A new-patient special is one of the most common offers in chiropractic advertising: a free consultation, a discounted first visit, an exam and adjustment for one set price. Run well, it gives a nervous first-timer a low-risk way to try the practice.
It's also one of the most regulated lines a chiropractor can put in an ad. Many states have rules written specifically for free and discounted chiropractic services, and they differ a lot from one state to the next. This chapter walks through what those rules ask for, how they fit into a Google ad that holds 90 characters, and how to write an offer that matches the ad, the page and the bill.
None of this is legal advice. It's a map of what we found, so you know which questions to bring to your own state board or attorney before the offer goes live.
Florida Wants a 72-Hour Right-to-Refuse Statement in Capital Letters on a Free Exam Ad
Florida's rule is the most detailed one we found. Any ad for a "free, discounted fee, or reduced fee service, examination, or treatment" by a licensed health professional, chiropractors included, must carry a statement "in capital letters clearly distinguishable from the rest of the text." In plain terms, it tells the patient, and anyone else paying, that they have the right to refuse to pay for, cancel or be reimbursed for any other service done within 72 hours of answering the ad for the free or discounted service.
The statute spells out the exact wording, and the ad has to use it word for word, so copy it from the law itself rather than from this summary.
Florida's chiropractic practice act adds two more requirements. A chiropractor can be disciplined for advertising a reduced, discounted or free service "without prominently stating in the advertisement the usual fee," and for advertising a fee that's different from the fee the practice submits to insurers.
So a Florida practice advertising "$49 first visit" needs three things on hand: the 72-hour statement, the usual fee for the same visit, and an advertised price that matches what it bills insurers.
Ohio, Arizona and Texas Want a Free Exam Ad to List Exactly What the Visit Includes
Of the twelve states we checked, eleven have a rule that touches free or discounted chiropractic offers. They fall into a few groups:
- A 72-hour right to cancel or refuse. Florida (above), Kentucky, which wants the notice in print "of no less than ten (10) point font," and Arkansas.
- Say exactly what's included. Ohio requires a disclaimer that "shall clearly state specifically what goods or services are discounted or free and what goods or services are not included," and excludes a plain free consultation from that rule. Arizona disciplines advertising a price "without also specifying the services, procedures or items included," and advertising a service as free "without also disclosing what services or items are included." Texas says a service may not be called free "unless the communication or advertising clearly states all component services which are included."
- A signed disclosure at the visit. Georgia and Washington want the patient to sign a written statement explaining when charges begin.
- Other limits. California requires telling the patient the cost of anything beyond the free service, and getting their agreement, before charges accrue. Pennsylvania treats a free service tied to a required purchase as misleading unless the condition is disclosed. New York limits inducements and asks practices to keep a copy of every ad.
One of the twelve didn't fit: we haven't yet confirmed whether Colorado has a free-exam rule. North Carolina, outside our twelve, repealed its 72-hour rule in 2021.
A practice with offices in more than one state, like the one in Chapter 13 with offices in Maryland and Virginia, has to meet each state's rule separately. The simplest way is a separate offer ad group and landing page for each state, each set to that state's locations, so a patient in one state never lands on the other state's terms.
The practical takeaway works almost everywhere: name exactly what the offer includes, say whether X-rays or other services are extra, and state the regular price.
A 90-Character Google Ad Can't Hold Florida's Statement, So the Landing Page Has To
Chapter 8 covered the format: up to 15 headlines of 30 characters and 4 descriptions of 90. Florida's statement alone runs to several hundred characters. It won't fit in a Search ad.
Our reading, and it's a question for your attorney rather than a settled answer: put every required disclosure, in full, on the landing page the offer ad points to, close to the offer itself, and use the ad's limited space for what the rules care about most. In practice, that means:
- In the ad: the offer and what it includes, in plain words. "Exam, X-Ray Review, Adjustment" tells a nervous first-timer far more than a generic special or intro label does.
- On the landing page: the full offer, the regular fee, what's not included, and any statement your state requires, in the format it requires.
- At the front desk: the signed form, where your state asks for one.
Whether a landing page satisfies a rule that says "in any advertisement" isn't something we found an answer to. Ask before you launch, not after. New York requires keeping a copy of each ad for a year; keeping the landing page too is our suggestion, and an easy habit everywhere.
A Free Offer Aimed at Medicare Patients Runs Into Federal Inducement Rules
Medicare adds a federal layer. Federal rules treat "transfers of items or services for free or for other than fair market value" to Medicare and Medicaid patients as a form of remuneration, and the exception for waiving copays and deductibles is lost once the waiver is advertised. An older federal fraud alert also lists ads promising Medicare patients no out-of-pocket cost among suspect marketing practices, and a 2016 federal policy treats gifts to Medicare patients of up to $15 per item and $75 a year as nominal value.
Chapter 3 covered what Medicare pays a chiropractor for: the adjustment, and not the exam. Our reading is that the cautious route for a practice that sees Medicare patients is to make clear the free or discounted offer doesn't apply to Medicare or Medicaid patients, the way at least one national chain's offer page does by noting the offer may vary for Medicare-eligible patients. This is exactly the kind of question to run past a health care attorney.
Chains Put a Price in Half Their Ads. Local Chiropractors Put a Price in 8 of 116.
When we read the Google ads running in our example market, Baltimore, the chains and the local practices made different choices. Twenty-one of 43 ads from three national chains named a price, usually a $29 or $49 first visit, at all three chains. Eight of 116 ads from local practices did, and those came from just two practices. Four of the twelve local sites we read listed a price on the site, and five offered a free consultation.
Neither approach is wrong. A practice that decides to put an offer in its ads can make the offer do more work:
- Lead with what the visit includes, not only the number. Ohio, Arizona and Texas require that anyway.
- Give it its own ad group with its own landing page, so the offer and its disclosures live in one place.
- Keep the offer in the ad you wrote. Chapter 13 showed that AI Max can write prices into ads; a messaging restriction tells it to avoid prices you didn't write; check its ads anyway.
- Write headlines that state the offer plainly. For example, "Exam and Adjustment, $49" or "Free First Visit Consultation" (each under Chapter 8's 30-character limit), paired with a description that names what's included and points to the page with the full terms.
- Track it like everything else. Judge the offer ad group by kept first visits (Chapter 1), and by how many of those patients return for a second visit.
Arizona Disciplines a Chiropractor Who Bills More Than the Advertised Price
The last check happens after the visit. Arizona's rules list "billing or charging a patient or third-party payor a higher price than the advertised price" as grounds for discipline. Florida's rule about advertising a fee different from what's billed to insurers points the same way.
Chapter 4 made the case for matching the ad to the page: every promise in the ad should appear, in the same words, on the landing page. With an offer, the match runs one step further, to the bill. If the ad said "$49 exam and adjustment," the landing page should say the same, and the first statement the patient receives should show it too. When those three agree, the offer does its job. When they don't, a patient notices, and so might the state.
Before an offer goes live, run it past the front desk and whoever handles billing:
- Does the visit include exactly what the ad and page say?
- Is the regular fee written down, and does it match what's billed to insurers?
- Does the front desk know what to say, and what to have signed, when an offer patient checks in?
If you'd like help building an offer ad group that matches your page and your state's rules, our Google Ads agency team does this with the practices we work with, alongside their own attorneys.
Next: Physical Therapy Ads Promise "No Referral Needed." None of the Chiropractic Ads We Read Say It
The last chapter looks at the competitors many chiropractors don't think of as competitors: physical therapy and orthopedic practices bidding on the same back and neck searches. The earlier chapters, from auto-injury patients back to tracking, are on the Google Ads for Chiropractors guide home.
