Greenbrook Tms Inc (GBNH) 2021 Q2 法說會逐字稿

Welcome to the Greenbrook TMS Inc. second-quarter 2021 results conference call and webcast. (Operator Instructions) I would like to remind you that this conference is being recorded today and is also being webcast on the company's website at www.greenbrooktms.com under the Investors section, events. (Operator Instructions) Analysts and investors are reminded that any additional questions can be directed to the company at investorrelations@greenbrooktms.com.

This call contains forward-looking statements, which reflect the current expectations or beliefs of the company's based on current available information. Forward-looking statements are subject to a number of risks and uncertainties that may cause the actual results of the company to differ materially from those discussed in the forward-looking statements.

Factors that could cause actual results or events to differ materially from current expectations or disclosed under the heading, Risk Factors, in the company's annual information form dated March 30, 2021, and in the company's MD&A for the period ended June 30, 2021, which are available on SEDAR, EDGAR, and on the company's website.

Any forward-looking statement speaks only as of the date on which it is made, and the company disclaims any intent or obligations to update any forward-looking statements unless required by law. I would now like to turn the meeting over to Bill Leonard, President and Chief Executive Officer of Greenbrook TMS; and Erns Loubser, Chief Financial Officer.

Go ahead, Mr. Leonard.

Thank you, Adrianne, and thanks, everyone, for joining our conference call and webcast today. We are proud to announce our highest quarterly consolidated revenue results to date with 40% year-over-year growth over Q2 2020 and 21% over Q1 2021. This quarter, we achieved a return to entity-wide regional operating profitability, driven by a record high in treatment volume and new patient starts.

Quarterly treatment volumes increased by 37% to a record high of 58,219 as compared to Q2 2020, and 12% as compared to Q1 2021. New patient starts increased by 36% to a record high of 1,659 as compared to Q2 2020, and by [40%] to 3,242 in year-to-date 2021 as compared to year-to-date 2020.

From a development perspective, we added one new active TMS Center during Q2 2021, with an additional seven TMS Centers in development, bringing the total company network to 129 TMS Centers as at June 30, 2021. This is up from 125 in Q2 of 2020.

We expect to return to our center growth strategy through the remainder of 2021, as we begin to move forward with opportunities that were previously paused or delayed by the COVID-19 pandemic. We are also particularly pleased with several other milestones for the company and the industry.

We've successfully rolled out our Spravato pilot program, and continue to build on our long-term business plan of utilizing our network of TMS Centers as a platform for delivery of innovative treatments for MDD and other mental health disorders in a community-based setting.

We are very pleased with the progress made in the strategy through the Spravato pilot and are excited to continue to develop this program. Based on these problems and findings, we expect to expand our offerings Spravato to additional eight TMS Centers, bringing our total to 13 TMS centers now offering Spravato.

We will also explore opportunities to utilize the buy-and-bill billing method and explore offering for Spravato using mid-level practitioners, such as nurse practitioners or physician assistance. Where possible from a regulatory perspective, these mechanisms could potentially enhance the economics associated with the delivery of Spravato. At the same time, we continue to collaborate with device manufacturers to expand the range of indications for TMS.

Finally, on June 14, 2021, we completed a non-brokered private placement of 2.3 common shares at an operating price of $10 million (sic - see slide 3, "$10.00") per common share for aggregate gross proceeds of approximately $23.5 million, effectively strengthening our balance sheet.

And now, for a more detailed review of the company's financial and operating performance, I will turn it over to our CFO, Erns Loubser.

Thank you, Bill. As Bill mentioned, quarterly revenue increased by 40% to a record high of $13.7 million as compared to Q2 2020, and by 21% compared to the Q1 2021. Year-to-date 2021, revenue increased by 18% to $25 million as compared to year-to-date 2020. This is predominantly due to record quarterly treatments performed in Q1 2021, as market conditions continue to normalize after the initial onset of the COVID-19 pandemic.

We also saw increase in reimbursement rates from certain players that we have long-standing relationships with in our more established regions, which further contributed to this growth. Average revenue per treatment normalized at $235 in Q2 2021, which represents a 2% year-over-year increase compared to Q2 2020. Year-to-date 2021 average revenue per treatment decreased by 3% to $227 as compared to $238 (sic - see slide 13, "$234") in year-to-date 2020. This was predominantly attributable to the adjustment to variable consideration, as I said, offset by favorable payer mix and higher average reimbursement in Q2 2021.

Same-region sales growth was 38% in Q2 2021 and 16% in year-to-date 2021. The increase was primarily due to the increased revenue as market conditions continue to normalize.

Moving to regional operating income, Q2 2021 marked a return to entity-wide regional operating profitability. Our entity-wide regional operating income was $900,000 in Q2 2021, as compared to the entity-wide regional operating loss of $200,000 in Q2 2020. This was predominantly attributable to revenue growth rate of 40% in Q2 2021, which eclipsed the direct center and regional cost growth rate of 28% over the same period.

The continued development of TMS Centers bed with revenue growth within our existing regional cost structures enables us to leverage these costs towards increased entity-wide regional operating profitability as we continue to scale.

Year-to-date 2021 results in an entity-wide regional operating loss of $600,000, as compared to entity-wide regional operating income of $500,000 in year-to-date 2020. The entity-wide regional operating loss year to date is primarily attributable to an adjustment to variable consideration estimate due to the continued impact of COVID-19 pandemic on payer processes.

This was increased by -- this was paired with increased marketing spend in Q1 2021 to lessen the impact of the COVID-19 pandemic and our operating metrics and increased momentum as the market conditions began to normalize. Year over year, aggregate corporate cost increased 84% to $5.8 million for Q2 2021 as compared to Q2 2020, primarily as a result of costs associated with professional and legal fees related to the equity financings.

On a normalized basis, year-over-year corporate cost increased by 61%. This is predominantly driven by cost associated with listing of our common shares on the NASDAQ, including compliance, regulatory, insurance, and audit-related professional fees, and also the normalization of spend relative to the curtailed COVID-19 related spend in the comparative Q2 2020.

The loss for the period in comprehensive loss decreased by 31% to $6.7 million during Q2 2021. This was predominantly due to a record quarterly revenue achieved in Q2 2021, offset by professional legal fees related to the NASDAQ listing and equity financing in Q2 2020.

Also to consider, we recognized the earn-out consideration in connection with achieved TMS acquisition that did not occur in Q2 2021. As a reminder, we were more than happy to -- that the achieved centers performed so well, as we expect to enjoy the benefit from that performance in the future.

From a balance sheet perspective, the accounts receivable balance remained stable. As of June 30, 2021, we had approximately $19 million in cash on hand.

Moving on to our core operating metrics. As of the end of Q2 2021, the TMS Center -- the active TMS Centers increased by 8% to 122 from 113 in a year ago. Total incentives grew by 3% year over year. As Bill mentioned, we expect an acceleration in development through 2021, as we begin to move forward with opportunities that were previously also delayed by the COVID-19 pandemic.

Compared to Q2 2020, the number of consultations performed increased by 70% to 3,533. The number of TMS treatments performed increased by 37% to a record of 58,219 and the new patients start increased by 36% to a record 1,659. Compared to Q1 2021, the number of consultations performed remained relatively flat, as we focused on more specific tightening to generate a higher quality lead.

The number of TMS treatment performance increased 12% and new patient starts increased by 5%. All leading indicators remain strong, which will promote future growth despite now moving into a typical slower summer season.

Back to you, Bill.

Thanks, Erns. As I mentioned, we produced our highest quarterly consolidated revenue results to date, driven by record quarterly treatment volumes and patient starts. We achieved a return to entity-wide regional operating profitability, and we experienced a record quarterly high in new patient starts, all of which speaks to our sound business fundamentals, and we believe positions us well for future growth.

We're also very pleased with the results of the Spravato pilot and look forward to extend our program. Mental health remains a key focus in the US with recent examples of professional athletes speaking out on mental health issues. This shows that mental health awareness continues to grow, shifting away from the stigma surrounding mental health issues.

According to the CDC, after the onset of COVID-19 pandemic, approximately 40% of the US adults reported strongly with mental health or substance abuse, making access to TMS therapy and other mental health treatment modalities more essential than ever. We believe these factors will continue to drive market growth.

Our business is positioned stronger than ever to take advantage of new TMS indications, new treatment valleys, and new expansion opportunities, both through organic TMS center growth and M&A. We have now treated over 19,000 patients with over 675,000 treatments performed, a significant positive impact on the lives of so many patients suffering from mental health disorders.

We look forward to keeping you updated on the progress of the company throughout 2021. Thank you for your time today. And with that, operator, we'll now take questions.

(Operator Instructions) David Newman, Desjardins Capital.

Good morning, gentlemen.

David, how are you?

Good, very good. How's key things?

Great, thank you.

Excellent. So you initially sort of targeting 140 centers by midyear, and you're at 129, and I know COVID was a bit of an impairment on getting at it. And now you sorted out the balance sheet with the private placement. So maybe just talk to us a little bit about what your organic and inorganic plans are? And I know there's a couple of areas you really are looking at, California and Northeast US, and how you densify the footprint and leverage, what you've got.

So maybe you can just talk about, now that you got all that behind you, well it's not -- COVID's not behind us yet, but what your business plans are back half, which you sound very excited about?

Very much so, thanks for that question. Yeah, we're not quite at 140 centers yet, mainly due to a timing issue. However, we're a little bit more conservative due to COVID, but we remain extremely bullish on our pipeline and expect to be in the range of 150 centers by the end of the year.

Okay. And then what about those jurisdictions, those other jurisdictions that you're looking at, Bill, in terms of maybe inorganic growth like California and Northeast US, how is the pipeline on M&A kind of thing?

Strong pipeline, it continues to be a strong pipeline, as we talked about before. When you look at our business model in terms of expansion, it really is going to come from a couple of key areas. One is M&A opportunities. We do target locations that have multiple centers in play, both regional players and more of a corporate provider that's somewhere between 15 to 25.

However, as part of our growth strategy, we still have only 50% of our centers or so, two years of age. We need to add density in those locations, locations like Michigan, Florida and obviously take advantage of a great platform out in California. So I think you'll see a combination of growth through a couple of various pipelines.

Got it. And you look at your Oxford funds that you had there that help you get to the next sort of an acquisition of $15 million in delayed draw term loans. I know you have three tranches of $5 million and you can't access it right now according to the release, but what does it take to get to the first tranche to get them to help you out with inorganic growth?

So there's a few requirements relating to that, the main one being EBITDA target. And as we've always said, we aim to be EBITDA profitable by the mid-next year. And that is a pre-requisite in terms of accessing that additional funds. So we don't anticipate accessing them over the near term. But it would certainly be helpful in 12 to 18 months away period.

Excellent. That's very helpful. And then if you look at moving past COVID here and the number -- obviously, people reporting mental health issues, et cetera and -- but the depressive disorders have seemed to have declined a little bit, as we emerged from COVID and vaccines, and arms, and things like that.

But as we move past first-line treatments, I think, Bill, you alluded to that the pipeline still looks very, very strong. And maybe just a reduction of stigma that's associated with mental health. I mean, as you look in the pipeline, how does it look -- if you talk about younger demographics and things like that, how does the pipeline look, as you look into the back half of this year and into 2022?

Still significantly big. I mean, again, we've always talked about in the past, there's already an underserved population that just grew based on the pandemic. The stigma is no longer really out there anymore. I mean, if you just recently watched the Olympics, you saw some own vials talk about it, and you saw Michael Phelps' reporter in his conversations. So more than ever, you have more people talking about it. I think we are still working through COVID.

But at the same time, when we looked at our numbers, and for TMS therapy, there was at 1.6 million patients that were probably eligible for TMF therapy. And that was before the pandemic. So I think right now, you have people that are still suffering from depression, but they're also, for the first time in two years, enjoying taking a family vacation, having the grand kids visit the grandparents, and they're taking advantage of that at this particular moment.

So I think the pipeline still remains extremely strong. And obviously, mental health continues to be underserved at an all-time high.

Excellent. Thanks, Bill. I'll handle the line but good traction here.

Thank you.

Noel Atkinson, Clarus Securities.

Good morning, Bill, and Erns. Well done in the quarter and thanks for taking the questions. First off, just a couple of clarifications here. So in terms of the new outlook for a range of 150 centers by the end of 2021, is that active plus development centers?

That is active in development.

Okay. And you mentioned in your comments from the previous question, are you still targeting mid-2022 for positive adjusted EBITDA on a quarterly basis?

Correct. We're still right towards that.

Great. So can you give us a number of clinics that are currently open and active?

122 is currently active, with seven that remains in development.

Okay. So, okay, it hasn't changed since June 30?

Oh, so Q2. That's not actually in 30. I believe there's one more that's become active since.

Okay, cool. The $235 per treatment average rate was a really strong improvement quarter over quarter. You're back to pre-COVID normalized levels. Do you see any more potential improvement in the pipeline in the near term?

I think there's two factors that really contributed to that. As you saw, we still took adjustments for variable consideration. That obviously declined as a percentage of the, call it, gross revenue. So that's one factor that's contributed to that.

And then, as we mentioned, we've made significant investments in our billing and reimbursement team, and they've done a great job at getting higher reimbursement from some established payers. So that is priced into the $235. And I think we will stabilize at that level with potential upside, as we continue negotiations with payers and trying to get better rates.

Okay, great.

That's quite for -- a moment I'd like to -- that should stabilize as it was pre-COVID.

Okay. Perfect. And then, there was quite a significant quarter-over-quarter slowdown in local marketing expense in Q2. Was that a one-time event or is that a decent run rate?

So I think that's a decent run rate. I think you see we had, call it, abnormal spend, both in Q4 last year and in Q1. And that was really a product of maintaining lead flow and some additional marketing relating to COVID. And then in Q1, we really wanted to take advantage of normalization of the market and the momentum. So we spent a little bit more. We've normalized that to a more expected rates on a quarterly basis.

Okay, great. I'll get back in the queue. Thanks very much.

(Operator Instructions) David Martin, Bloom Burton.

Yeah. Hi, guys. I wanted to go back to the question about the $235 per treatment. I know you said that there's still some adjustment down the variable consideration because it delays some of it linked to COVID, some of it linked to the new way you're billing, which ultimately will prove to be positive.

But I also thought you were going to be collecting some of the aged receivables from Q4, some of the payments that you didn't receive that you would be collecting into this year. So I'm trying to figure out in Q2 was the positive effect more than the negative effect? And ultimately, without these other factors weighing in, where would your revenue per treatment to be in this quarter?

So I mean, if you look at the year-to-date rates, I mean, that's probably where we would have been without the positive uptick. The adjustment variable consideration, as you mentioned, we continue to collect in aged receivables, and that percentage, as a percentage of gross revenue continued to ratchet down, which stabilized reimbursement rates.

But a lot of that in uptick in Q2 also had to do with positive traction as it relates to payers, and which will be a go-forward benefit. So yes, in terms of -- there remains upside as it relates to collections older -- all they are. But a lot of that had -- the lower percentage of provision in Q2 already reflected some of that.

So for the second half of the year, should we be modeling $235 per treatment, or a bit lower, a bit higher?

I mean, I think, as I mentioned to Noel at the moment, the expectation is stable with potential upside if we, as you mentioned, continue to collect on aged receivables.

Okay. Okay, thank you.

Tania Gonsalves, Canaccord Genuity.

Good morning, guys, thanks for taking my questions. So first off, on the salaries and wages line to your G&A then, it seems like it was a pretty material uptick there quarter over quarter. Just wondering if this is the new salary run rate or if there was some kind of bonus or anything in there that I'm not accounting for?

So important to note, and in terms of the comparative quarter, was obviously the growth rate, the comparative quarter not really comparing apples to apples. We were in the midst of COVID-19 with a curtailment in spend and less headcount on all fronts. So that's one thing to consider.

As it relates to the normalized rate, we've invested fairly heavily in the billing reimbursement function, which has obviously, as you said, yielded results. So a good return on investment there. There may be some efficiencies going forward there. There are also may be some efficiencies as it relates to the integration of Achieve TMS integration.

But obviously, we also become [semi-geo] listed company, and that comes with a significant additional investment in people, including HR, compliance, and as I mentioned, the revenue cycle. So I think this run rate is what we can expect, but definitely stability as it relates to not growing at the same rate going forward.

Perfect, thank you. And you mentioned the expectation that you will turn EBITDA positive around mid-next year. Any idea when we'll we start seeing free cash flow turn positive?

So I mean, that's a product or working capital cycle, but you typically will see that follow two quarters or so after.

Okay. Perfect. And then last question from me, the conversion rates. So consults to application starts is pretty healthy this quarter. I know, historically, you guys have been able to do over 50% conversion and it's been a little bit lower because a lot of the consults are happening online. Without shipping back to in-person consults, do you think that conversion rate has the potential to go back above 50%? And if so, when do you think that could happen?

Yeah. I do think that has the ability to go back up, Tania, but I also think we're seeing a patient that is a little bit more unique in a sense that we're getting phone calls for general site because a lot of the offices are still not open and still dealing with COVID situation. So some of the patients that are coming into the pipeline are really not candidates for TMS therapy yet, but we do still want to see those patients so that we can put them in a pipeline, assuming they don't get better with first-line treatment.

So I do think there's upside potential as that patient begins to continue to go through there, what I would say, eventual sell-med cycles.

That's all for me. Thank you so much, good morning.

Justin Keywood, Stifel GMP.

Hi, good morning. Thanks for taking my call. I just had a follow-up question on the operating leverage to the business. We saw some of that take place in the current quarter on the higher sales, and the EBITDA loss was narrower than what we were expecting. And just on the comment of achieving positive adjusted EBITDA mid-next year, are you able to give any parameters around how many centers that would entail or a target revenue range, in which point we could see that positive EBITDA?

So I mean, we haven't given guidance on revenue. We obviously expect to continue our revenue growth trajectory. As you mentioned, how do we get to positive adjusted EBITDA? There's operating leverage both in our regional cost infrastructure. So you'll see an increase in regional operating income and then a stabilization of corporate and G&A. So that's really what's going to drive the positive EBITDA, and we expect to continue our current growth trajectory.

Okay. If I can ask in a different way, at 150 centers, would the business be able to achieve positive adjusted EBITDA?

Yes. I mean the answer always is, we can add 150 centers, that's all we wanted to do, is just run 150 centers. We can certainly run the business possibly. In terms of -- we will -- as Bill mentioned, we'll be in 150 range. We expect to be in that 150 range by year end.

But we don't -- we've got more operating leverage in that. But the plan is not to stop at 150, but obviously continue to grow our business significantly. And there's obviously costs associated with that. So to answer your question directly, yes, we can run the business possibly 150 centers.

What you will see in terms of the evolution of the model, is we will continue to have a little bit of operating leverage on the regional basis as we add centers, and we wait for those centers to scale to profitability. Does that answer your question, Justin?

Yes, very helpful. And then I had a question on the Spravato pilot, the expansion from eight centers to 13, and it's based on some promising findings. I'm wondering if you could just provide some additional context on what the KPIs that you were looking at to warrant the additional expansion, and what KPIs will be monitored for the additional clinics to, perhaps expand even in a more material way across the entire network?

Yeah. Great question, Jus. Really, as we've talked about, the focus now is expanding the offering and moving from a pilot to the beginning of the roll out to various centers within regions to cover that patient care needed. What we were hoping to validate, really, in the pilot, was reimbursable product capturing a wider range of patients, the network response in terms of continuing to send patients and obviously, center utilization.

The revenue per treatment is slightly higher with Spravato utilizing the administrative observed method. But obviously, with changes to our model, potentially in terms of regulatory standpoint, we really feel we can move to a more favorable position as well.

So everything we saw in the pilot, we were thrilled with. We had the opportunity to attract patients to contain more revenue in that particular patient from prior non-responding TMS patient. We were able to capture someone further along down the depression line. So we like what we saw with Spravato, and we'll continue to ramp up the offering.

Thank you. Are you able to disclose the number of patients that you have served with Spravato so far?

We didn't disclose that. It was enough for us to get our pilot results. And from our standpoint, keep in mind that when we launched our pilot, we still haven't turned on the faucet either. We have not sent out our educators into the field to call on doctors to discuss the offering for Greenbrook for both TMS or Spravato. We have not done any direct-to-consumer approach with Spravato yet.

So really significant upside in terms of spread gaining more traction within our model, not only with getting the word out, but also more center openings.

And when do you turn on that faucet?

Hey, that was a -- it's a couple of things. One is the fact we're really working towards a greater good, and there's the fact from a regulatory standpoint really trying to get to the next level in terms of that higher reimbursable opportunity. For me, it's like really hitting our business position with Spravato for 2022 to start to make an impact in our patient care.

Understood. And thank you for taking my questions.

Thanks, Jus.

David Martin, Bloom Burton.

Yeah, hi, thanks for taking the follow up. As far as Spravato, you mentioned you could change the model to enhance the economics. Right now, is the profitability of administering Spravato similar in line with TMS or higher or lower?

So as Bill said, the reimbursement is a little bit higher if you look at it from a global-treatment patient perspective. The contribution is various economics, very similar to TMS.

What it obviously does for us from enhancing the economics of the center is that the Spravato patient is less sensitive to the timing of which they come in. As we've previously said, TMS patients like that morning session, lunch time session, and late in the day, because they typically are working patients and they drive themselves to and from the center.

What Spravato does is it enables us to utilize that additional capacity in the lower demand times and adding contribution, and with that, effectively enhancing the economics of the center.

Okay. The other question is the forecasting of adjusted EBITDA breakeven positive mid-next year. If you accelerated your growth plans to a higher number of centers than you plan right now, would that delay it? Or do you have a big enough base right now you could buffer, and like you'll get to this breakeven point mid-next year regardless?

That's brilliant. But like I've mentioned to Justin, that really depends on the velocity of expansion. Obviously, as we add organically new centers, those take time to ramp to profitability. So that will erode your regional operating margin. So if we really turn on the pedal and develop organically, that will delay the adjusted EBITDA breakeven point. As I mentioned, our current plan velocity breakeven is mid-2022.

Okay.

Okay, thank you.

David Newman, Desjardins Capital.

Just a quick follow-up. I think the question has been framed a few times just on the breakeven EBITDA, but -- looking in mid-2022. But if you look out, you've got this relationship now or partnership with Cybin on psychedelics and obviously, a lot of promise there.

And then if you look at the Spravato as well and smoothing out, I'll call it, your date parts, almost like a restaurant, and trying to keeping the -- you're operating leverage there in terms of your cost structure, et cetera, I mean what are you guys thinking in terms of turning these centers into a holistic mental health centers where you have Spravato? You've got perhaps psychedelics. You've got TMS therapy. What's your targeted Spravato? Is it still 30 centers for next year, mid-next year? What are you doing with the Cybin partnership? And where do you want to take this such that it sort of drives that EBITDA?

Great question, David. Obviously, from our standpoint, as we talked about before, we never got into this business to be only TMS. We think there's some great opportunities for unique delivery platform and our unique delivery platform to offer both TMS Spravato and psychedelics when ready. We're excited for the collaboration with Cybin. It's probably a little bit too early to talk about how that's going to impact our bottom line.

But what we are working towards as a company is when someone is suffering from depression, OCD, who has failed drug treatment, we want them to think about Greenbrook as the place to go. We have great doctors, great staff, who could deliver a great patient experience. We've always wanted to be that place that offers all this. So that is what we're working towards.

What we're working towards is the fact that, as I've said before, we don't need Spravato or Cybin or psychedelic at every single office because the patient does not have to come on a daily basis. But we'll continue to build towards those 30, 40, and we don't want to put a number on it yet, but centers of excellence who can house that and really create that special patient experience.

Okay. And that's great. And is there any other things that we're not thinking of that you could bring into your service offering, other alternative treatments? Like, have you covered it off? Or is there something else out there that we should be thinking about?

I know. I think we're always open to other potential opportunities in the marketplace, such as Alzheimer's, kind of treatments. But right now, we continue that we have a great Chief Marketing Officer, continues -- and Chief Medical Officer, continue to look at those opportunities for us.

What we do think we do really well is, again, that patient experience at the center level, great doctors, great staff. We think we can add different product lines into it. Do I think we'll vary from mental health now? No, but I think the pipeline continues to grow with mental health. And not only just from newer treatments, but also the indications from the current manufacturers that are in development that will expand on, again, TMS.

We can do this without adding additional significant costs of our model or staff capable. And so we're thrilled with our position to be that unique delivery platform in a community-based offering to have that person think about Greenbrook to help them in these difficult challenges.

Perfect. Thanks, Bill.

Noel Atkinson, Clarus Securities.

Hi. Thanks for the follow up. I just want to confirm, so for a patient visit for Spravato delivery without the buy and bill, Greenbrook would hopefully be receiving over $235?

That's correct, in terms of its combination of codes. But for that treatment, essentially, the treatment with the position and the two to our observation periods.

Okay. Would you -- okay, perfect. And then secondly, what do you think your TMS capacity utilization is right now across the overall clinic portfolio?

So I'm looking at -- we generally operate at about a 70% capacity as we grow, because we generally, in newer region especially, add new centers when we get to that capacity. With COVID in some scalability centers, we're probably just below that on a global basis. But we generally target about 70% -- realistically, we can be at a 70% utilization as an overall company with mature TMS Centers operating at about 80% capacity utilization, as there are inherent inefficiencies in terms of scheduling, as I mentioned earlier.

Yeah. I think, Noel, from my perspective, we're still dealing with a market that is still being impacted by COVID. We're now seeing record quarters and continue to show our ability to perform in a tough environment. I can't wait to see what we're capable of when normalcy returns in terms of utilization.

Okay, great. And then just finally for me. So on OCD, I mean you talked about this earlier, I apologize, but there's been pretty good initial reimbursement activity from BrainsWay for OCD. What are you seeing for treatment volume or in patient interest level, that sort of thing?

Yeah, I think there is definitely patient interest. We are starting to see the reimbursement pipeline definitely support the providers in terms of providing care for that OCD patient. I still think there's possible enhancements to that policy and the reimbursement. But I think it's a great start for BrainsWay in terms of starting to get that coverage.

Coverage is limited right now in terms of the number of payers covering it. But I do think it's a great first step and I expect most of the payers to follow. So again, another platform that can get added to our center in terms of indication, it's reimbursable, that we will benefit from without any additional staffing needs.

Great, okay. That's it for me. Thanks.

I will now turn the call back over for closing remarks.

Well, thank you, everyone, for coming out today and hearing the update on Greenbrook. I hope everyone enjoys the rest of their summer. Stay safe and I look forward to talking to you again in the fall.

This concludes today's conference call. You may now disconnect.