Earlier chapters made a lot of small, careful choices. One ad group per condition (Chapter 4). A landing page for each one. Headlines in the patient's words (Chapter 8). Exact match first, broad match only once the account is booking patients (Chapters 5 and 6).
AI Max hands several of those careful chiropractic choices back to Google. This chapter is about what that means on a real chiropractic website, where the page you picked for the sciatica ad sits among dozens of others, and how to keep AI Max on the pages you'd choose yourself.
AI Max Reaches Chiropractic Searches You Never Added, the Way Broad Match Does
A chiropractor who flips the AI Max switch is really turning on three things at once:
- Search term matching, which Google builds on its broad match technology plus the practice's assets and pages, so a sciatica ad group can show for searches nobody added to it.
- Text customization, which writes extra headlines and descriptions on the practice's behalf.
- Final URL expansion, which can trade the condition page you chose for some other page on the domain. Chapter 10 unchecked it in Performance Max.
The first one matters most for how the account is built. Isolation is exact match on purpose. Exploration adds broad match deliberately, once the account books about 30 quality leads a month. AI Max adds broad-match-style reach to whatever campaign it's turned on in. Turned on in Isolation, it undoes the point of Isolation. That's why Chapter 9 switched it off in every new campaign, and why it comes last.
The other two features are where a chiropractic website comes in.
One Chiropractic Site We Read Has 49 Pages Across Two States. AI Max Can Send a Sciatica Click to Many of Them.
For this guide we read the websites of twelve chiropractic practices that advertise in our example market, Baltimore. Every one of them has separate pages for conditions or services, from 5 on one site to 48 on another. Three of them also have pages for towns or neighborhoods they serve, with 8, 19 and 44 of those pages each.
The practice with the most offices has 21 condition pages, 16 service pages and 12 office pages: 49 pages a patient could land on, before counting the insurance, billing, new-patient and blog pages.
That's what a good chiropractic website looks like, and a practice with several offices or a long list of services will naturally end up with dozens of pages. Chapter 4 recommended exactly this: a page for each condition, so the sciatica ad can land on the sciatica page. The pages aren't the problem. The problem is that AI Max doesn't have to use the one you chose.
Google says Final URL expansion sends traffic to the pages on your domain it judges most relevant to the search, and only to pages that are "query relevant and themed to your ad group." On a site with 49 pages, plenty of them will look relevant to a sciatica search.
Final URL Expansion Can Land a Baltimore Sciatica Click on an Office in Virginia
The site with 49 pages belongs to a practice with offices in Maryland and Northern Virginia. Each office has its own page, and the Baltimore office page we read links to the practice's condition pages, sciatica and whiplash among them.
Picture a patient in Baltimore searching for sciatica help. The campaign targets Baltimore, and the ad was written to land on the Baltimore sciatica page. Turn on Final URL expansion and Google can decide that another page fits the search better. If that page happens to be an office page in another state, the patient sees a location they'll never drive to, and the practice pays for the click.
The same goes for pages that were never meant for a new patient: the billing page, the insurance details, the workers' comp page, an old blog post.
There's a second, quieter cost. Its help page adds that any headline you pinned stops being used for a click Google sends to another page, since the pinned line was written for a different page. A headline pinned in Chapter 8 is no longer a sure thing.
URL Exclusions Keep AI Max Off the Billing Page, the Blog and the Offices Too Far Away
When the account is ready for AI Max, there are two ways to keep it on the right pages.
URL exclusions are the lighter control. They're set for the whole campaign, and they tell Final URL expansion which pages it can never use. Pages go on the list one by one, or a single rule can block a whole section; for example, a rule for addresses containing "/blog/", if the rule options in the account allow it. The list sits in the AI Max panel of the campaign settings, and Google switches it on only alongside text customization and page swapping, so a practice that later turns AI Max off loses the list's effect too. A starting list for a chiropractic practice:
- Billing, payment and insurance-details pages
- Careers and staff-login pages
- The blog
- Office pages outside the campaign's target area
- Paperwork pages, such as intake forms and workers' comp documents
URL inclusions are the stricter control. They're set per ad group, and they limit the landing pages to the ones you list. Google's page explains that if you turn on URL inclusions with Final URL expansion off, only your listed pages are used. For a sciatica ad group, that can mean just the sciatica page and the main office page. Note that pinned headlines aren't used when URL inclusions are on, either.
A "$" Exclusion Won't Stop AI Max From Writing a Price Into a Chiropractic Ad
Text customization draws on the practice's whole domain as well as on what's already in the account. That includes prices.
Four of the twelve sites we read show a price somewhere: a new-patient rate or a first-visit package. Chapter 8 found that most local practices leave prices out of their ads, and that the reviews quoting a low intro price were all one to three stars. A practice that kept the price off its ads on purpose may not want AI Max putting it back.
Google's text guidelines give a campaign two controls. Term exclusions name exact words or phrases that generated text can never use; a campaign gets 25 of them. Messaging restrictions describe what to avoid in plain language. Google is specific about prices: a "$" term exclusion can't stop generated text with prices in it, so it recommends a messaging restriction instead, with an example of the kind of price to avoid.
A chiropractic starter set:
- Messaging restriction: "Avoid mentioning any prices or new-patient rates, for example $49 first visit or $75 per adjustment."
- Messaging restriction: "Don't promise same-day or walk-in visits." Add it only if the practice doesn't offer them; Chapter 4 found one ad promising same-day visits on a site that said same-week, and one promising walk-ins the site never mentioned.
- Term exclusions: the names of services you've stopped offering, and any offer that has ended.
Google says the guidelines work on new and existing campaigns, and that term exclusions are language-specific, so a practice with Spanish ads (Chapter 9) needs the Spanish versions too.
AI Max Learns From Booked Patients, So a Chiropractor Without Steady Bookings Has Nothing to Teach It
Google's setup page ties all three AI Max features to bidding that runs on conversions. A chiropractic account that books a handful of patients a month gives that bidding almost nothing to learn from.
That's the same gate as the rest of the automation in this guide. Exploration waited for about 30 quality leads a month. Performance Max and Demand Gen waited longer. AI Max comes after them, once the account has steady calls, forms and kept first visits flowing back from Chapter 1's tracking, and once the practice knows what a new patient costs from Chapter 3's worksheet.
One AI Max Test Campaign Teaches a Chiropractor More Than Switching It On Everywhere
When the account is ready, don't turn AI Max on across the board. Test it.
The Experiments page inside Google Ads offers an AI Max experiment: a one-click test that, instead of copying the campaign, splits your current campaign 50/50 between the version with AI Max and the version without. Run it on Exploration, the campaign already built to find new searches, and leave Isolation alone. Set the URL exclusions and text guidelines before it starts.
Google adds a report view for AI Max that puts the search, the headline that showed and the landing page side by side. For a chiropractor, that's the view to read every week:
- The search. Is it a patient? Add negatives for anything that isn't, as Chapter 6 taught.
- The headline. Read every one Google wrote. If one says something the practice wouldn't, add a restriction.
- The landing page. Did the sciatica search land on the sciatica page? If not, add the page it used to the exclusions, or switch that ad group to URL inclusions.
Then judge it on cost per kept first visit, not clicks. Give it long enough for both halves to book real patients: at least 4 to 6 weeks, as Google recommends. If the AI Max half brings real patients at a similar or lower cost, keep it. If it doesn't, end the test.
If you'd like help setting up the exclusions and running the test, our Google Ads agency team does this for the chiropractic accounts we manage before switching on any AI feature.
Next: Car Accident Chiropractor Searches Carry the Highest Bids in Chiropractic
Auto injury is a different business inside many chiropractic practices, with its own searches, payers and rules. Chapter 14 looks at the bids those searches carry and why they belong in their own campaign. The earlier chapters, from the map pack back to tracking, are on the Google Ads for Chiropractors guide home.
