significant

Active

Observable

Unobservable

Carrying

Markets

Inputs

Amount

Fair Value

(Level 1)

(Level 2)

(Level 3)

Assets

Money market funds (cash equivalents)

69,405

—

December 31, 2021

Fair Value Measurement Based on

Quoted

Significant

Prices In

other

Significant

Active

Observable

Unobservable

Carrying

Markets

Inputs

Amount

Fair Value

(Level 1)

(Level 2)

(Level 3)

Assets

Money market funds (cash equivalents)

91,236

—

- 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 + Details

Accounts Receivable

9 Months Ended

Sep. 30, 2022

Receivables [Abstract]

Accounts Receivable

6. ACCOUNTS RECEIVABLE

The following table presents the composition of accounts receivable, net as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Gross accounts receivable - trade	$	13,754	$	9,168
Less: Allowances for doubtful accounts		(1,791)		(1,462)
Accounts receivable, net	$	11,963	$	7,706

Property and Equipment and Capitalized Software

9 Months Ended

Sep. 30, 2022

Property Plant And Equipment [Abstract]

Property and Equipment and Capitalized Software

7. PROPERTY AND EQUIPMENT AND CAPITALIZED SOFTWARE

The following table presents the composition of property and equipment, net as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Laboratory equipment	$	466	$	249
Office equipment		508		497
Computer equipment and software		1,711		1,598
Manufacturing equipment		344		341
Leasehold improvements		1,422		471
Rental equipment		575		601
Property and equipment, gross		5,026		3,757
Less: Accumulated depreciation		(2,917)		(2,537)
Property and equipment, net	$	2,109	$	1,220

As of September 30, 2022 and December 31, 2021, the Company had capitalized software costs, net of $3.7 million and $2.5 million, respectively, which are included in “Prepaid expenses and other current assets” and “Other assets” on the balance sheet.

Depreciation and amortization expense was $0.4 million and $0.2 million for the three months ended September 30, 2022 and 2021, respectively, and $1.0 million and $0.8 million for the nine months ended September 30, 2022 and 2021, respectively.

Note Receivable

9 Months Ended

Sep. 30, 2022

Accounts, Notes, Loans and Financing Receivable, Gross, Allowance, and Net [Abstract]

Note Receivable

8. NOTE RECEIVABLE

On September 29, 2021, Neuronetics, Inc. the Company entered into an exclusive, five-year master sales agreement (the “Commercial Agreement”) with Check Five, LLC d/b/a Success TMS (“Success TMS”). In connection with the Commercial Agreement, the Company agreed to loan Success TMS the principal amount of $10.0 million for a period of five years pursuant to a secured promissory note (the “Note”). The Note bore interest at a floating rate equal to the prime rate plus 6.00% per annum. The Note included an interest-only period through October 1, 2022, after which time Success TMS was required to make monthly payments of principal and interest. Under the terms of the Note, the Company had received a first priority security interest in substantially all of the assets of Success TMS. Success TMS has also granted the Company an observer seat on the Board of Managers of Success TMS.

In the Note, Success TMS made certain representations and warranties and was required to comply with certain customary affirmative and negative covenants during the term of the Note.

On April 29, 2022, the Company entered into a Subordination Agreement (the “Subordination Agreement”) with ZW Partners, LLC, a New Jersey limited liability company (“ZW Partners”), pursuant to which the Company agreed to subordinate its rights under the Note to the rights of ZW Partners under a revolving promissory note, dated as of April 29, 2022 (the “Senior Note”), issued by Success TMS to ZW Partners in an amount up to $10.0 million. As a result, payments in respect of the Note were subordinate and subject in right and time of payment to payment in full of the Senior Note, and ZW Partners’ liens and security interests upon the collateral securing both the Senior Note and the Note are superior in priority to the Company’s liens and security interests upon such collateral. Under the Agreement, the Company had the right to purchase, at par, the entire aggregate amount of debt under the Senior Note at any time.

On July 14, 2022, Success TMS repaid in full the Note issued on September 29, 2021 with a cash payment of $10.5 million, which included all outstanding principal, prepayment premium and accrued but unpaid interest. The repayment extinguished the Note in its entirety and terminated the Subordination Agreement entered into by the Company and ZW Partners.

Interest income recognized by the Company was $0.5 million and $1.0 million for the three and nine months ended September 30, 2022, respectively.

Leases

9 Months Ended

Sep. 30, 2022

Leases [Abstract]

Leases

9. LEASES

Lessee:

The Company has operating leases for its corporate headquarters, a training facility and office equipment, including copiers. The Company leases an approximately 32,000 square foot facility in Malvern, Pennsylvania for its corporate headquarters, which includes office and warehouse space. The Company leases an approximately 9,600 square foot facility in Charlotte, North Carolina as a training facility for its NeuroStar Advanced Therapy Systems. The Company does not currently have any finance leases or executed leases that have not yet commenced.

Operating lease rent expense was $0.2 million and $0.2 million for the three months ended September 30, 2022 and 2021, respectively, and $0.6 million and $0.4 million for the nine months ended September 30, 2022 and 2021, respectively. As of September 30, 2022, the weighted-average remaining lease term of operating leases was 5.3 years and the weighted-average discount rate was 7.1%.

The following table presents the supplemental cash flow information as a lessee related to leases (in thousands):


	Nine Months Ended
	September 30, 2022		September 30, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	632	$	526

The following table sets forth by year the required future payments of operating lease liabilities (in thousands):


	September 30, 2022
Remainder of 2022	$	209
2023		852
2024		875
2025		898
2026		921
Thereafter		999
Total lease payments		4,754
Less imputed interest		(825)
Present value of operating lease liabilities	$	3,929

Lessor sales-type leases:

Certain customers have purchased NeuroStar Advanced Therapy Systems on a rent-to-own basis. The lease term is three or four years with a customer option to purchase the NeuroStar Advanced Therapy System at the end of the lease or automatic transfer of ownership of the NeuroStar Advanced Therapy System at the end of the lease.

The following table sets forth the profit recognized on sales-type leases (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Profit recognized at commencement, net	$	122	$	262	$	543	$	543
Interest income		—		—		—		—
Total sales-type lease income	$	122	$	262	$	543	$	543

The following table sets forth a maturity analysis of the undiscounted lease receivables related to sales-type leases (in thousands):


	September 30,
	2022
Remainder of 2022	$	605
2023		1,572
2024		858
2025		368
2026		88
Total sales-type lease receivables	$	3,491

As of September 30, 2022, the carrying amount of the lease receivables is $3.5 million. The Company does not have any unguaranteed residual assets.

Lessor operating leases:

NeuroStar Advanced Therapy Systems sold for which collection is not probable are accounted for as operating leases. For the three months ended September 30, 2022 and 2021, the Company recognized operating lease income of $0.07 million and $0.03 million, respectively. For the nine months ended September 30, 2022 and 2021, the Company recognized operating lease income of $0.2 million and $0.2 million, respectively.

The Company maintained Rental Equipment, net of $0.5 million and $0.6 million as of September 30, 2022 and December 31, 2021, respectively, which are included in “Property and equipment, net” on the balance sheet. Rental equipment depreciation expense was $0.02 million and $0.01 million for the three months ended September 30, 2022 and 2021, respectively, and $0.07 million and $0.03 million for the nine months ended September 30, 2022 and 2021.

Prepaid Commission Expense

9 Months Ended

Sep. 30, 2022

Amortization Of Deferred Charges [Abstract]

Prepaid Commission Expense

10. PREPAID COMMISSION EXPENSE

The Company pays a commission on both NeuroStar Advanced System sales and Treatment Session sales. Since the commission paid for System sales is not commensurate with the commission paid for Treatment Sessions, the Company capitalizes commission expense associated with NeuroStar Advanced Therapy System sales commissions paid that is incremental to specifically anticipated future Treatment Session orders. In developing this estimate, the Company considered its historical Treatment Session sales and customer retention rates, as well as technology development life cycles and other industry factors. These costs are periodically reviewed for impairment.

NeuroStar Advanced Therapy System commissions are deferred and amortized on a straight-line basis over a seven-year period equal to the average customer term, which the Company deems to be the expected period of benefit for these costs.

On the Company’s balance sheets, the current portion of capitalized contract costs is represented by the current portion of prepaid commission expense, while the long-term portion is included in prepaid commission expense. Amortization expense was $0.5 million and $0.3 million for the three months ended September 30, 2022 and 2021, respectively, and $1.3 million and $0.9 million for the nine months ended September 30, 2022 and 2021, respectively.

Accrued Expenses

9 Months Ended

Sep. 30, 2022

Payables And Accruals [Abstract]

Accrued Expenses

11. ACCRUED EXPENSES

The following table presents the composition of accrued expenses as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Compensation and related benefits	$	8,022	$	5,090
Consulting and professional fees		760		537
Research and development expenses		637		388
Sales and marketing expenses		246		268
Warranty		337		306
Sales and other taxes payable		558		664
Other		933		980
Accrued expenses	$	11,493	$	8,233

Deferred Revenue

9 Months Ended

Sep. 30, 2022

Deferred Revenue [Abstract]

Deferred Revenue

12. DEFERRED REVENUE

Payment terms typically require payment upon shipment or installation of the System and additional payments as access codes for Treatment Sessions are delivered, which can span several years after the System is first delivered and installed. The timing of revenue recognition compared to billings and cash collections typically results in accounts receivable. However, sometimes customer advances and deposits might be required for certain customers and are recorded as contract liabilities (deferred revenue). For multi-year agreements, the Company generally invoices customers annually at the beginning of each annual coverage period and recognizes revenue over the term of the coverage period.

As of September 30, 2022, the Company expects to recognize approximately the following percentages of deferred revenue by year:


	Revenue
Year:	Recognition
Remainder of 2022	25	%
2023	40	%
2024	25	%
2025	8	%
2026	2	%
Total	100	%

Revenue recognized for the three and nine months ended September 30, 2022 that was included in the contract liability balance at the beginning of the year was $0.4 million and $2.2 million, respectively, and primarily represented revenue earned from separately priced extended warranties, customer deposits, milestone revenue, and clinical training.

Customers

For the three months ended September 30, 2022 and 2021, one customer accounted for more than 10% of the Company’s revenues, respectively. For the nine months ended September 30, 2022 and 2021, one customer accounted for more than 10% of the Company’s revenues, respectively.

- 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
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI https://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
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-Paragraph 10
-URI https://asc.fasb.org/extlink&oid=126920106&loc=SL49130551-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Name Accounting Standards Codification
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+ Details

Debt

9 Months Ended

Sep. 30, 2022

Debt Disclosure [Abstract]

Debt

13. DEBT

The following table presents the composition of debt as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Outstanding principal	$	35,000	$	35,000
Accrued final payment fees		1,925		1,925
Less debt discounts		(1,166)		(1,590)
Total debt, net		35,759		35,335
Less current portion		(8,750)		—
Long-term debt, net	$	27,009	$	35,335

For the three months ended September 30, 2022, the Company recognized interest expense of $1.1 million, of which $0.9 million was cash and $0.2 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees. For the three months ended September 30, 2021, the Company recognized interest expense of $1.0 million, of which $0.8 million was cash and $0.2 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees.

For the nine months ended September 30, 2022, the Company recognized interest expense of $3.0 million, of which $2.5 million was cash and $0.5 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees.

Solar Credit Facility

On March 2, 2020, the Company entered into a loan and security agreement with Solar Capital Ltd., or Solar, as collateral agent, and other lenders defined in the agreement, for a credit facility, or the Solar Facility, that

replaced the Company’s previous $35.0 million credit facility with Oxford Finance LLC, or Oxford, and such facility, the Oxford Facility.

The Solar Facility originally permitted the Company to borrow up to an aggregate amount of $50.0 million in two tranches of term loans, a “Term A Loan” and “Term B Loan.” On March 2, 2020, the Company borrowed an aggregate amount of $35.0 million, which was the aggregate amount available under the Term A Loan portion of the Solar Facility. The Term A Loan portion of the Solar Facility matures, and all amounts borrowed thereunder are due, on February 28, 2025. Under the Term B Loan portion of the Solar Facility, the Company is permitted to borrow, at its election, up to an aggregate amount of $15.0 million, (i) upon the Company achieving a specified amount of trailing twelve months net product revenue, and (ii) assuming there has been no event of default under the Solar Facility prior to such election. Once the net product revenue condition has been satisfied, the Company may make an election to borrow under the Term B Loan portion of the Solar Facility until the earlier of (a) December 15, 2021, (b) 30 days following achievement of the net product revenue condition or (c) the occurrence of an event of default.

Each of the Term A Loan and Term B Loan accrue interest from the date of borrowing through the date of repayment at a floating per annum rate of interest, which resets monthly and is equal to 7.65% plus the greater of (a) 1.66% or (b) the rate per annum rate published by the Intercontinental Exchange Benchmark Administration Ltd. The Term A Loan and the Term B Loan both include an interest-only period through March 1, 2022, after which time the Company will be required to make monthly payments of principal and interest. Monthly principal payments are to be paid in equal amounts on a pro rata basis to lenders. At the Company’s election, the interest only period may be extended through February 2023 if the Company satisfies a minimum net product revenue covenant through March 1, 2022 and no event of default shall have occurred.

In addition to the principal and interest payments due under the Solar Facility, the Company is required to pay a final payment fee to Solar due upon the earlier of prepayment, acceleration or the maturity date of the Term A Loan or Term B Loan portion of the Solar Facility equal to 5.50% of the principal amount of the term loans actually funded. The Company is accruing the final payment fees using the effective interest rate, with a charge to non-cash interest expense, over the term of borrowing. If the Company prepays either of the Term A Loan or Term B Loan prior to their respective scheduled maturities, the Company will also be required to pay prepayment fees to Solar equal to 3% of the principal amount of such term loan then-prepaid if prepaid on or before the first anniversary of funding, 2% of the principal amount of such term loan then-prepaid if prepaid after the first anniversary and on or before the second anniversary of funding, or 1% of the principal amount of such term loan then-prepaid if prepaid after the second anniversary of funding of the principal amounts borrowed.

The Company is also required to pay Solar an exit fee upon the occurrence, prior to March 2, 2030, of (a) any liquidation, dissolution or winding up of the Company, (b) transaction that results in a person obtaining control over the Company, (c) the Company achieving $100 million in trailing twelve month net product revenue or (d) the Company achieving $125 million in trailing twelve month net product revenue. The exit fee for liquidation, dissolution, winding up or change of control of the Company is equal to 4.50% of the principal amount of the term loans actually funded. The exit fee for achieving either $100 million or $125 million in trailing twelve-month net product revenue is equal to 2.25% of the principal amount of the term loans actually funded or, if both net product revenue milestones are achieved, 4.50% of the principal amount of the term loans actually funded. The exit fee is capped at 4.50% of the principal amount of the term loans actually funded.

The Company’s obligations under the Solar Facility are secured by a first priority security interest in substantially all of its assets, including its intellectual property. The loan and security agreement requires the Company to comply with certain financial covenants, including the attainment of a minimum trailing net revenue amount beginning on December 31, 2020, as well as customary affirmative and negative covenants.

The Solar Facility contains events of default, including, without limitation, events of default upon: (i) failure to make payment pursuant to the terms of the agreement; (ii) violation of covenants; (iii) material adverse changes to the Company’s business; (iv) attachment or levy on the Company’s assets or judicial restraint on its business; (v) insolvency; (vi) material cross-defaults; (vii) significant judgments, orders or decrees for payments by the Company not covered by insurance; (viii) incorrectness of representations and warranties; (ix) incurrence of subordinated debt; (x) a termination or breach of a guaranty; (xi) revocation of governmental approvals necessary for the Company to conduct its business; and (xii) failure by the Company to maintain a valid and perfected lien on the collateral securing the borrowing. The Solar Facility includes subjective acceleration clauses which permit the lenders to accelerate the maturity date under certain circumstances, including, but not limited to, material adverse effects on a Company’s financial status or otherwise.

On December 8, 2020, the Company, Solar Capital Ltd., and our other lenders defined in the Solar Facility, executed an amendment to the Solar Facility (the “Solar Amendment”). The Solar Amendment divided the aggregate Term B Loan borrowing amount of $15.0 million allowable upon our achievement of specific trailing twelve-month net product revenue targets into three separate $5.0 million tranches (“Amended Term B Loan”, “Term C Loan” and “Term D Loan”). The three tranches are available through June 20, 2021, December 20, 2021, and June 20, 2022, respectively, based on the achievement of agreed upon trailing twelve-month net product revenue targets for each tranche.

The Solar Amendment also reduced the trailing twelve-month net product revenue requirement for the Amended Term B Loan portion of the facility. Subject to certain conditions, the Company has the ability to extend the interest only period on the initial Term A Loan to 36 months from 24 months upon achieving the revenue targets associated with the Amended Term B Loan. The Company was required to pay an amendment fee of $0.1 million to Solar, which was recognized as a deferred debt issuance cost as of December 31, 2020 that will be amortized to interest expense using the effective interest method.

On February 15, 2022, the Company, SLR Investment Corp. (formerly known as Solar Capital Ltd.) (“Solar”), and our other lenders defined in the Solar Facility, executed an amendment to the Solar Facility and the Solar Amendment (the “2022 Solar Amendment”). The 2022 Solar Amendment waived any default under the Solar Facility and Solar Amendment that resulted from the Company’s failure to comply with the minimum monthly trailing twelve months net product revenue financial covenant, beginning with the testing period for the calendar month ending December 31, 2021 and continuing to the execution date of the 2022 Solar Amendment; (ii) decreased the amount of trailing twelve months net product revenue that the Company is required to achieve, for testing periods on and from the calendar month ending January 31, 2022; (iii) modified the definition of the fourth draw period with respect to the Company’s ability to borrow the Term D Loan portion of the Solar Facility, such that after giving effect to the 2022 Solar Amendment, the Term D Loan portion of the Solar Facility is no longer available to be drawn by the Company; and (iv) modified the definition of interest only extension conditions to allow commencement of loan principal amortization under the Solar Facility to be extended to March 1, 2023. The Company was required to pay an amendment fee of $0.06 million to Solar, which has been recognized as a deferred debt issuance cost as of March 31, 2022 that will be amortized to interest expense using the effective interest method.

As of September 30, 2022, the Company is in compliance with all covenants in the Solar Facility and is projected to be in compliance with the reduced minimum revenue covenant amounts going forward.

- 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

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Common Stock

9 Months Ended

Sep. 30, 2022

Equity [Abstract]

Common Stock

14. COMMON STOCK

Common Stock Offering

On February 2, 2021, we closed on our public offering and sale (the “Offering”) of our common stock in which we issued and sold 5,566,000 shares of our common stock, which included shares pursuant to an option granted to underwriters to purchase additional shares, at a public offering price of $15.50 per share. We received net proceeds of $80.6 million after deducting underwriting discounts, commissions and offering expenses.

Common Stock

The following table summarizes the total number of shares of the Company’s common stock issued and reserved for issuance as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30, 2022	December 31, 2021
Shares of common stock issued	27,060	26,395
Shares of common stock reserved for issuance for:
Common stock warrants outstanding	75	75
Stock options outstanding	1,424	1,499
Restricted stock units outstanding	4,060	2,124
Shares available for grant under stock incentive plan	1,067	2,037
Shares available for sale under employee stock purchase plan	1,063	799
Total shares of common stock issued and reserved for issuance	34,749	32,929

Common Stock Warrants

The following tables summarize the Company’s outstanding common stock warrants as of September 30, 2022, and December 31, 2021:


September 30, 2022
Warrants
Outstanding
(in thousands)	Exercise Price		Expiration Date
14	$	19.55	Dec-2022
20	$	9.73	Aug-2023
20	$	9.73	Mar-2024
21	$	9.73	Dec-2024
75


December 31, 2021
Warrants
Outstanding
(in thousands)	Exercise Price		Expiration Date
14	$	19.55	Dec-2022
20	$	9.73	Aug-2023
20	$	9.73	Mar-2024
21	$	9.73	Dec-2024
75

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
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-URI https://asc.fasb.org/extlink&oid=126731327&loc=SL126733271-114008

+ Details

Loss Per Share

9 Months Ended

Sep. 30, 2022

Earnings Per Share [Abstract]

Loss Per Share

15. LOSS PER SHARE

The Company’s basic loss per common share is computed by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period. The Company’s restricted stock awards

(non-vested shares) are issued and outstanding at the time of grant but are excluded from the Company’s computation of weighted-average shares outstanding in the determination of basic loss per share until vesting occurs.

A net loss cannot be diluted, so when the Company is in a net loss position, basic and diluted loss per common share are the same. If in the future the Company achieves profitability, the denominator of a diluted earnings per common share calculation will include both the weighted-average number of shares outstanding and the number of common stock equivalents, if the inclusion of such common stock equivalents would be dilutive. Dilutive common stock equivalents potentially include warrants, stock options, non-vested restricted stock units and non-vested performance restricted stock units using the treasury stock method, along with the effect, if any, from the potential conversion of outstanding securities, such as convertible preferred stock.

The following potentially dilutive securities outstanding as of September 30, 2022 and 2021 have been excluded from the denominator of the diluted loss per share of common stock outstanding calculation (in thousands):


	September 30,
	2022	2021
Stock options	1,424	1,567
Non-vested performance restricted stock units	395	395
Non-vested restricted stock units	3,665	1,647
Common stock warrants	75	75

Share-Based Compensation

9 Months Ended

Sep. 30, 2022

Disclosure Of Compensation Related Costs Share-based Payments [Abstract]

Share-Based Compensation

16. SHARE-BASED COMPENSATION

The amount of share-based compensation expense recognized by the Company by location in its statements of operations for the three and nine months ended September 30, 2022 and 2021 is as follows (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Cost of revenues	$	35	$	23	$	94		56
Sales and marketing		1,074		515		3,258		1,608
General and administrative		939		1,368		2,950		4,368
Research and development		130		55		331		134
Total	$	2,178	$	1,961	$	6,633	$	6,166

2018 Equity Incentive Plan

In June 2018, the Company adopted the 2018 Equity Incentive Plan, or 2018 Plan, which authorized the issuance of up to 1.4 million shares, subject to an annual 4% increase based on the number of shares of common stock outstanding, in the form of restricted stock, stock appreciation rights and stock options to the Company’s directors, employees and consultants. The amount and terms of grants are determined by the Company’s board of directors. All stock options granted to date have had exercise prices equal to the fair value, as determined by the closing price as reported by the Nasdaq Global Market, of the underlying common stock on the date of grant. The contractual term of stock options is up to 10 years, and stock options are exercisable in cash or as otherwise determined by the board of directors. Generally, stock options vest 25% upon the first anniversary of the date of grant and the remainder ratably monthly thereafter for 36 months. Restricted stock units generally vest ratably in three equal installments on the first, second and third anniversaries of the grant date. Performance restricted stock units (“PRSUs”) generally vest based on appreciation of the Company’s common stock to a certain price as determined by the Company’s board of directors measured using a trailing 30-day volume weighted average price of a share of the Company’s common stock. The fair value of the PRSU awards are determined using a risk neutral Monte Carlo

simulation valuation model. As of September 30, 2022, there were 0.6 million shares available for future issuance under the 2018 Plan.

2020 Inducement Incentive Plan

In December 2020, the Company adopted the 2020 Inducement Incentive Plan, which authorized the issuance of up to 0.4 million shares, subject to increase by approval of the Company’s board of directors, in the form of stock options, stock appreciation rights, restricted stock awards, restricted stock unit awards, performance stock awards and other stock awards to eligible employees who satisfy the standards for inducement grants under Nasdaq Global Market rules. In March 2022, the Company’s board of directors approved an additional 500,000 shares for the issuance under the plan. An individual who previously served as an employee or director of the Company is not eligible to receive awards under this plan. The amount and terms of grants are determined by the Company’s board of directors. As of September 30, 2022, there were 0.5 million shares available for future issuance under the 2020 Inducement Incentive Plan.

Stock Options

The following table summarizes the Company’s stock option activity for the nine months ended September 30, 2022:


					Aggregate
	Number of	Weighted-		Weighted-	average
	Shares under	average		Remaining	Intrinsic
	Option	Exercise Price		Contractual	Value
	(in thousands)	per Option		Life (in years)	(in thousands)
Outstanding at December 31, 2021	1,499	$	4.01
Granted	—	$	—
Exercised	(51)	$	1.01
Forfeited	(24)	$	13.41
Outstanding at September 30, 2022	1,424	$	3.96	7.2	$	1,260
Exercisable at September 30, 2022	913	$	4.62	6.9	$	708
Vested and expected to vest at September 30, 2022	1,424	$	3.96	7.2	$	1,260

The Company recognized share-based compensation expense related to stock options of $0.2 million and $0.2 million for the three months ended September 30, 2022 and 2021, respectively, and $0.5 million and $0.6 million for the nine months ended September 30, 2022 and 2021, respectively. As of September 30, 2022, there was $0.7 million of total unrecognized compensation cost related to non-vested stock options which the Company expects to recognize over a weighted-average period of 1.4 years. The total intrinsic value of stock options exercised during the nine months ended September 30, 2022 was $0.1 million.

Restricted Stock Units and Performance Restricted Stock Units

The following table summarizes the Company’s restricted stock unit and performance restricted stock unit activity for September 30, 2022:


	Non-vested		Weighted-	Non-vested		Weighted-
	Restricted		average	Performance Restricted		average
	Stock Units		Grant-date	Stock Units		Grant-date
	(in thousands)		Fair Value	(in thousands)		Fair Value
Non-vested at December 31, 2021	1,729	$	7.29	395	$	6.77
Granted	2,775	$	3.32	—	$	—
Vested	(613)	$	7.64	—	$	—
Forfeited	(226)	$	6.12	—	$	—
Non-vested at September 30, 2022	3,665	$	4.29	395	$	6.77

The Company recognized $2.0 million and $1.8 million in share-based compensation expense related to the restricted stock units and performance restricted stock units for the three months ended September 30, 2022 and 2021, respectively, and $6.1 million and $5.5 million the nine months ended September 30, 2022 and 2021, respectively. As of September 30, 2022, there was $11.0 million of unrecognized compensation cost related to non-vested restricted stock units and performance restricted stock units, which the Company expects to recognize over a weighted-average period of 1.9 years. The total fair value at the vesting date of restricted stock units and performance restricted stock units vested during the nine months ended September 30, 2022, was $2.2 million.

The Company did not grant performance restricted stock units during the period ended September 30, 2022. For the period ended December 31, 2021, the grant-date fair value of the performance restricted stock units was estimated at the time of grant using the following inputs and assumptions in the Monte Carlo simulation valuation model:


		December 31, 2021
Closing price of common stock	$	15.92
Risk-free interest rate		1.15	%
Expected volatility		99.7	%

Commitments and Contingencies

9 Months Ended

Sep. 30, 2022

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

17. COMMITMENTS AND CONTINGENCIES

Legal Matters

The Company is subject from time to time to various claims and legal actions arising during the ordinary course of its business. Management believes that there are currently no claims or legal actions that would reasonably be expected to have a material adverse effect on the Company’s results of operations, financial condition, or cash flows.

Geographical Segment Information

9 Months Ended

Sep. 30, 2022

Segments Geographical Areas [Abstract]

Geographical Segment Information

18. GEOGRAPHICAL SEGMENT INFORMATION

Operating segments are defined as components of an enterprise about which separate discrete information is available for evaluation by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company currently operates in one business segment as it is managed and operated as one business. A single management team that reports to the chief operating decision maker comprehensively manages the entire business. The Company does not operate any material separate lines of business or separate business entities with respect to its products or product development.

The following geographic data includes revenue generated from the Company’s third-party distributors. The Company’s revenue was generated in the following geographic regions and by product line for the periods indicated (in thousands):


	Revenues by Geography
	Three Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
United States	$	16,244	98	%	$	13,280	96	%
International		254	2	%		519	4	%
Total revenues	$	16,498	100	%	$	13,799	100	%


	U.S. Revenues by Product Category
	Three Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	3,934	24	%	$	2,612	20	%
Treatment sessions		11,864	73	%		10,259	77	%
Other		446	3	%		409	3	%
Total U.S. revenues	$	16,244	100	%	$	13,280	100	%


	International Revenues by Product Category
	Three Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	96	38	%	$	306	59	%
Treatment sessions		31	12	%		90	17	%
Other		127	50	%		123	24	%
Total International revenues	$	254	100	%	$	519	100	%


	Revenues by Geography
	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
United States	$	45,893	98	%	$	38,891	97	%
International		1,115	2	%		1,399	3	%
Total revenues	$	47,008	100	%	$	40,290	100	%


	U.S. Revenues by Product Category
	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	11,959	26	%	$	6,945	18	%
Treatment sessions		32,627	71	%		30,688	79	%
Other		1,307	3	%		1,258	3	%
Total U.S. revenues	$	45,893	100	%	$	38,891	100	%


	International Revenues by Product Category
	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	460	41	%	$	797	57	%
Treatment sessions		214	19	%		235	17	%
Other		441	40	%		367	26	%
Total International revenues	$	1,115	100	%	$	1,399	100	%

- 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.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8924-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 34
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8981-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Section 50
-Paragraph 21
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Topic 280
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-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 32
-Subparagraph (e)
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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-Paragraph 41
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Paragraph 32
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-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 22
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

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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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
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-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-URI https://asc.fasb.org/topic&trid=2134510

+ Details

Severance

9 Months Ended

Sep. 30, 2022

Restructuring And Related Activities [Abstract]

Severance

19. SEVERANCE

The Company entered into transition agreements outlining the separation with certain former employees during the period ended September 30, 2022 and 2021. In connection with these agreements, the Company recorded $0.0 million and $0.3 million of charges in salary, payroll tax and bonus expenses for the three months ended September 30, 2022 and 2021, respectively, and $0.2 million and $0.5 million for the nine months ended September 30, 2022 and 2021, respectively. For the nine months ended September 30, 2022 and 2021, $0.4 million and $1.1 million of termination benefits were paid associated with the termination of the employees and charged against this liability. As of September 30, 2022 and December 31, 2021, $0.0 million and $0.1 million, respectively, remain in accrued liabilities for the unpaid portion of the separation benefits.

Risks and Uncertainties

9 Months Ended

Sep. 30, 2022

Risks and Uncertainties [Abstract]

Risks and Uncertainties

20. RISKS AND UNCERTAINTIES

Information About Significant Customers

Significant customers are those which represent more than 10% of the Company’s total revenue or are considered significant based on combination of quantitative and qualitative factors during the periods. For each significant customer, revenue as a percentage of total revenue was as follows (in thousands, except for percentages):


	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
Customer 1	$	9,183	20	%	$	8,759	22	%
Total	$	9,183	20	%	$	8,759	22	%

Accounts receivable outstanding related to these customers as of September 30, 2022 was as follows (in thousands):


		September 30,
		2022
Customer 1	$	4,886
Total accounts receivable	$	4,886

Summary of Significant Accounting Policies (Policies)	9 Months Ended
Summary of Significant Accounting Policies (Policies)	Sep. 30, 2022
Accounting Policies [Abstract]
Interim Financial Statements	Interim Financial Statements The accompanying unaudited interim financial statements have been prepared from the books and records of the Company in accordance with GAAP for interim financial information and Rule 10-01 of Regulation S-X promulgated by the United States Securities and Exchange Commission, or SEC, which permit reduced disclosures for interim periods. All adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the accompanying balance sheets and statements of operations and stockholders’ equity and cash flows have been made. Although these interim financial statements do not include all of the information and footnotes required for complete annual financial statements, management believes the disclosures are adequate to make the information presented not misleading. Unaudited interim results of operations and cash flows for the three and nine months ended September 30, 2022 are not necessarily indicative of the results that may be expected for the full year. Unaudited interim financial statements and footnotes should be read in conjunction with the audited financial statements and footnotes included in the Company’s Form 10-K filed with the SEC on March 8, 2022, wherein a more complete discussion of significant accounting policies and certain other information can be found.
Use of Estimates	Use of Estimates The preparation of financial statements in accordance with GAAP and the rules and regulations of the SEC requires the use of estimates and assumptions, based on judgments considered reasonable, which affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. The Company bases its estimates and assumptions on historical experience, known trends and events and various other factors that management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Although management believes its estimates and assumptions are reasonable when made, they are based upon information available at the time they are made. Management evaluates the estimates and assumptions on an ongoing basis and, if necessary, makes adjustments. Due to the risks and uncertainties involved in the Company’s business and evolving market conditions, including those related to the COVID-19 pandemic, and given the subjective element of the estimates and assumptions made, actual results may differ materially from estimated results.

Fair Value Measurement and Financial Instruments (Tables)

9 Months Ended

Sep. 30, 2022

Fair Value Disclosures [Abstract]

Schedule of Carrying Amounts and Fair Values of Financial Instruments

The following tables set forth the carrying amounts and fair values of the Company’s financial instruments as of September 30, 2022 and December 31, 2021 (in thousands):

September 30, 2022

Fair Value Measurement Based on

Quoted

Significant

Prices In

other

Significant

Active

Observable

Unobservable

Carrying

Markets

Inputs

Amount

Fair Value

(Level 1)

(Level 2)

(Level 3)

Assets

Money market funds (cash equivalents)

69,405

—

December 31, 2021

Fair Value Measurement Based on

Quoted

Significant

Prices In

other

Significant

Active

Observable

Unobservable

Carrying

Markets

Inputs

Amount

Fair Value

(Level 1)

(Level 2)

(Level 3)

Assets

Money market funds (cash equivalents)

91,236

—

Accounts Receivable (Tables)

9 Months Ended

Sep. 30, 2022

Receivables [Abstract]

Composition of Accounts Receivable, Net

The following table presents the composition of accounts receivable, net as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Gross accounts receivable - trade	$	13,754	$	9,168
Less: Allowances for doubtful accounts		(1,791)		(1,462)
Accounts receivable, net	$	11,963	$	7,706

Property and Equipment and Capitalized Software (Tables)

9 Months Ended

Sep. 30, 2022

Property Plant And Equipment [Abstract]

Summary of Composition of Property and Equipment, Net

The following table presents the composition of property and equipment, net as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Laboratory equipment	$	466	$	249
Office equipment		508		497
Computer equipment and software		1,711		1,598
Manufacturing equipment		344		341
Leasehold improvements		1,422		471
Rental equipment		575		601
Property and equipment, gross		5,026		3,757
Less: Accumulated depreciation		(2,917)		(2,537)
Property and equipment, net	$	2,109	$	1,220

Leases (Tables)

9 Months Ended

Sep. 30, 2022

Leases [Abstract]

Schedule of Supplemental Cash Flow Information as Lessee Related to Leases

The following table presents the supplemental cash flow information as a lessee related to leases (in thousands):


	Nine Months Ended
	September 30, 2022		September 30, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	632	$	526

Schedule of Future Payments of Operating Lease Liabilities

The following table sets forth by year the required future payments of operating lease liabilities (in thousands):


	September 30, 2022
Remainder of 2022	$	209
2023		852
2024		875
2025		898
2026		921
Thereafter		999
Total lease payments		4,754
Less imputed interest		(825)
Present value of operating lease liabilities	$	3,929

Schedule of Profit Recognized on Sales-type Leases

The following table sets forth the profit recognized on sales-type leases (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Profit recognized at commencement, net	$	122	$	262	$	543	$	543
Interest income		—		—		—		—
Total sales-type lease income	$	122	$	262	$	543	$	543

Schedule of Maturity Analysis of Undiscounted Lease Receivables Related to Sales-type Leases

The following table sets forth a maturity analysis of the undiscounted lease receivables related to sales-type leases (in thousands):


	September 30,
	2022
Remainder of 2022	$	605
2023		1,572
2024		858
2025		368
2026		88
Total sales-type lease receivables	$	3,491

Accrued Expenses (Tables)

9 Months Ended

Sep. 30, 2022

Payables And Accruals [Abstract]

Summary of Composition of Accrued Expenses

The following table presents the composition of accrued expenses as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Compensation and related benefits	$	8,022	$	5,090
Consulting and professional fees		760		537
Research and development expenses		637		388
Sales and marketing expenses		246		268
Warranty		337		306
Sales and other taxes payable		558		664
Other		933		980
Accrued expenses	$	11,493	$	8,233

Deferred Revenue (Tables)

9 Months Ended

Sep. 30, 2022

Deferred Revenue [Abstract]

Summary of Percentages of Deferred Revenue by Year

As of September 30, 2022, the Company expects to recognize approximately the following percentages of deferred revenue by year:


	Revenue
Year:	Recognition
Remainder of 2022	25	%
2023	40	%
2024	25	%
2025	8	%
2026	2	%
Total	100	%

Debt (Tables)

9 Months Ended

Sep. 30, 2022

Debt Disclosure [Abstract]

Summary of Composition of Debt

The following table presents the composition of debt as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30,		December 31,
	2022		2021
Outstanding principal	$	35,000	$	35,000
Accrued final payment fees		1,925		1,925
Less debt discounts		(1,166)		(1,590)
Total debt, net		35,759		35,335
Less current portion		(8,750)		—
Long-term debt, net	$	27,009	$	35,335

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI https://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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-Topic 235
-SubTopic 10
-Section S99
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-Subparagraph (SX 210.12-04(a))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e24072-122690

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-Topic 835
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+ Details

Common Stock (Tables)

9 Months Ended

Sep. 30, 2022

Equity [Abstract]

Summary of Common Stock Issued and Reserved for Issuance

The following table summarizes the total number of shares of the Company’s common stock issued and reserved for issuance as of September 30, 2022 and December 31, 2021 (in thousands):


	September 30, 2022	December 31, 2021
Shares of common stock issued	27,060	26,395
Shares of common stock reserved for issuance for:
Common stock warrants outstanding	75	75
Stock options outstanding	1,424	1,499
Restricted stock units outstanding	4,060	2,124
Shares available for grant under stock incentive plan	1,067	2,037
Shares available for sale under employee stock purchase plan	1,063	799
Total shares of common stock issued and reserved for issuance	34,749	32,929

Summary of Outstanding Warrants

The following tables summarize the Company’s outstanding common stock warrants as of September 30, 2022, and December 31, 2021:


September 30, 2022
Warrants
Outstanding
(in thousands)	Exercise Price		Expiration Date
14	$	19.55	Dec-2022
20	$	9.73	Aug-2023
20	$	9.73	Mar-2024
21	$	9.73	Dec-2024
75


December 31, 2021
Warrants
Outstanding
(in thousands)	Exercise Price		Expiration Date
14	$	19.55	Dec-2022
20	$	9.73	Aug-2023
20	$	9.73	Mar-2024
21	$	9.73	Dec-2024
75

- Definition

Tabular disclosure of an entity's stock, including par or stated value per share, number and dollar amount of share subscriptions, shares authorized, shares issued, shares outstanding, number and dollar amount of shares held in an employee trust, dividend per share, total dividends, share conversion features, par value plus additional paid in capital, the value of treasury stock and other information necessary to a fair presentation, and EPS information. Stock by class includes common, convertible, and preferred stocks which are not redeemable or redeemable solely at the option of the issuer. Includes preferred stock with redemption features that are solely within the control of the issuer and mandatorily redeemable stock if redemption is required to occur only upon liquidation or termination of the reporting entity. If more than one issue is outstanding, state the title of each issue and the corresponding dollar amount; dollar amount of any shares subscribed but unissued and the deduction of subscriptions receivable there from; number of shares authorized, issued, and outstanding.

+ References

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+ Details

Loss Per Share (Tables)

9 Months Ended

Sep. 30, 2022

Earnings Per Share [Abstract]

Schedule of Potentially Dilutive Securities Outstanding Excluded from Diluted Loss Per Share Calculation


	September 30,
	2022	2021
Stock options	1,424	1,567
Non-vested performance restricted stock units	395	395
Non-vested restricted stock units	3,665	1,647
Common stock warrants	75	75

Share-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2022

Disclosure Of Compensation Related Costs Share-based Payments [Abstract]

Summary of Share-Based Compensation Expense


	Three Months Ended September 30,				Nine Months Ended September 30,
	2022		2021		2022		2021
Cost of revenues	$	35	$	23	$	94		56
Sales and marketing		1,074		515		3,258		1,608
General and administrative		939		1,368		2,950		4,368
Research and development		130		55		331		134
Total	$	2,178	$	1,961	$	6,633	$	6,166

Summary of Stock Option Activity

The following table summarizes the Company’s stock option activity for the nine months ended September 30, 2022:


					Aggregate
	Number of	Weighted-		Weighted-	average
	Shares under	average		Remaining	Intrinsic
	Option	Exercise Price		Contractual	Value
	(in thousands)	per Option		Life (in years)	(in thousands)
Outstanding at December 31, 2021	1,499	$	4.01
Granted	—	$	—
Exercised	(51)	$	1.01
Forfeited	(24)	$	13.41
Outstanding at September 30, 2022	1,424	$	3.96	7.2	$	1,260
Exercisable at September 30, 2022	913	$	4.62	6.9	$	708
Vested and expected to vest at September 30, 2022	1,424	$	3.96	7.2	$	1,260

Summary of Restricted Stock Units and Performance Restricted Stock Units Activity

The following table summarizes the Company’s restricted stock unit and performance restricted stock unit activity for September 30, 2022:


	Non-vested		Weighted-	Non-vested		Weighted-
	Restricted		average	Performance Restricted		average
	Stock Units		Grant-date	Stock Units		Grant-date
	(in thousands)		Fair Value	(in thousands)		Fair Value
Non-vested at December 31, 2021	1,729	$	7.29	395	$	6.77
Granted	2,775	$	3.32	—	$	—
Vested	(613)	$	7.64	—	$	—
Forfeited	(226)	$	6.12	—	$	—
Non-vested at September 30, 2022	3,665	$	4.29	395	$	6.77

Summary of Inputs and Assumptions used to Estimated Grant-date Fair Value of Performance Restricted Stock Units


		December 31, 2021
Closing price of common stock	$	15.92
Risk-free interest rate		1.15	%
Expected volatility		99.7	%

Geographical Segment Information (Tables)

9 Months Ended

Sep. 30, 2022

Summary of Revenue Generated in Geographic Regions for Years Indicated


	Revenues by Geography
	Three Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
United States	$	16,244	98	%	$	13,280	96	%
International		254	2	%		519	4	%
Total revenues	$	16,498	100	%	$	13,799	100	%


	Revenues by Geography
	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
United States	$	45,893	98	%	$	38,891	97	%
International		1,115	2	%		1,399	3	%
Total revenues	$	47,008	100	%	$	40,290	100	%

United States

Summary of Revenue Generated in Product Category for Years Indicated


	U.S. Revenues by Product Category
	Three Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	3,934	24	%	$	2,612	20	%
Treatment sessions		11,864	73	%		10,259	77	%
Other		446	3	%		409	3	%
Total U.S. revenues	$	16,244	100	%	$	13,280	100	%


	U.S. Revenues by Product Category
	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	11,959	26	%	$	6,945	18	%
Treatment sessions		32,627	71	%		30,688	79	%
Other		1,307	3	%		1,258	3	%
Total U.S. revenues	$	45,893	100	%	$	38,891	100	%

International

Summary of Revenue Generated in Product Category for Years Indicated


	International Revenues by Product Category
	Three Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	96	38	%	$	306	59	%
Treatment sessions		31	12	%		90	17	%
Other		127	50	%		123	24	%
Total International revenues	$	254	100	%	$	519	100	%


	International Revenues by Product Category
	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
NeuroStar Advanced Therapy System	$	460	41	%	$	797	57	%
Treatment sessions		214	19	%		235	17	%
Other		441	40	%		367	26	%
Total International revenues	$	1,115	100	%	$	1,399	100	%

Risks and Uncertainties (Tables)

9 Months Ended

Sep. 30, 2022

Risks and Uncertainties [Abstract]

Schedules of Concentration of Risk by Significant Customers

For each significant customer, revenue as a percentage of total revenue was as follows (in thousands, except for percentages):


	Nine Months Ended September 30,
	2022				2021
			% of				% of
	Amount		Revenues		Amount		Revenues

	(in thousands, except percentages)
Customer 1	$	9,183	20	%	$	8,759	22	%
Total	$	9,183	20	%	$	8,759	22	%

Accounts receivable outstanding related to these customers as of September 30, 2022 was as follows (in thousands):


		September 30,
		2022
Customer 1	$	4,886
Total accounts receivable	$	4,886

Description of Business - Additional Information (Details) - USD ($) $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Description Of Business [Line Items]
Cash and cash equivalents	$ 73,698		$ 94,141
Accumulated deficit	337,602		308,733
Cash flows from operating activities	27,639	$ 23,459	$ 28,000
$35.0 Million Credit Facility \| Oxford Finance LLC
Description Of Business [Line Items]
Borrowings outstanding under credit facility	$ 35,000
Credit facility maturity date	Feb. 28, 2025

- Definition

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

+ References + Details

Fair Value Measurement and Financial Instruments - Schedule of Carrying Amounts and Fair Values of Financial Instruments (Details) - Money market funds - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Carrying Amount
Assets
Total assets	$ 69,405	$ 91,236
Fair Value
Assets
Total assets	69,405	91,236
Quoted Prices In Active Markets (Level 1)
Assets
Total assets	$ 69,405	$ 91,236

Accounts Receivable - Composition of Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Receivables [Abstract]
Gross accounts receivable - trade	$ 13,754	$ 9,168
Less: Allowances for doubtful accounts	(1,791)	(1,462)
Accounts receivable, net	$ 11,963	$ 7,706

Property and Equipment and Capitalized Software - Summary of Composition of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 5,026	$ 3,757
Less: Accumulated depreciation	(2,917)	(2,537)
Property and equipment, net	2,109	1,220
Laboratory Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	466	249
Office Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	508	497
Computer Equipment and Software
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,711	1,598
Manufacturing Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	344	341
Leasehold Improvements
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,422	471
Rental Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	575	601
Property and equipment, net	$ 500	$ 600

Property and Equipment and Capitalized Software - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Property Plant And Equipment [Line Items]
Depreciation and amortization expense	$ 0.4	$ 0.2	$ 1.0	$ 0.8
Prepaid expenses and other current assets
Property Plant And Equipment [Line Items]
Capitalized software cost, net	$ 3.7		$ 3.7
Other assets
Property Plant And Equipment [Line Items]
Capitalized software cost, net					$ 2.5

Note Receivable (Details) - USD ($) $ in Millions			3 Months Ended	9 Months Ended
Note Receivable (Details) - USD ($) $ in Millions	Jul. 14, 2022	Sep. 29, 2021	Sep. 30, 2022	Sep. 30, 2022	Apr. 29, 2022
Senior Note \| Maximum
Accounts, Notes, Loans and Financing Receivable [Line Items]
Payment amount of notes receivable					$ 10.0
Success T M S
Accounts, Notes, Loans and Financing Receivable [Line Items]
Repayment of notes issued	$ 10.5
Success T M S \| Secured Promissory Note
Accounts, Notes, Loans and Financing Receivable [Line Items]
Term of master sales agreement		5 years
Term of notes receivable		5 years
Principal amount of notes receivable		$ 10.0
Success T M S \| Secured Promissory Note \| Other income, net
Accounts, Notes, Loans and Financing Receivable [Line Items]
Interest income recognized			$ 0.5	$ 1.0
Success T M S \| Secured Promissory Note \| Prime Rate
Accounts, Notes, Loans and Financing Receivable [Line Items]
Interest rate (as a percent)		6.00%

Leases - Additional Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
Leases - Additional Information (Details) $ in Thousands	Sep. 30, 2022 USD ($) ft²	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) ft²	Sep. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)
Leases [Line Items]
Lessee, finance lease, lease not yet commenced, description			The Company does not currently have any finance leases or executed leases that have not yet commenced.
Operating lease, rent expense, net	$ 200	$ 200	$ 600	$ 400
Operating lease, weighted-average remaining lease term	5 years 3 months 18 days		5 years 3 months 18 days
Operating lease, weighted-average discount rate	7.10%		7.10%
Carrying amount of lease receivables	$ 3,500		$ 3,500
Unguaranteed residual assets	0		0
Operating lease income	70	30	200	200
Property and equipment, net	$ 2,109		$ 2,109		$ 1,220
NeuroStar Advanced Therapy Systems \| Minimum
Leases [Line Items]
Lessor sales-type lease, Term	3 years		3 years
NeuroStar Advanced Therapy Systems \| Maximum
Leases [Line Items]
Lessor sales-type lease, Term	4 years		4 years
Headquarters and Office Equipment, Including Copiers
Leases [Line Items]
Area of lease facility \| ft²	32,000		32,000
Rental Equipment
Leases [Line Items]
Property and equipment, net	$ 500		$ 500		$ 600
Rental equipment depreciation expense	$ 20	$ 10	$ 70	$ 30
Charlotte, North Carolina
Leases [Line Items]
Area of lease facility \| ft²	9,600		9,600

Leases - Schedule of Supplemental Cash Flow Information as Lessee Related to Leases (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 632	$ 526

Leases - Schedule of Future Payments of Operating Lease Liabilities (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Operating Lease Liabilities Payments Due [Abstract]
Remainder of 2022	$ 209
2023	852
2024	875
2025	898
2026	921
Thereafter	999
Total lease payments	4,754
Less imputed interest	(825)
Present value of operating lease liabilities	$ 3,929

Leases - Schedule of Profit Recognized on Sales-type Leases (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Sales Type Lease Lease Income [Abstract]
Profit recognized at commencement, net	$ 122	$ 262	$ 543	$ 543
Total sales-type lease income	$ 122	$ 262	$ 543	$ 543

Leases - Schedule of Maturity Analysis of Undiscounted Lease Receivables Related to Sales-type Leases (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Sales Type And Direct Financing Leases Lease Receivable Fiscal Year Maturity [Abstract]
Remainder of 2022	$ 605
2023	1,572
2024	858
2025	368
2026	88
Total sales-type lease receivables	$ 3,491

Prepaid Commission Expense - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Amortization Of Deferred Charges [Abstract]
Amortization period of deferred commissions			7 years
Amortization expense	$ 0.5	$ 0.3	$ 1.3	$ 0.9

Accrued Expenses - Summary of Composition of Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Payables And Accruals [Abstract]
Compensation and related benefits	$ 8,022	$ 5,090
Consulting and professional fees	760	537
Research and development expenses	637	388
Sales and marketing expenses	246	268
Warranty	337	306
Sales and other taxes payable	558	664
Other	933	980
Accrued expenses	$ 11,493	$ 8,233

Deferred Revenue - Summary of Percentages of Deferred Revenue by Year (Details)	Sep. 30, 2022
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	100.00%
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction Start Date [Axis]: 2022-10-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	25.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	3 months
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction Start Date [Axis]: 2023-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	40.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction Start Date [Axis]: 2024-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	25.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction Start Date [Axis]: 2025-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	8.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction Start Date [Axis]: 2026-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	2.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year

Deferred Revenue - Additional Information (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($) customer	Sep. 30, 2021 customer	Sep. 30, 2022 USD ($) customer	Sep. 30, 2021 customer
Deferred Revenue [Abstract]
Revenue recognized \| $	$ 0.4		$ 2.2
Number of customer accounted for more than 10% of revenues \| customer	1	1	1	1

Debt - Summary of Composition of Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
Outstanding principal	$ 35,000	$ 35,000
Accrued final payment fees	1,925	1,925
Less debt discounts	(1,166)	(1,590)
Total debt, net	35,759	35,335
Less current portion	(8,750)
Long-term debt, net	$ 27,009	$ 35,335

- Definition

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

+ References + Details

Debt - Additional Information (Details) $ in Thousands			3 Months Ended		9 Months Ended
Debt - Additional Information (Details) $ in Thousands	Dec. 08, 2020 USD ($) item	Mar. 02, 2020 USD ($) tranche	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($)	Mar. 31, 2022 USD ($)	Dec. 31, 2020 USD ($)	Mar. 31, 2017 USD ($)
Debt Instrument [Line Items]
Interest expense			$ 1,100	$ 1,000	$ 3,000
Cash interest expense			900	800	2,500
Non-cash interest expense			$ 200	$ 200	$ 500
Solar Capital Ltd
Debt Instrument [Line Items]
Amendment fee payable						$ 60	$ 100
Solar Capital Ltd \| Term A Loan \| Maximum
Debt Instrument [Line Items]
Extended period of interest only term loan	36 months
Solar Capital Ltd \| Term A Loan \| Minimum
Debt Instrument [Line Items]
Extended period of interest only term loan	24 months
Solar Capital Ltd \| Term A Loan and Term B Loan
Debt Instrument [Line Items]
Basis spread on variable rate		1.66%
Interest rate		7.65%
Interest-only period		2022-03
Interest-only period upon achievement of revenues		2023-02
Number of default events		0
Line of credit facility, conversion to term loan, conditions					At the Company’s election, the interest only period may be extended through February 2023 if the Company satisfies a minimum net product revenue covenant through March 1, 2022 and no event of default shall have occurred.
Solar Capital Ltd \| $35.0 Million Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity								$ 35,000
Solar Capital Ltd \| $35.0 Million Credit Facility \| Term A Loan
Debt Instrument [Line Items]
Borrowings outstanding under credit facility		$ 35,000
Solar Capital Ltd \| $50.0 Million Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 15,000	$ 50,000
Borrowings outstanding under credit facility	$ 5,000
Term loans number of tranches	3	2
Increase in final payment fees percentage upon extension interest only periods		5.50%
Trailing twelve month net product revenue first threshold limit to pay exit fee		$ 100,000
Trailing twelve month net product revenue Second threshold limit to pay exit fee		$ 125,000
Percentage of exit fee for liquidation, dissolution, winding up or change of control of the Company		4.50%
Percentage of exit fee upon achievement of any trailing twelve month revenues		2.25%
Percentage of exit fee upon achievement of both trailing twelve month revenues		4.50%
Capped exit fee percentage on term loan principal amount		4.50%
Solar Capital Ltd \| $50.0 Million Credit Facility \| Prepaid on or Before First Anniversary of Funding
Debt Instrument [Line Items]
Prepayment fees percentage		3.00%
Solar Capital Ltd \| $50.0 Million Credit Facility \| Prepaid After First and on or Before Second Anniversary of Funding
Debt Instrument [Line Items]
Prepayment fees percentage		2.00%
Solar Capital Ltd \| $50.0 Million Credit Facility \| Prepaid After Second Anniversary of Funding
Debt Instrument [Line Items]
Prepayment fees percentage		1.00%
Solar Capital Ltd \| $50.0 Million Credit Facility \| Term A Loan
Debt Instrument [Line Items]
Credit facility maturity date		Feb. 28, 2025
Solar Capital Ltd \| $15 Million Credit Facility \| Term B Loan
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity		$ 15,000
Line of credit facility, conversion to term loan, conditions					Under the Term B Loan portion of the Solar Facility, the Company is permitted to borrow, at its election, up to an aggregate amount of $15.0 million, (i) upon the Company achieving a specified amount of trailing twelve months net product revenue, and (ii) assuming there has been no event of default under the Solar Facility prior to such election. Once the net product revenue condition has been satisfied, the Company may make an election to borrow under the Term B Loan portion of the Solar Facility until the earlier of (a) December 15, 2021, (b) 30 days following achievement of the net product revenue condition or (c) the occurrence of an event of default.

Common Stock - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands		9 Months Ended
	Feb. 02, 2021	Sep. 30, 2021
Equity [Abstract]
Common stock shares issued and sold	5,566,000
Public offering price	$ 15.50
Net proceeds from initial public offering	$ 80,600	$ 80,972

Common Stock - Summary of Common Stock Issued and Reserved for Issuance (Details) - shares shares in Thousands	Sep. 30, 2022	Dec. 31, 2021
Stockholders Deficit [Line Items]
Shares of common stock issued	27,060	26,395
Shares of common stock reserved for issuance for:
Total shares of common stock issued and reserved for issuance	34,749	32,929
Common stock warrants
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	75	75
Stock options
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	1,424	1,499
Restricted stock units
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	4,060	2,124
Shares available for grant under stock incentive plan
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	1,067	2,037
Shares available for sale under employee stock purchase plan
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	1,063	799

Common Stock - Summary of Outstanding Common Stock Warrants (Details) - $ / shares shares in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	75	75
Exercise Price $19.55
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	14	14
Exercise Price	$ 19.55	$ 19.55
Expiration Date	2022-12	2022-12
Exercise Price $9.73
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	20	20
Exercise Price	$ 9.73	$ 9.73
Expiration Date	2023-08	2023-08
Exercise Price. $9.73
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	20	20
Exercise Price	$ 9.73	$ 9.73
Expiration Date	2024-03	2024-03
Exercise Price $9.73
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	21	21
Exercise Price	$ 9.73	$ 9.73
Expiration Date	2024-12	2024-12

Loss Per Share - Schedule of Potentially Dilutive Securities Outstanding Excluded from Diluted Loss Per Share Calculation (Details) - shares shares in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Stock options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Potentially dilutive securities outstanding excluded from diluted loss per share	1,424	1,567
Non-vested performance restricted stock units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Potentially dilutive securities outstanding excluded from diluted loss per share	395	395
Restricted stock units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Potentially dilutive securities outstanding excluded from diluted loss per share	3,665	1,647
Common stock warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Potentially dilutive securities outstanding excluded from diluted loss per share	75	75

Share-Based Compensation - Summary of Share-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	$ 2,178	$ 1,961	$ 6,633	$ 6,166
Cost of Revenues
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	35	23	94	56
Sales and Marketing
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	1,074	515	3,258	1,608
General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	939	1,368	2,950	4,368
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	$ 130	$ 55	$ 331	$ 134

Share-Based Compensation - Additional Information (Details) $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Mar. 31, 2022 shares	Sep. 30, 2022 USD ($) shares	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) installment shares	Sep. 30, 2021 USD ($)	Dec. 31, 2020 shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses		$ 2,178	$ 1,961	$ 6,633	$ 6,166
Intrinsic value of stock options exercised				100
Stock options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses		200	200	500	600
Unrecognized compensation cost related to non-vested stock options		700		$ 700
Non-vested awards not yet recognized weighted-average period for recognition				1 year 4 months 24 days
Restricted Stock Units and Performance Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses		2,000	$ 1,800	$ 6,100	$ 5,500
Non-vested awards not yet recognized weighted-average period for recognition				1 year 10 months 24 days
Unrecognized compensation cost related to non-vested restricted stock		$ 11,000		$ 11,000
Fair value of restricted stock vested				$ 2,200
2018 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Annual percentage increase in number of shares authorized for issuance				4.00%
Vesting terms of stock options				stock options vest 25% upon the first anniversary of the date of grant and the remainder ratably monthly thereafter for 36 months. Restricted stock units generally vest ratably in three equal installments on the first, second and third anniversaries of the grant date.
Number of vesting installments \| installment				3
Shares available for future issuance \| shares		600,000		600,000
2018 Equity Incentive Plan \| PRSUs \| Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Weighted average price, number of days trailing				30 days
2018 Equity Incentive Plan \| First Anniversary of Date of Grant
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting percentage of stock options				25.00%
2018 Equity Incentive Plan \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares authorized for issuance \| shares		1,400,000		1,400,000
Maximum contractual term of stock options				10 years
2020 Inducement Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of additional shares authorized for issuance \| shares	500,000
Shares available for future issuance \| shares		500,000		500,000
2020 Inducement Incentive Plan \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares authorized for issuance \| shares						400,000

Share-Based Compensation - Summary of Stock Option Activity (Details) - Stock options - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares under Option, Outstanding, Beginning balance	1,499
Number of Shares under Option, Exercised	(51)
Number of Shares under Option, Forfeited	(24)
Number of Shares under Option, Outstanding, Ending balance	1,424
Number of Shares under Option, Exercisable	913
Number of Shares under Option, Vested and expected to vest	1,424
Weighted-average Exercise Price per Option, Outstanding, Beginning balance	$ 4.01
Weighted-average Exercise Price per Option, Exercised	1.01
Weighted-average Exercise Price per Option, Forfeited	13.41
Weighted-average Exercise Price per Option, Outstanding, Ending balance	3.96
Weighted-average Exercise Price per Option, Exercisable	4.62
Weighted-average Exercise Price per Option, Vested and expected to vest	$ 3.96
Weighted-average Remaining Contractual Life, Outstanding	7 years 2 months 12 days
Weighted-average Remaining Contractual Life, Exercisable	6 years 10 months 24 days
Weighted-average Remaining Contractual Life, Vested and expected to vest	7 years 2 months 12 days
Aggregate Intrinsic Value, Outstanding	$ 1,260
Aggregate Intrinsic Value, Exercisable	708
Aggregate Intrinsic Value, Vested and expected to vest	$ 1,260

Share-Based Compensation - Summary of Restricted Stock Units and Performance Restricted Stock Unit Activity (Details) shares in Thousands	9 Months Ended
	Sep. 30, 2022 $ / shares shares
Restricted stock units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Non-vested, Beginning balance \| shares	1,729
Granted \| shares	2,775
Vested \| shares	(613)
Forfeited \| shares	(226)
Non-vested, Ending balance \| shares	3,665
Weighted-average Grant-date Fair Value, Non-vested, Beginning balance \| $ / shares	$ 7.29
Weighted-average Grant-date Fair Value, Granted \| $ / shares	3.32
Weighted-average Grant-date Fair Value, Vested \| $ / shares	7.64
Weighted-average Grant-date Fair Value, Forfeited \| $ / shares	6.12
Weighted-average Grant-date Fair Value, Non-vested, Ending balance \| $ / shares	$ 4.29
Performance Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Non-vested, Beginning balance \| shares	395
Non-vested, Ending balance \| shares	395
Weighted-average Grant-date Fair Value, Non-vested, Beginning balance \| $ / shares	$ 6.77
Weighted-average Grant-date Fair Value, Non-vested, Ending balance \| $ / shares	$ 6.77

Share-Based Compensation - Summary of Inputs and Assumptions used to Estimated Grant-date Fair Value of Performance Restricted Stock Unit (Details) - $ / shares	12 Months Ended
	Dec. 31, 2021	Feb. 02, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Closing price of common stock		$ 15.50
Performance Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Closing price of common stock	$ 15.92
Risk-free interest rate	1.15%
Expected volatility	99.70%

Geographical Segment Information - Additional Information (Details)	9 Months Ended
	Sep. 30, 2022 segment
Segments Geographical Areas [Abstract]
Number of operating business segment	1

Geographical Segment Information - Summary of Revenue Generated in Geographic Regions for Years Indicated (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Segment Reporting Information [Line Items]
Revenues	$ 16,498	$ 13,799	$ 47,008	$ 40,290
Revenue \| Geographic Concentration
Segment Reporting Information [Line Items]
Revenues	$ 16,498	$ 13,799	$ 47,008	$ 40,290
Percentage of Revenues	100.00%	100.00%	100.00%	100.00%
Revenue \| United States \| Geographic Concentration
Segment Reporting Information [Line Items]
Revenues	$ 16,244	$ 13,280	$ 45,893	$ 38,891
Percentage of Revenues	98.00%	96.00%	98.00%	97.00%
Revenue \| International \| Geographic Concentration
Segment Reporting Information [Line Items]
Revenues	$ 254	$ 519	$ 1,115	$ 1,399
Percentage of Revenues	2.00%	4.00%	2.00%	3.00%

- 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.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Geographical Segment Information - Summary of Revenue Generated in Product Category for Years Indicated (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Segment Reporting Information [Line Items]
Revenues	$ 16,498	$ 13,799	$ 47,008	$ 40,290
Product Category \| United States \| Revenue
Segment Reporting Information [Line Items]
Revenues	$ 16,244	$ 13,280	$ 45,893	$ 38,891
Percentage of Revenues	100.00%	100.00%	100.00%	100.00%
Product Category \| United States \| Revenue \| NeuroStar Advanced Therapy System
Segment Reporting Information [Line Items]
Revenues	$ 3,934	$ 2,612	$ 11,959	$ 6,945
Percentage of Revenues	24.00%	20.00%	26.00%	18.00%
Product Category \| United States \| Revenue \| Treatment Sessions
Segment Reporting Information [Line Items]
Revenues	$ 11,864	$ 10,259	$ 32,627	$ 30,688
Percentage of Revenues	73.00%	77.00%	71.00%	79.00%
Product Category \| United States \| Revenue \| Other
Segment Reporting Information [Line Items]
Revenues	$ 446	$ 409	$ 1,307	$ 1,258
Percentage of Revenues	3.00%	3.00%	3.00%	3.00%
Product Category \| International \| Revenue
Segment Reporting Information [Line Items]
Revenues	$ 254	$ 519	$ 1,115	$ 1,399
Percentage of Revenues	100.00%	100.00%	100.00%	100.00%
Product Category \| International \| Revenue \| NeuroStar Advanced Therapy System
Segment Reporting Information [Line Items]
Revenues	$ 96	$ 306	$ 460	$ 797
Percentage of Revenues	38.00%	59.00%	41.00%	57.00%
Product Category \| International \| Revenue \| Treatment Sessions
Segment Reporting Information [Line Items]
Revenues	$ 31	$ 90	$ 214	$ 235
Percentage of Revenues	12.00%	17.00%	19.00%	17.00%
Product Category \| International \| Revenue \| Other
Segment Reporting Information [Line Items]
Revenues	$ 127	$ 123	$ 441	$ 367
Percentage of Revenues	50.00%	24.00%	40.00%	26.00%

Severance - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Restructuring Cost And Reserve [Line Items]
Accrued liabilities	$ 11,493		$ 11,493		$ 8,233
Transition Separation Agreement
Restructuring Cost And Reserve [Line Items]
Restructuring charges	0	$ 300	200	$ 500
Accrued liabilities	$ 0		0		$ 100
Termination Benefits \| Transition Separation Agreement
Restructuring Cost And Reserve [Line Items]
Payments for restructuring			$ 400	$ 1,100

Risks and Uncertainties - Information About Significant Customers (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Concentration Risk [Line Items]
Accounts receivable	$ 11,963		$ 7,706
Significant Customers
Concentration Risk [Line Items]
Accounts receivable	4,886
Customer 1
Concentration Risk [Line Items]
Accounts receivable	4,886
Revenue \| Customer concentration risk \| Significant Customers
Concentration Risk [Line Items]
Revenues	$ 9,183	$ 8,759
Concentration of risk (as a percent)	20.00%	22.00%
Revenue \| Customer concentration risk \| Customer 1
Concentration Risk [Line Items]
Revenues	$ 9,183	$ 8,759
Concentration of risk (as a percent)	20.00%	22.00%

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

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