Ask a multi-specialty practice what a new patient is worth and you usually get one number. It's the wrong answer, and not because the math is sloppy. It's wrong because the question has at least five answers under one roof. A primary care patient, a therapy client, a knee surgery candidate and a LASIK consult all walk through the same front door, and Google Ads will happily charge all of them to one credit card.
This chapter prices each one separately. It uses Medicare's published rates as the floor, cash prices where they exist, and the practice's own numbers for everything that only the practice can know.
Medicare Pays About $118 for a New Patient's First Visit. That's a Starting Point, Not the Value.
Start with the one price list every practice can see. The Centers for Medicare & Medicaid Services (CMS) publishes the 2026 Physician Fee Schedule, and its national amounts for an office visit look like this:
- New patient, low complexity (99203): $117.57
- New patient, moderate complexity (99204): $177.36
- Established patient, low complexity (99213): $95.19
- Established patient, moderate complexity (99214): $135.61
Those are Medicare's national allowed amounts before geographic adjustment, and Medicare generally pays 80% with the patient paying the rest. Commercial insurers pay their own rates, and no single public source lists them. Your contracts are the real numbers, so use them. The Medicare figures are useful because they're public. Treat them as a reference point for pricing a first visit, never as the whole story.
A new patient is worth the first visit plus every visit, test and procedure that follows. For some specialties that's a checkup a year for a decade. For others it's one surgery. The first visit is the doorway. The value is the house behind it.
A Click Price Means Nothing Until You Follow It All the Way to a Patient
The method this guide teaches prices a click by walking it forward, one link at a time:
- Cost per click: the price Google bills each time the ad gets tapped.
- Booking rate: the share of clicks that book, request an appointment or make a qualifying call.
- Cost per booking: the click price divided by that booking rate.
- Show and close rate: the share of bookings that become patients.
- Cost per new patient: the booking cost divided by the show-and-close share.
- Value: what the patient is worth over the time they stay.
Links one through three come from the account once it's running. Link four lives at your front desk, and no benchmark can give it to you. A request that waits until tomorrow for a callback may already have been booked somewhere else, and the patients in our example market notice slow phones: the 824 reviews we read held 64 complaints about phones alone. A faster front desk lowers your cost per patient without touching a single bid.
The Cheapest Lead in Healthcare and the Most Expensive Are Both on One Practice's Menu
Here's what that chain looks like with real inputs. LocaliQ, an ad-management vendor, publishes average Google Ads results by healthcare specialty from its own clients' campaigns. It doesn't publish its date range or method, and it counts any call, form, chat or email as a lead, so treat these as vendor averages, not targets:
- Dermatology: $18.54 per lead.
- Physical therapy: $32.79 per lead.
- General practice and family medicine: $62.80 per lead.
- Mental health: $141.17 per lead.
The most expensive lead on that list costs more than seven times the cheapest. Now set each against what a patient pays. A physical therapy evaluation pays $97.86 under Medicare, before a single treatment visit. A 60-minute psychotherapy session pays $167.00. A total knee replacement pays the surgeon $1,159.35, and Medicare.gov puts the total cost of the procedure at $10,552 in a surgery center and $14,275 in a hospital outpatient department.
Walk one through as an illustration. If half of physical therapy leads become patients, each new patient costs about $66 in ad spend against a $97.86 evaluation, and the treatment visits that follow are revenue on top. For mental health, the same "half" assumption puts a new client at about $282, which the first two sessions cover. The half is a placeholder. Replace it with your own close rate, and the math becomes yours.
Cash-Pay Lines Put the Whole Price on the Table Up Front
Some service lines skip insurance entirely, and their math is simpler because the price is printed:
- Direct primary care: the American Academy of Family Physicians' 2022 survey found monthly fees of $50 to $100 for adults.
- Concierge medicine: one practice in our example market publishes "The all-inclusive monthly fee is $2,333 for an individual."
- LASIK: a surgery center in our example market lists a customary fee of $5,790 for both eyes.
- IVF: the American Society for Reproductive Medicine puts a single cycle at $15,000 to $20,000.
A cash-pay line has no reimbursement to wait for and no contract rate to guess at. That makes it the easiest line to price, and often the one that can afford the highest bids. It also makes it the line most likely to hide a bad month, because one big sale covers a lot of wasted clicks. Price it anyway.
Lifetime Value Comes From Your Own Visit Counts, Not a National Average
Here's the number everyone wants and nobody publishes: how long a patient stays with a practice. We looked for a national figure and didn't find one. The closest data points are narrower. The CDC reports that 77.5% of adults use a doctor's office or health center as their usual source of care. Zocdoc, a booking marketplace, reports from its own platform that 84% of patients who booked a new provider returned to that same provider for their next visit in that specialty.
So build lifetime value from the records you already have, one specialty at a time:
- Average visits per patient per year, from your scheduling system.
- Average payment per visit, from your billing, blended across payers.
- Average years a patient stays, from your own patient history.
- Multiply them, then add a fair allowance for referrals and reviews that a happy patient brings in.
Do it separately for each service line. Primary care's value comes from repetition. Orthopedics' comes from one big procedure. Therapy's comes from a run of sessions. One blended number hides all three.
Google Can Double a Day's Spend but Never the Month's
Once you know what a patient is worth, the budget follows. One Google rule catches a lot of practice owners off guard: "Your actual spend on any given day may exceed your average daily budget by up to 2 times." Google balances it over the month, and it won't charge more than the monthly limit, which it sets at 30.4 times your average daily budget. A $50 daily budget might run $100 on a heavy Monday, yet the month tops out at $1,520.
Set the budget from the patients you need, not the number that feels comfortable. A service line earns Exploration, the broad-match campaign we steer with a target cost per patient, when it reaches roughly 30 bookings in a month. Thirty leads at the vendor averages above would cost about $556 in dermatology, $984 in physical therapy, $1,884 in general practice and $4,235 in mental health. Bookings cost more than leads, so treat those as floors.
A Shared Budget Lets the Cheapest Clicks Starve Your Best Service Line
Put all of those lines into one campaign with one budget and Google does exactly what you'd expect: it spends where clicks are cheapest and conversions come fastest. By the vendor averages above, that's the dermatology side of the house. The therapy line and the surgical line, which cost more per lead and pay more per patient, get whatever is left, which is often nothing.
Split the lines apart: a campaign, a budget and a target for each. It's more to manage, and it's the only way each line gets priced on its own math. Chapter 7 sets bids line by line, and Chapter 14 lays out the whole multi-specialty account.
Our specialty guides price a patient in their own field. The dermatology guide covers pricing a dermatology click by the patient's whole year. The optometry guide covers why the optical shop, not the exam fee, sets what an eye exam click is worth. The plastic surgery guide covers how the consult-to-surgery rate decides what a click is worth.
Next: The Page Behind the Ad Changes What the Click Costs
With a price on every patient, the next question is how much of each click you actually pay. Google weighs the ad and the page it lands on, not just the bid. Chapter 4 shows why each service needs its own ad group and its own page.
Start from the beginning with Chapter 1 on tracking bookings without leaking symptoms and Chapter 2 on buying the ready patient first, or see every chapter on the guide home for Google Ads for Healthcare. When a practice hires us for Google Ads management, pricing each service line is part of the first month's work, before the budget gets set.
