Neuronetics (STIM) 10-Q 2 Nov 20 2020 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2020	Oct. 30, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Trading Symbol	STIM
Entity Registrant Name	NEURONETICS, INC.
Entity Central Index Key	0001227636
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Common Stock, Shares Outstanding		18,975,322
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity File Number	001-38546
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)
Security Exchange Name	NASDAQ
Entity Incorporation, State or Country Code	DE
Entity Interactive Data Current	Yes
Document Quarterly Report	true
Document Transition Report	false

Balance Sheets

Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 50,719	$ 75,708
Accounts receivable, net	5,564	6,569
Inventory	3,779	2,775
Current portion of net investments in sales-type leases	1,626	880
Current portion of prepaid commission expense	850	689
Prepaid expenses and other current assets	2,662	1,830
Total current assets	65,200	88,451
Property and equipment, net	787	1,107
Operating lease right-of-use assets	3,515	3,796
Net investments in sales-type leases	2,255	1,730
Prepaid commission expense	4,688	3,779
Other assets	1,894	1,305
Total Assets	78,339	100,168
Current liabilities:
Accounts payable	2,368	4,625
Accrued expenses	6,171	9,031
Deferred revenue	2,115	2,228
Current portion of operating lease liabilities	585	559
Current portion of long-term debt, net	34,542	11,250
Total current liabilities	45,781	27,693
Long-term debt, net		19,898
Deferred revenue	1,863	2,106
Operating lease liabilities	3,217	2,619
Total Liabilities	50,861	52,316
Commitments and contingencies (Note 16)
Stockholders’ Equity:
Preferred stock, $0.01 par value: 10,000 shares authorized; no shares issued or outstanding at September 30, 2020 and December 31, 2019
Common stock, $0.01 par value: 200,000 shares authorized; 18,959 and 18,645 shares issued and outstanding at September 30, 2020 and December 31, 2019, respectively	189	186
Additional paid-in capital	301,172	297,753
Accumulated deficit	(273,883)	(250,087)
Total Stockholders' Equity	27,478	47,852
Total Liabilities and Stockholders’ Equity	$ 78,339	$ 100,168

Balance Sheets (Parenthetical)

Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	18,959,000	18,645,000
Common stock, shares outstanding	18,959,000	18,645,000

Statements of Operations

Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Statement [Abstract]
Revenues	$ 12,448	$ 16,000	$ 33,665	$ 45,300
Cost of revenues	2,657	4,192	7,791	11,170
Gross Profit	9,791	11,808	25,874	34,130
Operating expenses:
Sales and marketing	6,053	10,362	24,926	31,477
General and administrative	4,210	4,285	13,508	13,145
Research and development	1,952	3,489	7,089	9,499
Total operating expenses	12,215	18,136	45,523	54,121
Loss from Operations	(2,424)	(6,328)	(19,649)	(19,991)
Other (income) expense:
Interest expense	1,002	930	3,511	2,780
Loss on extinguishment of debt			924
Other (income) expense, net	(8)	(391)	(288)	(1,281)
Net Loss	$ (3,418)	$ (6,867)	$ (23,796)	$ (21,490)
Net loss per share of common stock outstanding, basic and diluted	$ (0.18)	$ (0.37)	$ (1.27)	$ (1.17)
Weighted-average common shares outstanding, basic and diluted	18,890	18,508	18,773	18,296

Statement of Changes in Stockho

Statement of Changes in Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Deficit
Beginning balance at Dec. 31, 2018	$ 71,042	$ 177	$ 291,908	$ (221,043)
Beginning balance, shares at Dec. 31, 2018		17,744
Share-based awards and options exercises	1,407	$ 5	1,402
Share-based awards and options exercises, shares		483
Share-based compensation expense	501		501
Net loss	(7,529)			(7,529)
Ending balance at Mar. 31, 2019	65,421	$ 182	293,811	(228,572)
Ending balance, shares at Mar. 31, 2019		18,227
Beginning balance at Dec. 31, 2018	71,042	$ 177	291,908	(221,043)
Beginning balance, shares at Dec. 31, 2018		17,744
Net loss	(21,490)
Ending balance at Sep. 30, 2019	54,330	$ 186	296,677	(242,533)
Ending balance, shares at Sep. 30, 2019		18,602
Beginning balance at Mar. 31, 2019	65,421	$ 182	293,811	(228,572)
Beginning balance, shares at Mar. 31, 2019		18,227
Share-based awards and options exercises	470	$ 2	468
Share-based awards and options exercises, shares		218
Share-based compensation expense	1,022		1,022
Net loss	(7,094)			(7,094)
Ending balance at Jun. 30, 2019	59,819	$ 184	295,301	(235,666)
Ending balance, shares at Jun. 30, 2019		18,445
Share-based awards and options exercises	443	$ 2	441
Share-based awards and options exercises, shares		157
Share-based compensation expense	935		935
Net loss	(6,867)			(6,867)
Ending balance at Sep. 30, 2019	54,330	$ 186	296,677	(242,533)
Ending balance, shares at Sep. 30, 2019		18,602
Beginning balance at Dec. 31, 2019	47,852	$ 186	297,753	(250,087)
Beginning balance, shares at Dec. 31, 2019		18,645
Share-based awards and options exercises	76	$ 1	75
Share-based awards and options exercises, shares		81
Share-based compensation expense	1,196		1,196
Net loss	(12,613)			(12,613)
Ending balance at Mar. 31, 2020	36,511	$ 187	299,024	(262,700)
Ending balance, shares at Mar. 31, 2020		18,726
Beginning balance at Dec. 31, 2019	47,852	$ 186	297,753	(250,087)
Beginning balance, shares at Dec. 31, 2019		18,645
Net loss	(23,796)
Ending balance at Sep. 30, 2020	27,478	$ 189	301,172	(273,883)
Ending balance, shares at Sep. 30, 2020		18,959
Beginning balance at Mar. 31, 2020	36,511	$ 187	299,024	(262,700)
Beginning balance, shares at Mar. 31, 2020		18,726
Share-based awards and options exercises	48	$ 1	47
Share-based awards and options exercises, shares		83
Share-based compensation expense	646		646
Net loss	(7,765)			(7,765)
Ending balance at Jun. 30, 2020	29,440	$ 188	299,717	(270,465)
Ending balance, shares at Jun. 30, 2020		18,809
Share-based awards and options exercises	410	$ 1	409
Share-based awards and options exercises, shares		150
Share-based compensation expense	1,046		1,046
Net loss	(3,418)			(3,418)
Ending balance at Sep. 30, 2020	$ 27,478	$ 189	$ 301,172	$ (273,883)
Ending balance, shares at Sep. 30, 2020		18,959

Statements of Cash Flows (Unaud

Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Cash Flows from Operating Activities:
Net loss	$ (23,796)	$ (21,490)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	741	765
Share-based compensation	2,888	2,458
Non-cash interest expense	1,113	555
Cost of rental units purchased by customers	150	144
Loss on extinguishment of debt	622
Changes in certain assets and liabilities:
Accounts receivable, net	1,005	(1,933)
Inventory	(1,004)	(455)
Net investments in sales-type leases	(1,271)	(1,774)
Leasehold reimbursement	875
Prepaid commission expense	(1,070)	(2,907)
Prepaid expenses and other assets	(1,263)	183
Accounts payable	(2,340)	10
Accrued expenses	(2,981)	80
Deferred revenue	(356)	285
Net Cash Used in Operating Activities	(26,687)	(24,079)	$ (30,500)
Cash Flows from Investing Activities:
Purchases of property and equipment and capitalized software	(615)	(454)
Net Cash Used in Investing Activities	(615)	(454)
Cash Flows from Financing Activities:
Proceeds from issuance of long-term debt	41,360
Repayment of long-term debt	(38,860)
Payments of debt issuance costs	(721)
Proceeds from exercises of stock options	534	2,320
Net Cash Provided by Financing Activities	2,313	2,320
Net Decrease in Cash and Cash Equivalents	(24,989)	(22,213)
Cash and Cash Equivalents, Beginning of Period	75,708	104,583	104,583
Cash and Cash Equivalents, End of Period	50,719	82,370	$ 75,708
Supplemental disclosure of cash flow information:
Cash paid for interest	3,060	2,240
Transfer of inventory to property and equipment		37
Supplemental disclosure of non-cash investing and financing activities:
Purchases of property and equipment and capitalized software in accounts payable and accrued expenses	$ 83	$ 31

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Description of Business	1. 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 psychiatric 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. 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 monitoring the impact of the COVID-19 pandemic on all aspects of its business and geographies, including how it will impact the Company’s customers, supply chain, employees and other business partners. While the Company began to experience significant disruptions in March 2020 through the end of September 2020, from the COVID-19 pandemic, it is unable to predict the full impact that the COVID-19 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 pandemic, the actions taken to contain the pandemic or mitigate its impact and the direct and indirect economic effects of the pandemic and containment measures, among others. The outbreak of COVID-19 in many countries, including the United States, has significantly adversely impacted global economic activity and has contributed to significant volatility and negative pressure in financial markets. The Company applied for and received a $6.4 million loan in April 2020 under the Paycheck Protection Program (the “PPP”) established by the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) on March 27, 2020. Due to questions concerning the eligibility of public companies similarly situated to the Company, on May 7, 2020, the Company repaid the loan in full, including interest accrued to date. Liquidity As of September 30, 2020, the Company had cash and cash equivalents of $50.7 million and an accumulated deficit of $273.9 million. The Company incurred negative cash flows from operating activities of $30.5 million for the year ended December 31, 2019 and $26.7 million for the nine months ended September 30, 2020. 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 IPO, private placements of its convertible preferred securities, borrowings under its credit facilities and revenues from sales of its products. As of September 30, 2020, the Company had $35.0 million of borrowings outstanding under its credit facility, which has a final maturity in February 2025. As discussed in Note 12, the outstanding balance under the credit facility is classified as a current liability as of September 30, 2020. Management believes that the Company’s cash and cash equivalents and anticipated revenues from sales of its products are sufficient to fund the Company’s operations (including the potential repayment of the credit facility if a waiver or amendment is not obtained) for at least 12 months from the issuance of these financial statements.

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of Presentation	2. 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’ deficit 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, 2020 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 3, 2020, 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 and given the subjective element of the estimates and assumptions made, actual results may differ from estimated results.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	3. 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 3, 2020.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	9 Months Ended
	Sep. 30, 2020
New Accounting Pronouncements And Changes In Accounting Principles [Abstract]
Recent Accounting Pronouncements	4. New Accounting Standards Recently Adopted by the Company In August 2018, the FASB issued ASU 2018-15, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement that is a Service Contract ASU 2018-15 is effective for fiscal years beginning after December 15, 2019 and interim periods within those fiscal years. The amendments in ASU 2018-15 should be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. The Company adopted this standard on a prospective basis, effective January 1, 2020. 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” ASU 2019-04, ASU 2019-05, Financial Instruments - Credit Losses (Topic 326) : , 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 , applied on an instrument-by-instrument basis for eligible instruments. 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.

Fair Value Measurement and Fina

Fair Value Measurement and Financial Instruments	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurement and Financial Instruments	5. 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, 2020 and December 31, 2019 due to their short-term nature. The carrying values of the Company’s credit facility approximated its fair value as of September 30, 2020 and December 31, 2019 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, 2020 and December 31, 2019 (in thousands): September 30, 2020 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 48,115 $ 48,115 $ 48,115 $ - $ - December 31, 2019 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 67,650 $ 67,650 $ 67,650 $ - $ -

Accounts Receivable

Accounts Receivable	9 Months Ended
	Sep. 30, 2020
Receivables [Abstract]
Accounts Receivable	6. The following table presents the composition of accounts receivable, net as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Gross accounts receivable - trade $ 6,620 $ 7,117 Less: Allowances for doubtful accounts (1,056 ) (548 ) Accounts receivable, net $ 5,564 $ 6,569

Property and Equipment and Capi

Property and Equipment and Capitalized Software	9 Months Ended
	Sep. 30, 2020
Property Plant And Equipment [Abstract]
Property and Equipment and Capitalized Software	7. The following table presents the composition of property and equipment, net as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Laboratory equipment $ 150 $ 150 Office equipment 487 487 Computer equipment and software 1,301 1,218 Manufacturing equipment 273 273 Leasehold improvements 459 423 Rental equipment 462 763 Property and equipment, gross 3,132 3,314 Less: Accumulated depreciation (2,345 ) (2,207 ) Property and equipment, net $ 787 $ 1,107 As of September 30, 2020 and December 31, 2019, the Company had capitalized software costs, net of $1.3 million and $1.2 million, respectively, which are included in “Other assets” on the balance sheet. Depreciation and amortization expense was $0.2 million and $0.3 million for the three months ended September 30, 2020 and 2019, respectively and $0.7 million and $0.8 million for the nine months ended September 30, 2020 and 2019, respectively .

Leases

Leases	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Leases	8. LEASES Lessee: The Company has operating leases for its corporate headquarters and office equipment, including copiers. The Company leases approximately 42,000 square foot facility in Malvern, Pennsylvania for its corporate headquarters, which includes office and warehouse space. 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 $0.5 million for the three and nine months ended September 30, 2020 and 2019, respectively. As of September 30, 2020 the weighted-average remaining lease term of operating leases was 7.3 years and the weighted-average discount rate was 6.5%. In the first quarter of 2020, the Company received a reimbursement of $0.8 million for leasehold expenses previously incurred in connection with the lease agreement for its Malvern facility. The reimbursement was recorded as an offset to the non-current lease liability that was established when the lease agreement was executed. The following table presents the supplemental cash flow information as a lessee related to leases (in thousands): Nine Months Ended September 30, 2020 September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 575 $ 330 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ - $ 4,164 The following table sets forth by year the required future payments of operating lease liabilities (in thousands): September 30, 2020 Remainder of 2020 $ 148 2021 616 2022 641 2023 637 2024 646 Thereafter 2,147 Total lease payments 4,835 Less imputed interest (1,033 ) Present value of operating lease liabilities $ 3,802 Lessor sales-type leases: Certain customers have purchased NeuroStar Advanced Therapy Systems on a rent-to-own basis. The lease term is three 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, 2020 2019 2020 2019 Profit recognized at commencement, net $ 81 $ 506 $ 807 $ 768 Interest income - - - - Total sales-type lease income $ 81 $ 506 $ 807 $ 768 The following table sets forth a maturity analysis of the undiscounted lease receivables related to sales-type leases (in thousands): September 30, 2020 Remainder of 2020 $ 406 2021 1,624 2022 1,420 2023 431 Total sales-type lease receivables $ 3,881 As of September 30, 2020, the carrying amount of the lease receivables is $3.9 million. The Company does not have any unguaranteed residual assets. Lessor operating leases: NeuroStar Advanced Therapy Systems sold on a rent-to-own basis prior to January 1, 2019 are accounted for as operating leases. For the three months ended September 30, 2020 and 2019, the Company recognized operating lease income of $0.1 million and $0.2 million, respectively. For the nine months ended September 30, 2020 and 2019, the Company recognized operating lease income of $0.2 million and $0.6 million, respectively. The following table sets forth a maturity analysis of its undiscounted lease receivables related to operating leases: September 30, 2020 Remainder of 2020 $ 261 2021 150 Total lease receivables $ 411 The Company maintained Rental Equipment, net of $0.3 million and $0.5 million, as of September 30, 2020 and December 31, 2019, respectively, which are included in “Property and equipment, net” on the balance sheet. Rental equipment depreciation expense was $0.02 million and $0.1 million for the three months ended September 30, 2020 and 2019, respectively and $0.1 million and $0.2 million for the nine months ended September 30, 2020 and 2019 .

Prepaid Commission Expense

Prepaid Commission Expense	9 Months Ended
	Sep. 30, 2020
Amortization Of Deferred Charges [Abstract]
Prepaid Commission Expense	9. PREPAID COMMISSION EXPENSE The Company pays a commission on both 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 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 $0.2 million and $0.1 million for the three months ended September 30, 2020 and 2019, respectively, and $0.6 million and $0.2 million for the nine months ended September 30, 2020 and 2019, respectively.

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Accrued Expenses	10 . The following table presents the composition of accrued expenses as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Compensation and related benefits $ 3,704 $ 5,724 Consulting and professional fees 396 373 Research and development expenses 574 674 Sales and marketing expenses 43 127 Warranty 434 639 Sales and other taxes payable 586 700 Interest payable - 234 Other 434 560 Accrued expenses $ 6,171 $ 9,031

Deferred Revenue

Deferred Revenue	9 Months Ended
	Sep. 30, 2020
Deferred Revenue [Abstract]
Deferred Revenue	11. 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 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, 2020, the Company expects to recognize approximately the following percentages of deferred revenue by year: Year: Revenue Recognition Remainder of 2020 25 % 2021 29 % 2022 14 % 2023 14 % 2024 14 % Thereafter 4 % Total 100 % Revenue recognized for the three and nine months ended September 30, 2020 that was included in the contract liability balance at the beginning of the year was $0.4 million and $1.7 million respectively, and primarily represented revenue earned from separately priced extended warranties, rent-to-own revenue, milestone revenue, and clinical training. Customers For the three and nine months ended September 30, 2020 one customer accounted for more than 10% of the Company’s revenues. No customers accounted for more than 10% of the Company’s revenues for the three months ended September 30, 2019 and one customer accounted for more than 10% for the nine months ended September 30, 2019.

Debt

Debt	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Debt	1 2 . The following table presents the composition of debt as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Outstanding principal $ 35,000 $ 30,000 Accrued final payment fees 1,925 1,838 Less debt discounts (2,383 ) (690 ) Total debt, net 34,542 31,148 Less current portion (34,542 ) (11,250 ) Long-term debt, net $ - $ 19,898 For the three months ended September 30, 2020, 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 three months ended September 30, 2019, the Company recognized interest expense of $0.9 million, of which $0.7 million was cash paid for interest during the period 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, 2020, the Company recognized interest expense of $3.5 million, of which $3.1 million was cash and $0.4 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, 2019, the Company recognized interest expense of $2.8 million, of which $2.2 million was cash paid for interest during the period and $0.6 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 permits 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 only 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 the 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 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. As of September 30, 2020, the Company is in compliance with all covenants in the Solar Facility. The Solar Facility includes a financial covenant requiring the attainment of a minimum trailing net revenue amount beginning on December 31, 2020. Based upon the Company’s projected revenues for the rest of 2020, the Company believes that it is probable that this minimum revenue covenant will not be achieved. The Company is in discussions with the lenders for a potential covenant waiver or amendment, however, no formal agreement has been executed. The Solar Facility also 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. In accordance with FASB ASC 470 because the Solar Facility contains subjective acceleration clauses and the assessment that it is probable that the revenue covenant will not be met as of December 31, 2020, the outstanding principal under the Solar Facility is classified as a current liability in the accompanying balance sheet as of September 30, 2020. Oxford Credit Facility Prior to March 2020, the Company had a $35.0 million credit facility in place with Oxford, which it entered into in March 2017 and that allowed it to borrow up to $35.0 million in three tranches of term loans: a Term A Loan in the amount of $25 million, which was drawn immediately upon closing in March 2017, a Term B Loan in the amount of $5.0 million, which was drawn down in December 2017, and a Term C Loan in the amount of $5.0 million which was never drawn down. Each term loan accrued interest from the date of borrowing through the date of repayment at a floating per annum rate of interest, which reset monthly and was equal to the greater of (a) 8.15% or (b) the 30 day U.S. LIBOR on the last business day of the month plus 7.38%. This facility featured an interest-only period on all tranches through March 2019. In addition to principal and interest payments due under the $35.0 million Oxford credit facility, the Company was required to make final payment fees to Oxford upon the earlier of prepayment or maturity and equal to 8.5% and 7.5% of the principal amounts of the Term A and Term B Loans, respectively. The Company accrued final payment fees using the effective interest rate, with a charge to non-cash interest expense, over the term of borrowing and until its entry into the Solar credit facility in March 2020, at which time the Company paid Oxford $2.5 million in satisfaction of all final payment fee liabilities due under the Oxford credit facility. The Company evaluated whether the Solar Facility entered into in March 2020 represented a debt modification or extinguishment in accordance with ASC 470-50, Debt—Modifications and Extinguishments and determined that the existing debt was extinguished as a result of the full repayment of the existing facility and concurrent issuance of a new credit facility with a new lender. The unamortized balance of the Company’s combined debt discount and deferred issuance costs of $0.6 million related to the Oxford facility were accounted for as a loss on extinguishment of debt.

Common Stock

Common Stock	9 Months Ended
	Sep. 30, 2020
Equity [Abstract]
Common Stock	1 3 . 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, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Shares of common stock issued 18,959 18,645 Shares of common stock reserved for issuance for: Common stock warrants outstanding 105 105 Stock options outstanding 2,594 2,415 Restricted stock units and awards outstanding 2,350 245 Shares available for grant under stock incentive plan 1,354 1,215 Shares available for sale under employee stock purchase plan 608 421 Total shares of common stock issued and reserved for issuance 25,970 23,046 Common Stock Warrants The following table summarizes the Company’s outstanding common stock warrants as of September 30, 2020 and December 31, 2019: Warrants Outstanding (in thousands) Exercise Price Expiration Date 14 $ 19.55 Dec-2022 30 $ 9.73 Feb-2021 20 $ 9.73 Aug-2023 20 $ 9.73 Mar-2024 21 $ 9.73 Dec-2024 105

Loss Per Share

Loss Per Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Loss Per Share	1 4 . 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 and non-vested restricted stock awards and 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, 2020 and 2019 have been excluded from the denominator of the diluted loss per share of common stock outstanding calculation (in thousands): September 30, 2020 2019 Stock options 2,594 2,434 Non-vested performance restricted stock units 500 - Non-vested restricted stock units 1,850 240 Common stock warrants 105 105

Share-based Compensation

Share-based Compensation	9 Months Ended
	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Share-based Compensation	1 5 . 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, 2020 and 2019 is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cost of revenues $ 17 $ 18 $ 48 $ 47 Sales and marketing 370 368 1,036 976 General and administrative 572 429 1,440 1,126 Research and development 87 119 364 309 Total $ 1,046 $ 934 $ 2,888 $ 2,458 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 awards and restricted stock units generally vest ratably in three equal installments on the first, second and third anniversaries of the grant date. As of September 30, 2020, there were 1.4 million shares available for future issuance under the 2018 Plan. Stock Options The following table summarizes the Company’s stock option activity for the nine months ended September 30, 2020: Number of Shares under Option (in thousands) Weighted- average Exercise Price per Option Weighted- average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2019 2,415 $ 7.11 Granted 1,029 $ 2.01 Exercised (230 ) $ 2.32 Forfeited (620 ) $ 10.74 Outstanding at September 30, 2020 2,594 $ 4.64 7.0 $ 5,535 Exercisable at September 30, 2020 1,850 $ 4.79 4.1 $ 2,495 Vested and expected to vest at September 30, 2020 2,594 $ 4.64 7.0 $ 5,535 The Company recognized share-based compensation expense related to stock options of $0.3 million and $0.6 million for the three months ended September 30, 2020 and 2019, respectively and $1.2 million and $1.6 million for the nine months ended September 30, 2020 and 2019. As of September 30, 2020, there was $3.3 million of total unrecognized compensation cost related to non-vested stock options which the Company expects to recognize over a weighted-average period of 2.8 years. The weighted-average grant-date fair value of stock options granted during the nine months ended September 30, 2020 was estimated at $1.02 per option. The total intrinsic value of stock options exercised during the nine months ended September 30, 2020 was $0.4 million. For the nine months ended September 30, 2020, the grant-date fair value of stock options was estimated at the time of grant using the following weighted-average inputs and assumptions in the Black-Scholes option pricing model: Estimated fair value of common stock $ 2.01 Exercise price $ 2.01 Expected term (in years) 6.1 Risk-free interest rate 0.38 % Expected volatility 55.3 % Dividend yield 0 % Restricted Stock Awards and Restricted Stock Units The following table summarizes the Company’s restricted stock award and restricted stock unit activity for the nine months ended September 30, 2020: Non-vested Restricted Stock Units (in thousands) Weighted- average Grant-date Fair Value Non-vested at December 31, 2019 245 $ 15.23 Granted 2,155 $ 3.05 Vested (87 ) $ 14.13 Forfeited (463 ) $ 5.22 Non-vested at September 30, 2020 1,850 $ 3.60 The Company recognized $0.6 million and $0.3 million in share-based compensation expense related to restricted stock awards and restricted stock units for the three months ended September 30, 2020 and 2019, respectively and $1.7 million and $0.9 million for the nine months ended September 30, 2020 and 2019. As of September 30, 2020, there was $6.1 million of unrecognized compensation cost related to non-vested restricted stock awards and restricted stock units, which the Company expects to recognize over a weighted-average period of 2.6 years. The total fair value at the vesting date of restricted stock awards and restricted stock units vested during the nine months ended September 30, 2020 was $0.2 million. In July 2020 volume weighted average price of a share of the Company’s common stock The Company recognized less than $0.1 million in share-based expense related to the PRSU award for the three and nine months ended September 30, 2020. As of September 30, 2020, there was $0.8 million of unrecognized compensation costs which the Company plans to recognize over the initial estimated vesting period of 3.7 years.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	16. 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 Informatio

Geographical Segment Information	9 Months Ended
	Sep. 30, 2020
Segments Geographical Areas [Abstract]
Geographical Segment Information	1 7 . 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, 2020 2019 Amount % of Revenues Amount % of Revenues United States $ 12,029 97 % $ 15,294 96 % International 419 3 % 706 4 % Total revenues $ 12,448 100 % $ 16,000 100 % U.S. Revenues by Product Category Three Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 2,541 21 % $ 4,616 30 % Treatment sessions 9,083 76 % 10,252 67 % Other 405 3 % 426 3 % Total U.S. revenues $ 12,029 100 % $ 15,294 100 % International Revenues by Product Category Three Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 222 53 % $ 465 66 % Treatment sessions 99 24 % 114 16 % Other 98 23 % 127 18 % Total International revenues $ 419 100 % $ 706 100 % Revenues by Geography Nine Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues United States $ 32,473 96 % $ 43,730 97 % International 1,192 4 % 1,570 3 % Total revenues $ 33,665 100 % $ 45,300 100 % U.S. Revenues by Product Category Nine Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 7,474 23 % $ 12,594 29 % Treatment sessions 23,823 73 % 29,877 68 % Other 1,176 4 % 1,259 3 % Total U.S. revenues $ 32,473 100 % $ 43,730 100 % International Revenues by Product Category Nine Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 632 53 % $ 1,002 64 % Treatment sessions 291 24 % 247 16 % Other 269 23 % 321 20 % Total International revenues $ 1,192 100 % $ 1,570 100 %

Severance

Severance	9 Months Ended
	Sep. 30, 2020
Restructuring And Related Activities [Abstract]
Severance	18. SEVERANCE On April 8, 2020, the Company took action to reduce expenses through a reduction in force (“RIF”). As part of this action the Company terminated 95 employees who received separation benefits upon their termination. During the second quarter of 2020, the Company recorded a separation-related charge for the RIF equal to the fair value of the terminated employees benefits as of the communication date in the amount of $2.1 million. This amount was paid out during the quarter with the final payoff occurring on June 15, The Company entered into transition agreements outlining the separation with its former chief executive officer in March 2020 and the vice president of medical operations in September 2020. In connection with these agreements the company recorded $0.2 million and $1.3 million of charges in salary, payroll tax and bonus expenses in the three and nine months ended September 30, 2020, respectively. For the nine months ended September 30, 2020, $0.5 million of termination benefits were paid associated with the termination of the employees and charged against this liability. There were no other changes to the liability. As of September 30, 2020, $0.8 million remain in accrued liabilities for the unpaid portion of the separation benefits.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
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’ deficit 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, 2020 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 3, 2020, 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 and given the subjective element of the estimates and assumptions made, actual results may differ from estimated results.

Fair Value Measurement and Fi_2

Fair Value Measurement and Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2020
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, 2020 and December 31, 2019 (in thousands): September 30, 2020 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 48,115 $ 48,115 $ 48,115 $ - $ - December 31, 2019 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 67,650 $ 67,650 $ 67,650 $ - $ -

Accounts Receivable (Tables)

Accounts Receivable (Tables)	9 Months Ended
	Sep. 30, 2020
Receivables [Abstract]
Composition of Accounts Receivable, Net	The following table presents the composition of accounts receivable, net as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Gross accounts receivable - trade $ 6,620 $ 7,117 Less: Allowances for doubtful accounts (1,056 ) (548 ) Accounts receivable, net $ 5,564 $ 6,569

Property and Equipment and Ca_2

Property and Equipment and Capitalized Software (Tables)	9 Months Ended
	Sep. 30, 2020
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, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Laboratory equipment $ 150 $ 150 Office equipment 487 487 Computer equipment and software 1,301 1,218 Manufacturing equipment 273 273 Leasehold improvements 459 423 Rental equipment 462 763 Property and equipment, gross 3,132 3,314 Less: Accumulated depreciation (2,345 ) (2,207 ) Property and equipment, net $ 787 $ 1,107

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2020
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, 2020 September 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 575 $ 330 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ - $ 4,164
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, 2020 Remainder of 2020 $ 148 2021 616 2022 641 2023 637 2024 646 Thereafter 2,147 Total lease payments 4,835 Less imputed interest (1,033 ) Present value of operating lease liabilities $ 3,802
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, 2020 2019 2020 2019 Profit recognized at commencement, net $ 81 $ 506 $ 807 $ 768 Interest income - - - - Total sales-type lease income $ 81 $ 506 $ 807 $ 768
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, 2020 Remainder of 2020 $ 406 2021 1,624 2022 1,420 2023 431 Total sales-type lease receivables $ 3,881
Schedule of Maturity Analysis of Undiscounted Lease Receivable Related to Operating Leases	The following table sets forth a maturity analysis of its undiscounted lease receivables related to operating leases: September 30, 2020 Remainder of 2020 $ 261 2021 150 Total lease receivables $ 411

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Summary of Composition of Accrued Expenses	The following table presents the composition of accrued expenses as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Compensation and related benefits $ 3,704 $ 5,724 Consulting and professional fees 396 373 Research and development expenses 574 674 Sales and marketing expenses 43 127 Warranty 434 639 Sales and other taxes payable 586 700 Interest payable - 234 Other 434 560 Accrued expenses $ 6,171 $ 9,031

Deferred Revenue (Tables)

Deferred Revenue (Tables)	9 Months Ended
	Sep. 30, 2020
Deferred Revenue [Abstract]
Summary of Percentages of Deferred Revenue by Year	As of September 30, 2020, the Company expects to recognize approximately the following percentages of deferred revenue by year: Year: Revenue Recognition Remainder of 2020 25 % 2021 29 % 2022 14 % 2023 14 % 2024 14 % Thereafter 4 % Total 100 %

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Summary of Composition of Debt	The following table presents the composition of debt as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Outstanding principal $ 35,000 $ 30,000 Accrued final payment fees 1,925 1,838 Less debt discounts (2,383 ) (690 ) Total debt, net 34,542 31,148 Less current portion (34,542 ) (11,250 ) Long-term debt, net $ - $ 19,898

Common Stock (Tables)

Common Stock (Tables)	9 Months Ended
	Sep. 30, 2020
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, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Shares of common stock issued 18,959 18,645 Shares of common stock reserved for issuance for: Common stock warrants outstanding 105 105 Stock options outstanding 2,594 2,415 Restricted stock units and awards outstanding 2,350 245 Shares available for grant under stock incentive plan 1,354 1,215 Shares available for sale under employee stock purchase plan 608 421 Total shares of common stock issued and reserved for issuance 25,970 23,046
Summary of Outstanding Warrants	The following table summarizes the Company’s outstanding common stock warrants as of September 30, 2020 and December 31, 2019: Warrants Outstanding (in thousands) Exercise Price Expiration Date 14 $ 19.55 Dec-2022 30 $ 9.73 Feb-2021 20 $ 9.73 Aug-2023 20 $ 9.73 Mar-2024 21 $ 9.73 Dec-2024 105

Loss Per Share (Tables)

Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Schedule of Potentially Dilutive Securities Outstanding Excluded from Diluted Loss Per Share Calculation	The following potentially dilutive securities outstanding as of September 30, 2020 and 2019 have been excluded from the denominator of the diluted loss per share of common stock outstanding calculation (in thousands): September 30, 2020 2019 Stock options 2,594 2,434 Non-vested performance restricted stock units 500 - Non-vested restricted stock units 1,850 240 Common stock warrants 105 105

Share-Based Compensation (Table

Share-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Share-Based Compensation Expense	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, 2020 and 2019 is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cost of revenues $ 17 $ 18 $ 48 $ 47 Sales and marketing 370 368 1,036 976 General and administrative 572 429 1,440 1,126 Research and development 87 119 364 309 Total $ 1,046 $ 934 $ 2,888 $ 2,458
Summary of Stock Option Activity	The following table summarizes the Company’s stock option activity for the nine months ended September 30, 2020: Number of Shares under Option (in thousands) Weighted- average Exercise Price per Option Weighted- average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2019 2,415 $ 7.11 Granted 1,029 $ 2.01 Exercised (230 ) $ 2.32 Forfeited (620 ) $ 10.74 Outstanding at September 30, 2020 2,594 $ 4.64 7.0 $ 5,535 Exercisable at September 30, 2020 1,850 $ 4.79 4.1 $ 2,495 Vested and expected to vest at September 30, 2020 2,594 $ 4.64 7.0 $ 5,535
Summary of Weighted-average Inputs and Assumptions used to Estimate Grant-date Fair Value of Stock Options	For the nine months ended September 30, 2020, the grant-date fair value of stock options was estimated at the time of grant using the following weighted-average inputs and assumptions in the Black-Scholes option pricing model: Estimated fair value of common stock $ 2.01 Exercise price $ 2.01 Expected term (in years) 6.1 Risk-free interest rate 0.38 % Expected volatility 55.3 % Dividend yield 0 %
Summary of Restricted Stock Award and Restricted Stock Unit Activity	The following table summarizes the Company’s restricted stock award and restricted stock unit activity for the nine months ended September 30, 2020: Non-vested Restricted Stock Units (in thousands) Weighted- average Grant-date Fair Value Non-vested at December 31, 2019 245 $ 15.23 Granted 2,155 $ 3.05 Vested (87 ) $ 14.13 Forfeited (463 ) $ 5.22 Non-vested at September 30, 2020 1,850 $ 3.60

Geographical Segment Informat_2

Geographical Segment Information (Tables)	9 Months Ended
	Sep. 30, 2020
Summary of Revenue Generated in Geographic Regions for Years Indicated	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, 2020 2019 Amount % of Revenues Amount % of Revenues United States $ 12,029 97 % $ 15,294 96 % International 419 3 % 706 4 % Total revenues $ 12,448 100 % $ 16,000 100 % Revenues by Geography Nine Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues United States $ 32,473 96 % $ 43,730 97 % International 1,192 4 % 1,570 3 % Total revenues $ 33,665 100 % $ 45,300 100 %
United States
Summary of Revenue Generated in Product Category for Years Indicated	U.S. Revenues by Product Category Three Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 2,541 21 % $ 4,616 30 % Treatment sessions 9,083 76 % 10,252 67 % Other 405 3 % 426 3 % Total U.S. revenues $ 12,029 100 % $ 15,294 100 % U.S. Revenues by Product Category Nine Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 7,474 23 % $ 12,594 29 % Treatment sessions 23,823 73 % 29,877 68 % Other 1,176 4 % 1,259 3 % Total U.S. revenues $ 32,473 100 % $ 43,730 100 %
International
Summary of Revenue Generated in Product Category for Years Indicated	International Revenues by Product Category Three Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 222 53 % $ 465 66 % Treatment sessions 99 24 % 114 16 % Other 98 23 % 127 18 % Total International revenues $ 419 100 % $ 706 100 % International Revenues by Product Category Nine Months Ended September 30, 2020 2019 Amount % of Revenues Amount % of Revenues (in thousands, except percentages) NeuroStar Advanced Therapy System $ 632 53 % $ 1,002 64 % Treatment sessions 291 24 % 247 16 % Other 269 23 % 321 20 % Total International revenues $ 1,192 100 % $ 1,570 100 %

Description of Business - Addit

Description of Business - Additional Information (Details) - USD ($) $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019	Apr. 30, 2020
Description Of Business [Line Items]
Cash and cash equivalents	$ 50,719		$ 75,708
Accumulated deficit	273,883		250,087
Cash flows from operating activities	26,687	$ 24,079	$ 30,500
Paycheck Protection Program (the “PPP”) | Silicon Valley Bank
Description Of Business [Line Items]
Unsecured debt				$ 6,400
$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. 1, 2025

Fair Value Measurement and Fi_3

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, 2020	Dec. 31, 2019
Carrying Amount
Assets
Total assets	$ 48,115	$ 67,650
Fair Value
Assets
Total assets	48,115	67,650
Quoted Prices In Active Markets (Level 1)
Assets
Total assets	$ 48,115	$ 67,650

Accounts Receivable - Compositi

Accounts Receivable - Composition of Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Receivables [Abstract]
Gross accounts receivable - trade	$ 6,620	$ 7,117
Less: Allowances for doubtful accounts	(1,056)	(548)
Accounts receivable, net	$ 5,564	$ 6,569

Property and Equipment and Ca_3

Property and Equipment and Capitalized Software - Summary of Composition of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 3,132	$ 3,314
Less: Accumulated depreciation	(2,345)	(2,207)
Property and equipment, net	787	1,107
Laboratory Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	150	150
Office Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	487	487
Computer Equipment and Software
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,301	1,218
Manufacturing Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	273	273
Leasehold Improvements
Property Plant And Equipment [Line Items]
Property and equipment, gross	459	423
Rental Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	462	763
Property and equipment, net	$ 300	$ 500

Property and Equipment and Ca_4

Property and Equipment and Capitalized Software - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Property Plant And Equipment [Line Items]
Depreciation and amortization expense	$ 0.2	$ 0.3	$ 0.7	$ 0.8
Other Assets [Member]
Property Plant And Equipment [Line Items]
Capitalized software cost, net	$ 1.3		$ 1.3		$ 1.2

Leases - Additional Information

Leases - Additional Information (Details)	3 Months Ended			9 Months Ended
	Sep. 30, 2020USD ($)ft²	Mar. 31, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)ft²	Sep. 30, 2019USD ($)	Dec. 31, 2019USD ($)
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	$ 200,000		$ 500,000	$ 200,000	$ 500,000
Operating lease, weighted-average remaining lease term	7 years 3 months 18 days			7 years 3 months 18 days
Operating lease, weighted-average discount rate	6.50%			6.50%
Reimbursement of leasehold expenses		$ 800,000
Carrying amount of lease receivables	$ 3,900,000			$ 3,900,000
Unguaranteed residual assets	0			0
Operating lease income	100,000		200,000	200,000	600,000
Property and equipment, net	$ 787,000			$ 787,000		$ 1,107,000
NeuroStar Advanced Therapy Systems
Leases [Line Items]
Lessor sales-type lease, Term	3 years			3 years
Headquarters and Office Equipment, Including Copiers
Leases [Line Items]
Area of lease facility | ft²	42,000			42,000
Rental Equipment
Leases [Line Items]
Property and equipment, net	$ 300,000			$ 300,000		$ 500,000
Rental equipment depreciation expense	$ 20,000		$ 100,000	$ 100,000	$ 200,000

Leases - Schedule of Supplement

Leases - Schedule of Supplemental Cash Flow Information as Lessee Related to Leases (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 575	$ 330
Right-of-use assets obtained in exchange for lease obligations:
Operating leases		$ 4,164

Leases - Schedule of Future Pay

Leases - Schedule of Future Payments of Operating Lease Liabilities (Details) $ in Thousands	Sep. 30, 2020USD ($)
Operating Lease Liabilities Payments Due [Abstract]
Remainder of 2020	$ 148
2021	616
2022	641
2023	637
2024	646
Thereafter	2,147
Total lease payments	4,835
Less imputed interest	(1,033)
Present value of operating lease liabilities	$ 3,802

Leases - Schedule of Profit Rec

Leases - Schedule of Profit Recognized on Sales-type Leases (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Sales Type Lease Lease Income [Abstract]
Profit recognized at commencement, net	$ 81	$ 506	$ 807	$ 768
Total sales-type lease income	$ 81	$ 506	$ 807	$ 768

Leases - Schedule of Maturity A

Leases - Schedule of Maturity Analysis of Undiscounted Lease Receivables Related to Sales-type Leases (Details) $ in Thousands	Sep. 30, 2020USD ($)
Sales Type And Direct Financing Leases Lease Receivable Fiscal Year Maturity [Abstract]
Remainder of 2020	$ 406
2021	1,624
2022	1,420
2023	431
Total sales-type lease receivables	$ 3,881

Leases - Schedule of Maturity_2

Leases - Schedule of Maturity Analysis of Undiscounted Lease Receivable Related to Operating Leases (Details) $ in Thousands	Sep. 30, 2020USD ($)
Lessor Operating Lease Payments Fiscal Year Maturity [Abstract]
Remainder of 2020	$ 261
2021	150
Total lease receivables	$ 411

Prepaid Commission Expense - Ad

Prepaid Commission Expense - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Amortization Of Deferred Charges [Abstract]
Amortization period of deferred commissions			7 years
Amortization expense	$ 0.2	$ 0.1	$ 0.6	$ 0.2

Accrued Expenses - Summary of C

Accrued Expenses - Summary of Composition of Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Payables And Accruals [Abstract]
Compensation and related benefits	$ 3,704	$ 5,724
Consulting and professional fees	396	373
Research and development expenses	574	674
Sales and marketing expenses	43	127
Warranty	434	639
Sales and other taxes payable	586	700
Interest payable		234
Other	434	560
Accrued expenses	$ 6,171	$ 9,031

Deferred Revenue - Summary of P

Deferred Revenue - Summary of Percentages of Deferred Revenue by Year (Details)	Sep. 30, 2020
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: 2020-10-01
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	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2021-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	29.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2022-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	14.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2023-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	14.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2024-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	14.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2025-01-01
Revenue Remaining Performance Obligation Expected Timing Of Satisfaction [Line Items]
Revenue, remaining performance obligation	4.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	1 year

Deferred Revenue - Summary of_2

Deferred Revenue - Summary of Percentages of Deferred Revenue by Year 1 (Details)	Sep. 30, 2020
Revenue Performance Obligation Satisfied Over Time [Abstract]
Revenue, remaining performance obligation	100.00%

Deferred Revenue - Additional I

Deferred Revenue - Additional Information (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)Customer	Sep. 30, 2019Customer	Sep. 30, 2020USD ($)Customer	Sep. 30, 2019Customer
Deferred Revenue [Abstract]
Revenue recognized | $	$ 0.4		$ 1.7
Number of customer accounted for more than 10% of revenues | Customer	1	0	1	1

Debt - Summary of Composition o

Debt - Summary of Composition of Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Debt Disclosure [Abstract]
Outstanding principal	$ 35,000	$ 30,000
Accrued final payment fees	1,925	1,838
Less debt discounts	(2,383)	(690)
Total debt, net	34,542	31,148
Less current portion	$ (34,542)	(11,250)
Long-term debt, net		$ 19,898

Debt - Additional Information (

Debt - Additional Information (Details)	Mar. 02, 2020USD ($)TrancheEvent	Feb. 29, 2020USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Mar. 31, 2017USD ($)
Debt Instrument [Line Items]
Interest expense			$ 1,000,000	$ 900,000	$ 3,500,000	$ 2,800,000
Cash interest expense			800,000	700,000	3,100,000	2,200,000
Non-cash interest expense			200,000	$ 200,000	$ 400,000	$ 600,000
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 | Event	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							$ 35,000,000
Solar Capital Ltd | $35.0 Million Credit Facility | Term A Loan
Debt Instrument [Line Items]
Borrowings outstanding under credit facility	$ 35,000,000
Solar Capital Ltd | $50.0 Million Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity	$ 50,000,000
Term loans number of tranches | Tranche	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	$ 100,000,000
Trailing twelve month net product revenue Second threshold limit to pay exit fee	$ 125,000,000
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	$ 15,000,000
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 only 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.
Oxford Finance LLC | $35.0 Million Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity		$ 35,000,000	35,000,000		$ 35,000,000
Borrowings outstanding under credit facility			$ 35,000,000		$ 35,000,000
Credit facility maturity date					Feb. 1, 2025
Debt instrument, interest rate			8.15%		8.15%
Debt instrument, final payment fee					$ 2,500,000
Combined debt discount and deferred issuance costs			$ 600,000		$ 600,000
Oxford Finance LLC | $35.0 Million Credit Facility | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate					7.38%
Debt instrument, description of variable rate basis					30 day U.S. LIBOR
Oxford Finance LLC | $35.0 Million Credit Facility | Term A Loan
Debt Instrument [Line Items]
Borrowings outstanding under credit facility		$ 25,000,000
Final payment fees percentage		8.50%
Oxford Finance LLC | $35.0 Million Credit Facility | Term B Loan
Debt Instrument [Line Items]
Borrowings outstanding under credit facility		$ 5,000,000
Final payment fees percentage		7.50%
Oxford Finance LLC | $35.0 Million Credit Facility | Term C Loan
Debt Instrument [Line Items]
Line of credit facility, current borrowing capacity		$ 5,000,000

Common Stock - Summary of Commo

Common Stock - Summary of Common Stock Issued and Reserved for Issuance (Details) - shares	Sep. 30, 2020	Dec. 31, 2019
Stockholders Deficit [Line Items]
Shares of common stock issued	18,959,000	18,645,000
Shares of common stock reserved for issuance for:
Total shares of common stock issued and reserved for issuance	25,970,000	23,046,000
Common Stock Warrants Outstanding
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	105,000	105,000
Stock Options Outstanding
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	2,594,000	2,415,000
Restricted Stock Units and Awards Outstanding
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	2,350,000	245,000
Shares Available for Grant Under Stock Incentive Plan
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	1,354,000	1,215,000
Shares Available for Sales Under Employee Stock Purchase Plan
Shares of common stock reserved for issuance for:
Shares of common stock reserved for issuance	608,000	421,000

Common Stock - Summary of Outst

Common Stock - Summary of Outstanding Common Stock Warrants (Details) shares in Thousands	9 Months Ended
	Sep. 30, 2020$ / sharesshares
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	105
Exercise Price $19.55
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	14
Exercise Price | $ / shares	$ 19.55
Expiration Date	2022-12
Exercise Price $9.73
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	30
Exercise Price | $ / shares	$ 9.73
Expiration Date	2021-02
Exercise Price $9.73
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	20
Exercise Price | $ / shares	$ 9.73
Expiration Date	2023-08
Exercise Price $9.73
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	20
Exercise Price | $ / shares	$ 9.73
Expiration Date	2024-03
Exercise Price $9.73
Class Of Warrant Or Right [Line Items]
Warrants Outstanding	21
Exercise Price | $ / shares	$ 9.73
Expiration Date	2024-12

Loss Per Share - Schedule of Po

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, 2020	Sep. 30, 2019
Stock Options Outstanding
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Potentially dilutive securities outstanding excluded from diluted loss per share	2,594	2,434
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	500
Non-vested Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Potentially dilutive securities outstanding excluded from diluted loss per share	1,850	240
Common Stock Warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Potentially dilutive securities outstanding excluded from diluted loss per share	105	105

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Share-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	$ 1,046	$ 934	$ 2,888	$ 2,458
Cost of Revenues
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	17	18	48	47
Sales and Marketing
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	370	368	1,036	976
General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	572	429	1,440	1,126
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total	$ 87	$ 119	$ 364	$ 309

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Details) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Jul. 31, 2020USD ($)TrancheTrailing$ / sharesshares	Sep. 30, 2020USD ($)shares	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)Installment$ / sharesshares	Sep. 30, 2019USD ($)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses		$ 1,046	$ 934	$ 2,888	$ 2,458
Weighted-average grant-date fair value of stock options granted | $ / shares				$ 1.02
Intrinsic value of stock options exercised				$ 400
Expected volatility				55.30%
Risk-free interest rate				0.38%
Expected term (in years)				6 years 1 month 6 days
Stock Options Outstanding
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses		300	600	$ 1,200	1,600
Unrecognized compensation cost related to non-vested stock options		3,300		$ 3,300
Non-vested awards not yet recognized weighted-average period for recognition				2 years 9 months 18 days
Restricted Stock Awards and Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses		600	$ 300	$ 1,700	$ 900
Non-vested awards not yet recognized weighted-average period for recognition				2 years 7 months 6 days
Unrecognized compensation cost related to non-vested restricted stock		6,100		$ 6,100
Fair value of restricted stock vested				$ 200
PRSUs | Chief Executive Officer
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting terms of stock options				The grant was comprised of four equal tranches each of which vest in equal installments of 125,000 shares based on appreciation of the Company’s common stock price to $10, $15, $20 and $25 per share, respectively, measured using a trailing 30-day volume weighted average price of a share of the Company’s common stock
Non-vested awards not yet recognized weighted-average period for recognition				3 years 8 months 12 days
Unrecognized compensation cost related to non-vested restricted stock		800		$ 800
Shares awarded | shares	500,000
Number of equal tranches | Tranche	4
Expected volatility	87.40%
Closing price | $ / shares	$ 1.98
Risk-free interest rate	0.63%
Aggregate estimate fair value	$ 900
Expected term (in years)	3 years 10 months 24 days
PRSUs | Chief Executive Officer | Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Weighted average price, number of days trailing | Trailing	30
First Anniversary of Date of Grant | PRSUs | Chief Executive Officer | Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock price | $ / shares	$ 10
Four Equal Tranches | PRSUs | Chief Executive Officer
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares based on appreciation vest in equal installments | shares	125,000
Tranche Two | PRSUs | Chief Executive Officer | Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock price | $ / shares	$ 15
Tranche Three | PRSUs | Chief Executive Officer | Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock price | $ / shares	20
Tranche Four | PRSUs | Chief Executive Officer | Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock price | $ / shares	$ 25
Minimum [Member] | PRSUs | Chief Executive Officer
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based compensation expenses		$ 100		$ 100
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 awards and 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		1,400,000		1,400,000
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

Share-Based Compensation - Su_2

Share-Based Compensation - Summary of Stock Option Activity (Details) - Stock Options Outstanding - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares under Option, Outstanding, Beginning balance	2,415
Number of Shares under Option, Granted	1,029
Number of Shares under Option, Exercised	(230)
Number of Shares under Option, Forfeited	(620)
Number of Shares under Option, Outstanding, Ending balance	2,594
Number of Shares under Option, Exercisable	1,850
Number of Shares under Option, Vested and expected to vest	2,594
Weighted-average Exercise Price per Option, Outstanding, Beginning balance	$ 7.11
Weighted-average Exercise Price per Option, Granted	2.01
Weighted-average Exercise Price per Option, Exercised	2.32
Weighted-average Exercise Price per Option, Forfeited	10.74
Weighted-average Exercise Price per Option, Outstanding, Ending balance	4.64
Weighted-average Exercise Price per Option, Exercisable	4.79
Weighted-average Exercise Price per Option, Vested and expected to vest	$ 4.64
Weighted-average Remaining Contractual Life, Outstanding	7 years
Weighted-average Remaining Contractual Life, Exercisable	4 years 1 month 6 days
Weighted-average Remaining Contractual Life, Vested and expected to vest	7 years
Aggregate Intrinsic Value, Outstanding	$ 5,535
Aggregate Intrinsic Value, Exercisable	2,495
Aggregate Intrinsic Value, Vested and expected to vest	$ 5,535

Share-Based Compensation - Su_3

Share-Based Compensation - Summary of Weighted-average Inputs and Assumptions used to Estimate Grant-date Fair Value of Stock Options (Details)	9 Months Ended
	Sep. 30, 2020$ / shares
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Estimated fair value of common stock	$ 2.01
Exercise price	$ 2.01
Expected term (in years)	6 years 1 month 6 days
Risk-free interest rate	0.38%
Expected volatility	55.30%
Dividend yield	0.00%

Share-Based Compensation - Su_4

Share-Based Compensation - Summary of Restricted Stock Award and Restricted Stock Unit Activity (Details) - Non-vested Restricted Stock Units shares in Thousands	9 Months Ended
	Sep. 30, 2020$ / sharesshares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Non-vested, Beginning balance | shares	245
Granted | shares	2,155
Vested | shares	(87)
Forfeited | shares	(463)
Non-vested, Ending balance | shares	1,850
Weighted-average Grant-date Fair Value, Non-vested, Beginning balance | $ / shares	$ 15.23
Weighted-average Grant-date Fair Value, Granted | $ / shares	3.05
Weighted-average Grant-date Fair Value, Vested | $ / shares	14.13
Weighted-average Grant-date Fair Value, Forfeited | $ / shares	5.22
Weighted-average Grant-date Fair Value, Non-vested, Ending balance | $ / shares	$ 3.60

Geographical Segment Informat_3

Geographical Segment Information - Additional Information (Details)	9 Months Ended
	Sep. 30, 2020Segment
Segments Geographical Areas [Abstract]
Number of operating business segment	1

Geographical Segment Informat_4

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, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Segment Reporting Information [Line Items]
Revenues	$ 12,448	$ 16,000	$ 33,665	$ 45,300
Revenues | Geographic Concentration
Segment Reporting Information [Line Items]
Revenues	$ 12,448	$ 16,000	$ 33,665	$ 45,300
Percentage of Revenues	100.00%	100.00%	100.00%	100.00%
Revenues | United States | Geographic Concentration
Segment Reporting Information [Line Items]
Revenues	$ 12,029	$ 15,294	$ 32,473	$ 43,730
Percentage of Revenues	97.00%	96.00%	96.00%	97.00%
Revenues | International | Geographic Concentration
Segment Reporting Information [Line Items]
Revenues	$ 419	$ 706	$ 1,192	$ 1,570
Percentage of Revenues	3.00%	4.00%	4.00%	3.00%

Geographical Segment Informat_5

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, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Segment Reporting Information [Line Items]
Revenues	$ 12,448	$ 16,000	$ 33,665	$ 45,300
Product Category | United States | Revenues
Segment Reporting Information [Line Items]
Revenues	$ 12,029	$ 15,294	$ 32,473	$ 43,730
Percentage of Revenues	100.00%	100.00%	100.00%	100.00%
Product Category | United States | Revenues | NeuroStar Advanced Therapy System
Segment Reporting Information [Line Items]
Revenues	$ 2,541	$ 4,616	$ 7,474	$ 12,594
Percentage of Revenues	21.00%	30.00%	23.00%	29.00%
Product Category | United States | Revenues | Treatment Sessions
Segment Reporting Information [Line Items]
Revenues	$ 9,083	$ 10,252	$ 23,823	$ 29,877
Percentage of Revenues	76.00%	67.00%	73.00%	68.00%
Product Category | United States | Revenues | Other
Segment Reporting Information [Line Items]
Revenues	$ 405	$ 426	$ 1,176	$ 1,259
Percentage of Revenues	3.00%	3.00%	4.00%	3.00%
Product Category | International | Revenues
Segment Reporting Information [Line Items]
Revenues	$ 419	$ 706	$ 1,192	$ 1,570
Percentage of Revenues	100.00%	100.00%	100.00%	100.00%
Product Category | International | Revenues | NeuroStar Advanced Therapy System
Segment Reporting Information [Line Items]
Revenues	$ 222	$ 465	$ 632	$ 1,002
Percentage of Revenues	53.00%	66.00%	53.00%	64.00%
Product Category | International | Revenues | Treatment Sessions
Segment Reporting Information [Line Items]
Revenues	$ 99	$ 114	$ 291	$ 247
Percentage of Revenues	24.00%	16.00%	24.00%	16.00%
Product Category | International | Revenues | Other
Segment Reporting Information [Line Items]
Revenues	$ 98	$ 127	$ 269	$ 321
Percentage of Revenues	23.00%	18.00%	23.00%	20.00%

Severance - Additional Informat

Severance - Additional Information (Details) $ in Thousands	Apr. 08, 2020Employee	Sep. 30, 2020USD ($)	Jun. 30, 2020USD ($)	Sep. 30, 2020USD ($)	Dec. 31, 2019USD ($)
Restructuring Cost And Reserve [Line Items]
Accrued liabilities		$ 6,171		$ 6,171	$ 9,031
Transition Separation Agreement
Restructuring Cost And Reserve [Line Items]
Restructuring charges		200		1,300
Accrued liabilities		$ 800		800
Reduction in Force
Restructuring Cost And Reserve [Line Items]
Number of employees terminated | Employee	95
Restructuring charges			$ 2,100
Termination Benefits | Transition Separation Agreement
Restructuring Cost And Reserve [Line Items]
Payments for restructuring				$ 500