What a new PT evaluation costs to buy, channel by channel

Early June is when a PT clinic’s summer gets settled. July is the thinnest month on most outpatient schedules, as vacations interrupt plans of care, so whatever brings patients in has to be running before then. The question owners ask is the same every year: where should the next marketing dollar go?

For a physical therapy clinic there are three realistic answers: Google search ads, Local Services Ads, and more of the owner’s time spent on physician and surgeon referrals. Each has a cost, and only two of them show it on an invoice.

What a Google search lead costs in physical therapy

The most specific numbers come from LocaliQ’s healthcare search benchmarks, published in December, which cover 3,542 search campaigns run from October 2024 to September 2025. For the category LocaliQ labels Physical Therapy, the medians were:

• Cost per click: $4.95
• Click-through rate: 6.61%
• Conversion rate: 15.35%, behind only Dermatology (25.33%) and Ophthalmology (18.29%) among 16 specialties
• Cost per lead: $32.79, against $66.02 for healthcare as a whole

LocaliQ also noted that the Physical Therapy cost per click fell by about 10% year over year. WordStream by LocaliQ’s 2026 Google Ads benchmarks, published last month for April 2025 to March 2026, have no physical therapy row; their broader Health & Fitness category came in at $6.17 a click, a 6.94% conversion rate and $67.36 a lead.

Physical therapy leads cost about half the healthcare median not because clicks are cheap but because people searching for a therapist usually want an appointment this week. Two cautions: these are medians across many advertisers, so your metro can sit well above them, and they count leads, not evaluations that showed up.

Search ads also give control: your own landing page, negative keywords to keep out job seekers and students looking at PT programs, and call tracking that keeps health details off the ad platform.

Local Services Ads: a calls-only product in health care

Physical therapist is a Local Services Ads category with the Google Verified badge, the single badge Google moved to last October. Google’s requirements include provider and practice checks, liability and malpractice insurance, state licenses where they apply, a verified Google Business Profile and National Provider Identifier verification. Screening averages three to four weeks once documents go in, and health care cannot run pre-badge ads in the meantime.

You pay for each valid lead against a weekly budget. In health care, though, the product is cut down to a phone line:

• No message leads, which Google says usually cost less than phone leads.
• No booking through the ad.
• No call recordings to review afterward.
• No lead credits, so a junk call stays charged.

We have not seen a published Local Services cost per lead for physical therapy that we would build a budget on, and an agency quoting one should be able to name its source. What the format sells is placement, a badge and a call button above the map for “physical therapy near me”. It pays only when a person answers live.

The referral that looks free

Physician referrals cost nothing in media and remain the main door for most clinics. The cost is time: lunches, updates, a plan-of-care letter for every shared patient. For Medicare patients that letter is not optional. Medicare has let patients see a therapist without a physician referral since 2005, APTA notes, but a physician or nonphysician practitioner still has to certify the plan of care.

The case for self-referred patients rests partly on old data. In private insurance claims summarized in APTA’s 2025 direct access report, from a study published in 2011, self-referred episodes cost $347 against $420 for physician-referred ones, across 17,497 self-referred and 45,210 physician-referred episodes. That is the payer’s cost, not your revenue. It is also the argument insurers have listened to: on June 17, 2025, Aetna stopped requiring a referral or a signed plan of care for physical therapy, opening direct access to more than 26 million members, according to APTA.

A self-referred patient is not a lesser patient. Keep the referral relationships, and pay for the evaluations that will never come through them.

Weigh the lead against the plan of care

A $33 lead means little until it is set against what an evaluation turns into. No published source we trust gives a typical visit price, but the payer’s effect is clear:

• Medicare. Medicare.gov says there is no annual limit on medically necessary outpatient therapy; the patient pays 20% of the approved amount after the Part B deductible, $283 this year. CMS requires the KX modifier on claims above $2,480 of PT and speech therapy combined, and claims above $3,000 can be reviewed, so a long plan needs documentation that keeps up.
• Commercial plans. By June many patients on calendar-year plans have paid into their deductible, and by fall some will have met it. HealthCare.gov notes that a plan year need not match the calendar, so the front desk should ask rather than assume.
• Self-pay. CMS says providers usually must give patients who are not using insurance a good faith estimate, and a bill $400 or more above it can be disputed. A plain price page earns its place.

An evaluation that becomes a completed plan of care is worth far more than one that stops after the second visit, which is why follow-up between visits belongs in the same budget conversation as the ads.

The line item nobody budgets: the missed call

CallRail’s January 2025 report found healthcare had the highest missed call rate of the industries it measured, at 32%, close to one call in three. On a search campaign a missed call wastes a click. On a health care Local Services lead it wastes the whole lead, with no recording to learn from and no credit to recover.

When the phone rings, the front desk is usually checking someone in or taking a copay. A second line, an answering service or an AI voice agent that takes a name and a callback time, never symptoms, and hands off to staff is part of the cost of every lead.

What we are telling clients

• Fix phone coverage during treatment hours before paying for any calls.
• Run search ads on injury and “physical therapy near me” searches, judged on evaluations that arrived rather than leads.
• Apply for Local Services Ads now if you want them for the fall: screening averages three to four weeks, with no ads while it runs.
• Put your state’s direct-access rule and the plans you accept on the site and profile, so self-referred callers get past the first question.
• Keep one referral habit going: a short plan-of-care letter for every shared patient, sent within days.
• Track cost per arrived evaluation by source and payer, and revisit the split in August.

Most clinics end up using all three, in order of readiness: the phone first, then search, then Local Services Ads, with referrals running underneath. How we run search and Local Services side by side is on our Google Ads page, and the rest of how we approach the trade is on our page for physical therapy clinics.