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SIGNIFICANT ACCOUNTING POLICIES (Tables)
 9 Months Ended
Sep. 30, 2023
Accounting Policies [Abstract]  
Schedule of Service Fee Revenue
Our total service revenues during the three and nine months ended September 30, 2023 and 2022 are presented in the table below based on an allocation of the estimated transaction price with the patient between the primary patient classification of insurance coverage (in thousands):
 Three Months Ended
September 30,		Nine Months Ended
September 30,
2023202220232022
Commercial insurance$223,555 $189,634 $665,604 $573,259 
Medicare91,886 78,034 267,955 226,827 
Medicaid10,742 9,669 30,882 28,456 
Workers' compensation/personal injury9,952 13,200 35,478 38,785 
Other patient revenue10,664 7,646 30,793 22,334 
Management fee revenue3,957 6,099 12,203 17,199 
Teleradiology and Software revenue2,111 3,430 7,327 9,849 
Other6,173 3,431 20,625 12,054 
Revenue under capitation arrangements40,041 38,001 117,982 114,366 
Imaging Center Segment Revenue399,081 349,144 1,188,849 11888490001,043,129 
AI Segment Revenue2,887 900 7,398 3,056 
Total service revenue$401,968 $350,044 $1,196,247 $1,046,185 
Schedule of Goodwill Activity in goodwill for the nine months ended September 30, 2023 is provided below (in thousands):
Imaging CenterArtificial IntelligenceTotal
Balance as of December 31, 2022606,483 $71,182 $677,665 
Goodwill from acquisitions6,473 — 6,473 
Valuation adjustment1,603 — 1,603 
Currency translation223 (353)(130)
Contribution of imaging centers(9,235)— (9,235)
Balance as of September 30, 2023$605,547 $70,829 $676,376 
Schedule of Annual Amortization Expense
As of September 30, 2023:

2023*
2024202520262027ThereafterTotalWeighted average amortization period remaining in years
Management Service Contracts$572 $2,287 $2,287 $2,287 $2,287 $8,958 $18,678 8.2
Covenant not to compete and other contracts339 941 692 406 122 42 2,542 3.4
Customer Relationships181 1,202 1,070 949 749 10,966 15,117 17.8
Patent and Trademarks77 316 315 316 316 398 1,738 5.6
Developed Technology & Software1,714 6,657 6,657 6,617 6,083 5,392 33,120 5.8
Trade Names amortized19 77 77 77 77 89 416 5.5
Trade Names indefinite life— — — — — 7,100 7,100 — 
IPR&D— — — — — 13,122 13,122 — 
Total Annual Amortization$2,902 $11,480 $11,098 $10,652 $9,634 $46,067 $91,833 
*Excluding the nine months ended September 30, 2023



As of December 31, 2022:
20232024202520262027ThereafterTotalWeighted average amortization period remaining in years
Management Service Contracts$2,287 $2,287 $2,287 $2,287 $2,287 $8,958 $20,393 8.9
Covenant not to compete and other contracts1,319 891 642 356 72 40 3,320 3.1
Customer Relationships1,244 1,244 1,112 991 816 12,396 17,803 18.6
Patent and Trademarks298 298 298 298 298 322 1,812 6.4
Developed Technology & Software6,297 6,297 6,297 6,257 5,722 7,196 38,066 6.7
Trade Names amortized305 77 77 77 77 89 702 4.5
Trade Names indefinite life— — — — — 7,100 7,100 — 
IPR&D— — — — — 17,032 17,032 — 
Total Annual Amortization$11,750 $11,094 $10,713 $10,266 $9,272 $53,133 $106,228 
Schedule of Effect of Derivative Instruments on Comprehensive Income( Loss)
A tabular presentation of the effect of derivative instruments on our consolidated statement of comprehensive income (loss) of the 2019 Swaps which remain ineffective is as follows (amounts in thousands):
For the three months ended September 30, 2023
AccountJune 30, 2023 BalanceAmount of comprehensive loss recognized on derivative net of taxesAmount of loss reclassified out of accumulated OCI into income (prior period effective portion), net of taxesSeptember 30, 2023 BalanceLocation
Accumulated Other Comprehensive Loss, net of taxes$(13,357)$—$921$(12,436)Equity

For the nine months ended September 30, 2023
AccountDecember 31, 2022 BalanceAmount of comprehensive loss recognized on derivative net of taxesAmount of loss reclassified out of accumulated OCI into income (prior period effective portion), net of taxesSeptember 30, 2023 BalanceLocation
Accumulated Other Comprehensive Loss, net of taxes$(15,201)$—$2,765$(12,436)Equity

A tabular presentation of the effect of derivative instruments on our statement of operations of the 2019 Swaps which remain ineffective is as follows (amounts in thousands):
For the three months ended September 30, 2023
Ineffective interest rate swapAmount of loss recognized in income on derivative (current period ineffective portion)Location of loss recognized in Income on derivative (current period ineffective portion)Amount of loss reclassified from accumulated OCI into income (prior period effective portion)Location of loss reclassified from accumulated OCI into income (prior period effective portion)
Interest rate contracts$(1,015)Other income (expense)$(921)Interest Expense
For the nine months ended September 30, 2023
Ineffective interest rate swapAmount of gain recognized in income on derivative (current period ineffective portion)Location of gain recognized in Income on derivative (current period ineffective portion)Amount of loss reclassified from accumulated OCI into income (prior period effective portion)Location of loss reclassified from accumulated OCI into income (prior period effective portion)
Interest rate contracts$(949)Other income (expense)$(2,765)Interest Expense
Schedule of Business Acquisitions by Acquisition, Contingent Consideration A tabular rollforward of contingent consideration is as follows (amounts in thousands):
For the three months ended September 30, 2023
EntityAccountJune 30, 2023 BalanceSettlement of contingent considerationChange in valuation of Contingent ConsiderationCurrency TranslationSeptember 30, 2023 Balance
AidenceOther Long Term Liabilities$7,191 $— $(7,191)$— $— 
QuantibAccrued Expenses & Other Long Term Liabilities$5,271 $(5,110)$(161)$— $— 
Heart and Lung LimitedAccrued Expenses & Other Long Term Liabilities$14,358 $(3,402)$915 $(772)$11,099 
For the nine months ended September 30, 2023
EntityAccountJanuary 1, 2023 BalanceSettlement of contingent considerationChange in valuation of Contingent ConsiderationCurrency TranslationSeptember 30, 2023 Balance
AidenceOther Long Term Liabilities11,158 (4,000)$(7,158)$— $— 
QuantibAccrued Expenses & Other Long Term Liabilities3,709 (5,110)$1,401 $— $— 
MontclairAccrued Expenses1,200 — $(1,200)$— $— 
Heart and Lung LimitedAccrued Expenses & Other Long Term Liabilities11,656 (3,402)$2,906 $(61)$11,099 
Schedule of Fair Value of Assets and Liabilities
The tables below summarize the estimated fair values of certain of our financial assets that are subject to fair value measurements, and the classification of these assets on our condensed consolidated balance sheets, as follows (in thousands):
 As of September 30, 2023
Level 1Level 2Level 3Total
Current and long term assets    
2019 Swaps - Interest Rate Contracts$— $22,354 $— $22,354 
 As of December 31, 2022
Level 1Level 2Level 3Total
Current and long term assets    
2019 Swaps - Interest Rate Contracts$— $23,302 $— $23,302 
The table below summarizes the estimated fair values of contingencies and holdback relating to our Heart and Lung Imaging Limited acquisition on November 1, 2022 that are subject to fair value measurements and the classification of these liabilities on our consolidated balance sheets, as follows (in thousands):
 As of September 30, 2023
Level 1Level 2Level 3Total
Accrued expenses and other non-current liabilities    
Heart and Lung Imaging Limited$— $— $11,099 $11,099 
The table below summarizes the estimated fair value compared to our face value of our long-term debt as follows (in thousands):
 As of September 30, 2023
Level 1Level 2Level 3Total Fair ValueTotal Face Value
First Lien Term Loans and Truist Term Loan$— $850,405 $— $850,405 $853,063 
 As of December 31, 2022
Level 1Level 2Level 3Total Fair ValueTotal Face Value
First Lien Term Loans and Truist Term Loan$— $843,594 $— $843,594 $864,125 
Schedule of Earnings Per Share Earnings per share is based upon the weighted average number of shares of common stock and common stock equivalents outstanding, net of common stock held in treasury, as follows (in thousands except share and per share data):
 Three Months Ended September 30,Nine Months Ended September 30,
2023202220232022
Net income attributable to RadNet, Inc.'s common stockholders$17,540 $668 $4,904 $11,585 
BASIC NET INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC.'S COMMON STOCKHOLDERS
Weighted average number of common shares outstanding during the period67,793,404 56,744,419 62,113,707 56,041,017 
Basic net income per share attributable to RadNet, Inc.'s common stockholders$0.26 $0.01 $0.08 $0.21 
DILUTED NET INCOME PER SHARE ATTRIBUTABLE TO RADNET, INC.'S COMMON STOCKHOLDERS
Weighted average number of common shares outstanding during the period67,793,404 56,744,419 62,113,707 56,041,017 
Add non-vested restricted stock subject only to service vesting217,238 179,268 202,082 141,492 
Add additional shares issuable upon exercise of stock options and contingently issuable shares799,176 728,074 905,462 853,908 
Weighted average number of common shares used in calculating diluted net income per share68,809,818 57,651,761 63,221,251 57,036,417 
Changes in FV associated with contingently issuable shares$— $— $— $(586)
Net income attributable to RadNet, Inc's common stockholders for diluted share calculation$17,540 $668 $4,904 $— $10,999 
Diluted net income per share attributable to RadNet, Inc.'s common stockholders$0.25 $0.01 $0.08 $0.19 
Earnings per share disclosures:
Fair value change for contingently issuable shares excluded from the computation of diluted per share amounts as its effect would be antidilutive$— $278 $— $— 
Stock options and non-vested restricted awards excluded from the computation of diluted per share amounts as their effect would be antidilutive:
Non-vested restricted stock subject to service vesting— — — — 
Shares issuable upon the exercise of stock options88,600 84,885 761,708 67,289 
Shares issuable subject to satisfaction of certain contingencies— 113,303 — — 
Weighted average shares for which the exercise price exceeds average market price of common stock— 83,972 94,346 73,094 
Contingently issuable shares— — 193,207 — 
Schedule of Investment in Joint Ventures
The following table is a summary of our investment in joint ventures during the nine months ended September 30, 2023 (in thousands):
Balance as of December 31, 2022$57,893 
Equity in earnings in these joint ventures3,935 
Distribution of earnings(8,540)
Equity contributions in existing joint ventures41,184 
Balance as of September 30, 2023$94,472 
Schedule of Joint Venture Investment and Financial Information
The following table is a summary of key balance sheet data for these joint ventures as of September 30, 2023 and December 31, 2022 and income statement data for the nine months ended September 30, 2023 and 2022 (in thousands):
Balance Sheet Data:September 30, 2023December 31, 2022
Current assets$44,605 $39,304 
Noncurrent assets176,527 134,694 
Current liabilities(42,486)(29,588)
Noncurrent liabilities(73,770)(37,952)
Total net assets$104,876 $106,458 
Income statement data for the nine months ended September 30,
20232022
Net revenue$129,020 $107,241 
Net income$7,906 $17,034