As previously disclosed, Mednax has incurred certain expenses related to transformational and restructuring related activities. For the fourth quarter of 2020, these expenses totaled $13.0 million, compared to $28.9 million for the fourth quarter of 2019. Of the expense recorded during the fourth quarter of 2020, $9.5 million related to executive management restructuring, contract termination fees, and position eliminations, while the remainder related to third-party consulting fees.
Adjusted EBITDA from continuing operations, which is defined as earnings from continuing operations before interest, taxes, depreciation and amortization, and transformational and restructuring related expenses, was $58.3 million for the 2020 fourth quarter, compared to $77.5 million for the prior-year period.
Depreciation and amortization expense was $7.7 million for the fourth quarter of 2020 compared to $7.1 million for the fourth quarter of 2019.
Investment and other income was $4.8 million for the fourth quarter of 2020 compared to $0.9 million for the fourth quarter of 2019. This increase primarily represents the reimbursement related to the transition services being provided to the buyers of American Anesthesiology Mednax Radiology Solutions.
Interest expense was $27.3 million for the fourth quarter of 2020 compared to $27.7 million for the fourth quarter of 2019.
Mednax generated income from continuing operations of $4.4 million, or $0.05 per diluted share, for the 2020 fourth quarter, based on a weighted average 85.1 million shares outstanding. This compares with income from continuing operations of $9.9 million, or $0.12 per diluted share, for the 2019 fourth quarter, based on a weighted average 83.3 million shares outstanding.
For the fourth quarter of 2020, Mednax reported Adjusted EPS from continuing operations of $0.25, compared to $0.45 for the fourth quarter of 2019. For these periods, Adjusted EPS from continuing operations is defined as diluted income from continuing operations per common and common equivalent share excluding non-cash amortization expense, stock-based compensation expense, transformational and restructuring related expenses, and discrete tax items.
Operating Results from Continuing Operations – Year Ended December 31, 2020
For the year ended December 31, 2020, Mednax generated revenue from continuing operations of $1.73 billion, compared to revenue of $1.78 billion for the prior-year period. Adjusted EBITDA from continuing operations for the year ended December 31, 2020 was $219.9 million, compared to $264.5 million for the prior year. Mednax reported loss from continuing operations of $9.6 million, or $0.11 per share, for the year ended December 31, 2020, based on a weighted average 83.4 million shares outstanding, which compares to income from continuing operations of $42.2 million, or $0.50 per share, based on a weighted average 84.0 million shares outstanding for the year ended December 31, 2019. For the year ended December 31, 2020, Mednax reported Adjusted EPS from continuing operations of $0.95, compared to $1.40 for the same period of 2019.