Drug Rehab PPC Management: The Complete Guide for Treatment Centers
You’re spending $15,000, $30,000, maybe $80,000 per month on pay-per-click advertising for your treatment center. Your agency sends reports full of graphs and metrics. But you can’t answer the one question that actually matters: How many admissions came from that spend?
You’re not alone. We’ve audited scores of treatment center PPC accounts in the last three years, and 85% were wasting at least 40% of their budget on preventable mistakes.
This guide covers everything you need to know about PPC management for drug rehab and addiction treatment facilities. You’ll learn what normal performance looks like, how to spot waste, why healthcare PPC is fundamentally different from other industries, and how to get actual ROI from your ad spend.
What you’ll learn:
- Why drug rehab PPC is different from general PPC (and why that matters)
- Google Ads, Meta, LinkedIn, and other platforms for treatment centers
- Compliance challenges: LegitScript, HIPAA, and platform bans
- Real cost benchmarks and ROI expectations
- Common mistakes that waste $2,000-$15,000 monthly
- How to evaluate PPC management services
- When to audit, when to switch, when to bring it in-house
Quick Navigation:
- Why Drug Rehab PPC Is Different
- PPC Platforms for Treatment Centers
- Compliance: The Game Changer
- Budget and ROI Benchmarks
- Common Mistakes
- Choosing PPC Management
- FAQ
[Get Your PPC Audit]
Introduction
Why PPC Matters for Treatment Centers
Pay-per-click advertising remains one of the fastest ways to generate qualified leads for addiction treatment facilities. Unlike SEO, which often takes 6-12 months to gain traction, properly configured PPC campaigns can generate calls and form submissions within days.
But here’s the problem:
Most marketing agencies approach drug rehab PPC the same way they handle lawyers, plumbers, or others.
They likely don’t understand:
- HIPAA compliance requirements for patient data
- Healthcare-specific advertising restrictions on major platforms
- Why “drug test near me” will never become a patient admission
- The unique patient journey from awareness to admission
We have also seen other agencies who claim to be healthcare or addiction treatment specialty web agencies completely fail for hipaa, ada, and ftc compliance. Would you bet $150k and then put your website into our free audit checker?
This creates massive waste. We routinely find facilities spending $50,000+ annually on clicks that will never convert to patients.
What Makes This Guide Different
We’ve worked with addiction treatment, healthcare and behavioral health facilities since 2004. We’re not a general marketing agency that “also does healthcare.”
This guide is based on:
- PPC account audits conducted 2021-2025
- Management of over $6 million in annual ad spend for treatment centers
- Direct experience with platform policy violations and compliance issues
- Real performance data from residential, IOP, outpatient, and detox facilities
You won’t find generic advice like “write better ad copy” or “improve your quality score.” You’ll get specific strategies that work for addiction treatment facilities, backed by actual data.
Why Drug Rehab PPC Is Different From General PPC
Some marketing agencies work across electricians, lawyers, plumbers, and treatment centers. They understand PPC mechanics. What they don’t understand: healthcare advertising is a completely different game.
The Compliance Maze
Every platform has specific healthcare restrictions:
Google Ads:
- Requires LegitScript certification for addiction treatment ads
- Bans certain addiction-related terms in ad copy
- Can suspend ads, or entire accounts without warning for policy violations
Meta (Facebook/Instagram):
- Restricts addiction treatment advertising
- Before/after imagery prohibited
- Testimonials heavily restricted
- Regular policy changes with little notice [CITE: Meta Special Ad Categories policy]
- Often Bans Ad Accounts and Deletes Company Pages
Your general marketing agency doesn’t deal with these restrictions for their other clients. They learn the hard way when your account gets banned.
The Patient Privacy Factor
HIPAA compliance affects everything in PPC:
You cannot use Google Analytics. Standard Google Analytics violates HIPAA because it shares patient data with Google. [CITE: HHS guidance on HIPAA and tracking technologies] You need HIPAA-compliant analytics solutions that cost more and require technical expertise to implement correctly.
You cannot track conversions normally. Standard conversion tracking often violates patient privacy. You need careful implementation that doesn’t expose protected health information.
Landing pages must be compliant. Every form, every tracking pixel, every third-party script must meet HIPAA standards. One non-compliant element can expose you to violations.
Data storage matters. Where patient information is stored, who has access, and how it’s secured all affect your legal liability.
Most PPC agencies have zero HIPAA expertise. They’ll set up tracking that works technically but violates healthcare privacy laws.
The Intent Problem
This is where agencies waste the most money:
Someone searching “drug test near me” is NOT looking for treatment. They’re looking for employment screening, legal compliance, or probation requirements. A click costs you $50-$200. That person will never become a patient.
Someone searching “how to pass a drug test” is actively trying to avoid detection. Also not a patient. Also costs $50-$200 per click.
Someone searching “inpatient drug rehab near me” with a qualifier like “covered by Aetna” or “accepts medicaid” is a real potential patient.
The difference between understanding addiction treatment search intent and not understanding it is $4,000+ per month in wasted spend.
General PPC agencies don’t know this. They see “drug test” and think “addiction-related keyword, must be good.”
The Urgency Factor
Addiction treatment is a crisis industry. This affects everything:
Ad scheduling matters more. Running ads at 3am wastes money unless you have 24/7 admissions support.
Response time is critical. A lead that comes in at 2pm needs a call by 2:15pm. Wait until tomorrow and they’ve called three other facilities.
Seasonal patterns exist. January has higher search volume (New Year’s resolutions). November/December drop significantly (holidays). Summer shows different patterns than winter.
Your agency needs to understand these patterns specific to addiction treatment.
PPC Platforms for Treatment Centers
Each platform serves different purposes for treatment centers. Most facilities need a multi-platform approach, but the emphasis varies based on your programs and target market.
Google Ads: The Foundation
Why Google Ads works:
- High intent searches (“inpatient drug rehab near me”)
- People actively looking for help right now
- Geographic targeting capabilities
- Detailed keyword control
Why Google Ads is challenging:
LegitScript Certification Required: You must maintain active LegitScript certification to advertise addiction treatment services on Google. facilities with 9 or few locations is $1,595 application fee and $3095 per year per location [CITE: LegitScript pricing as of 2025] Without it, your ads don’t run.
Ad Bans and Account Bans Are Common: Google’s automated systems frequently flag addiction-related ads for policy violations even when they comply with policies. Your account can be suspended with little warning. Getting it reinstated requires:
- Manual review requests
- Sometimes weeks of back-and-forth with Google support
Ad Copy Restrictions: You cannot:
- Use certain addiction-related terms that Google considers “negative”
- Mention competitor names (violates LegitScript rules too)
- Make outcome promises or guarantees
- Use certain before/after language
- Include some testimonial formats
These restrictions mean your ad copy options are limited compared to other industries.
Moderation Delays: Even compliant ads may get flagged for manual review. This can take:
- 24-48 hours for initial review
- 3-5 business days for appeals
- 1-2 weeks for complex issues
During moderation, your ads don’t run. You’re paying your agency but getting zero impressions.
does the word fentanyl appear on the landing page for the ad? (your website) – oh boy, let’s talk about that. (See our videos section for more, search landing page)
Google’s Ad Systems Will Trick You / Other Professionals
Googles ads ecosystem, from the ads dashboard recommendations to the emails they send and even live help use tricky language to convince you to use things that may burn your money or create compliance issues.
We have a ‘watch anytime webinar’ if you are qualified, sign up to learn more about these things. The proof, our experience, it’s easy to go down these roads and just think it’s google, they couldn’t lie or cheat right?
It’s easy to click all the recommendations from google and think that increasing by X many clicks does X times the benefits – and not understand what is really happening with things like performance max, broad keyword match (and what kind of clicks it brings that you pay for), the nag bar across the top telling you to accept the call tracking terms, you need the screen space and don’t think the fine print puts you into a Hipaa situation – but it does, and helps indemnify them.
Ask us for a ppc audit that includes the gotchas.
Meta Ads (Facebook/Instagram): The Challenge
Meta advertising for addiction treatment is possible but heavily restricted.
What works on Meta:
- Awareness campaigns targeting family members
- Educational content about addiction
- Community support messaging
- Professional/alumni networking for aftercare
What doesn’t work:
- Before/after imagery
- Outcome-based testimonials
- Health condition targeting
The Ban Problem:
Meta’s automated systems frequently suspend addiction treatment ad accounts, personal and company pages.
Common triggers:
- Imagery that implies health conditions
- Copy mentioning specific substances
- Testimonials about recovery outcomes
- Landing pages with compliance-required disclaimers that Meta interprets as problematic
When your account gets banned:
- Appeals take 2-4 weeks minimum
- You lose all campaign history and optimization data
- You may need to create entirely new ad accounts
- There’s no guarantee of reinstatement
[CITE: Meta healthcare advertising restrictions, 2024-2025]
Realistic Meta Performance:
- Cost per click: $3-$12 (much lower than Google)
- Cost per lead: $80-$250
- Lead quality: Generally lower intent than search
- Best use: Supporting search campaigns, building awareness
Our recommendation: Allocate 10-15% of total PPC budget to Meta if:
- You have 24/7 admissions support
- You’re targeting family members (not just patients)
- You have strong follow-up processes for lower-intent leads
- You understand you’re playing compliance roulette
Don’t rely on Meta as your primary patient acquisition channel.
Microsoft Ads (Bing): The Underutilized Opportunity
Microsoft Ads (formerly Bing Ads) is often overlooked but can deliver strong ROI.
Why it works:
- 15-25% lower cost per click than Google
- Less competition from other facilities
- Older demographic (often decision-makers/family members)
- Similar certification requirements to Google (more stable than Meta)
The limitations:
- Lower search volume (approximately 15-20% of Google’s volume)
- Fewer targeting options
- Less sophisticated campaign management tools
- Slower data accumulation for optimization
Realistic performance:
- Cost per click: $12-$60 (vs $15-$75 on Google)
- Cost per admission: $2,500-$7,000
- Volume: Expect 15-25% of Google campaign volume
- *These numbers may not be typical in your market and certainly not for all keyword phrases you consider bidding on
Our recommendation: Once Google campaigns are profitable, allocate 10-15% of search budget to Microsoft. The lower competition often means better ROI, but limited volume means you can’t scale indefinitely.
LinkedIn Ads: Professional Referral Development
LinkedIn works differently for treatment centers. You can reach people who need your services, but you’ll reach many more people becuase it’s in feed ads, not per keyword phrase where you can target intent. It’s great for also building professional referral networks.
What works on LinkedIn:
- Targeting interventionists
- Reaching therapists and counselors
- Connecting with HR professionals
- Building relationships with EAP coordinators
- Executive/professional program awareness
Realistic costs:
- Cost per click: $8-$25
- Best for: High-end executive programs, professional networking
- Not for: Direct admission generation (mostly)
Budget allocation: 5-10% of total PPC budget, only if you have:
- Executive or professional-focused programs
- Strong referral development strategy
- Dedicated follow-up for professional contacts
YouTube: Emerging Opportunity
Video pre-roll advertising on YouTube is an emerging channel for treatment centers.
Advantages:
- Lower cost per view ($0.10-$0.50)
- Storytelling capability
- Less restrictive than Meta for video content
- Good for awareness and education
Challenges:
- Longer path to conversion
- Attribution complexity
- Video production requirements
- Still subject to healthcare advertising policies
Budget allocation: 5% for testing if you have video assets. This is supplemental, not primary.
Platform Priority Recommendations
For most treatment centers:
- Google Ads: 60-70% of budget – Highest intent, most admissions
- Microsoft Ads: 15-20% of budget – Lower cost, good ROI supplement
- Meta: 10-15% of budget – Awareness, family targeting (with caution)
- LinkedIn: 5% of budget – Professional programs only
- YouTube: 5% for testing – If you have video content
Don’t spread budget equally. Prioritize where you see actual admissions, not just leads.
Compliance: The Game Changer
Compliance isn’t optional in healthcare PPC. Violations create legal liability, platform bans, and wasted ad spend and time.
LegitScript Certification
What it is: Third-party certification that verifies your facility meets operational and advertising standards.
Why you need it: Required for Google Ads addiction treatment advertising in most states.
Cost breakdown (2025):
- Application fee: $1,595
- Annual certification: $3,095 per location (for facilities with 9 or fewer locations)
- Multi-location pricing varies
Timeline: 4-6 weeks for initial certification (?)
Common rejection reasons:
- Unlicensed staff listed on website
- Misleading outcome claims
- Lack of proper state licensure documentation
- Non-compliant privacy policies
[CITE: LegitScript certification requirements and pricing]
What happens without it: Your Google Ads don’t run. Period. There’s no workaround.
HIPAA Compliance in PPC
HIPAA affects every aspect of digital advertising for treatment centers.
The tracking technology problem:
In December 2022, HHS issued guidance clarifying that website tracking technologies (analytics, pixels, etc.) can violate HIPAA when they transmit protected health information to third parties. [CITE: HHS HIPAA tracking technology guidance]
What this means:
- Standard Google Analytics: HIPAA violation
- Facebook Pixel on intake forms: HIPAA violation
- Standard conversion tracking: Often HIPAA violation
- Remarketing to website visitors: Probable Hipaa Violation, Definite Platform Violation
Compliant alternatives:
- HIPAA-compliant analytics (Matomo, Piwik PRO, WP-Analytics, Others if Configured Properly, not Google analytics)
- Server-side tracking implementations
Cost impact: HIPAA-compliant tracking solutions cost $500-$2,000+ monthly vs $0 for standard Google Analytics.
Most PPC agencies don’t know this. They’ll set up standard tracking that exposes you to violations.
Platform Policy Compliance
Each platform has specific healthcare advertising policies that change frequently.
Google Ads policies:
- Cannot mention competitor names
- Restricted use of addiction-related terms
- No outcome guarantees
- Landing pages must meet quality standards
- Must disclose if you’re a referral service (not direct treatment)
Meta policies:
- Cannot target by health conditions
- Cannot use before/after imagery
- Cannot make outcome claims
- Cannot use certain testimonial formats
- Regular policy changes often without notice
Common violation patterns we see:
- Ad copy that worked last month now triggers bans
- Landing pages with compliant disclaimers that platforms interpret as problematic
- Imagery showing people in distress (triggering health condition policies)
- Comparison language (even factual comparisons can trigger bans)
How to handle violations:
- Submit manual review requests immediately
- Document policy interpretation questions
- Have backup campaigns ready for when primary accounts get flagged
- Work with agencies that have healthcare advertising experience
The Compliance Paradox
Here’s the challenge: The disclaimers and transparency required by healthcare regulations sometimes trigger platform advertising policy violations.
Example: Your state requires you to disclose success rates. Meta interprets success rate disclosure as an outcome guarantee and bans your ad.
Solution: Platform-specific landing pages that meet both legal requirements and platform policies. This requires technical expertise and healthcare advertising knowledge most general agencies don’t have.
Budget and ROI Benchmarks
Let’s talk real numbers based on actual treatment center PPC performance data.
Minimum Effective Budget
The hard truth: You need minimum $15,000-$20,000 monthly in ad spend to run effective PPC for addiction treatment. (certain non-MAT IOP or coaching that’s not competing directly with 30 day inpatient facilities may have some success with smaller starting campaigns)
Why?
- Competitive keywords cost $20-$75 per click
- You need volume to gather meaningful data
- Multiple campaigns required (substance-specific, geographic, etc.)
- Platform learning periods require sustained spend
Total monthly investment:
- Ad spend: $15,000-$20,000
- Management fee: $2,500-$4,000 (typically 15-20% of spend)
- Tools/tracking: $500-$1,000
- Total: $18,000-$25,000 minimum
Below this, you’re not gathering enough data to optimize effectively.
Cost Benchmarks by Metric
Cost per click:
- Google Search: $15-$75 (competitive markets: $100-$200+)
- Microsoft Ads: $12-$60
- Meta: $3-$12
- LinkedIn: $8-$25
Cost per lead (call or form submission):
- Google Search: $150-$400
- Microsoft Ads: $120-$350
- Meta: $80-$250
- Overall blended: $150-$350
Cost per qualified lead:
- Google Search: $200-$500
- Microsoft Ads: $180-$450
- Meta: $150-$400
(Qualified = expressed interest in admission, not just information gathering)
Cost per admission:
- Industry average: $3,000-$8,000
- Optimized campaigns: $2,500-$6,000
- Struggling campaigns: $8,000-$15,000+
If you’re consistently over $12,000 per admission, something is fundamentally broken.
ROI Expectations
Realistic first-year performance:
Month 1-2: Setup, compliance verification, learning period
- Expect higher costs per admission ($6,000-$10,000+)
- Limited data for optimization
- Platform learning algorithms active
Month 3-4: Optimization phase
- Cost per admission should decrease 20+%
- Pattern identification begins
- Negative keyword refinement
Month 5-6: Stabilization
- Cost per admission should be near benchmark range
- Consistent admission flow
- Clear ROI calculation possible
Long-term steady state:
- Cost per admission: $3,000-$8,000
- Admission rate from leads: 15-25%
- Monthly admissions (at $20k spend): 3-7 patients
Calculate your ROI:
Average patient lifetime value (LTV) for 30-day program:
- Insurance reimbursement: $15,000-$40,000
- Private pay: $20,000-$60,000
Acquisition cost: $3,000-$8,000
Basic ROI: (LTV – acquisition cost) / acquisition cost × 100
Example: ($25,000 – $5,000) / $5,000 = 400% ROI
Market-Specific Variations
Costs vary significantly by market:
High competition markets (Southern California, South Florida, Arizona):
- CPC: $50-$200+
- Cost per admission: $5,000-$12,000+
- Requires larger budgets for meaningful results
Medium competition markets (Texas, Colorado, Ohio):
- CPC: $20-$75
- Cost per admission: $3,000-$8,000
- Standard budgets effective
Lower competition markets (Rural areas, smaller metro regions):
- CPC: $15-$50
- Cost per admission: $2,000-$6,000
- Smaller budgets can be effective
Your agency should know your market’s competitive landscape.
Budget Scaling
What happens when you increase budget:
Doubling budget doesn’t double admissions. Here’s why:
- First $20k captures highest-intent searches
- Next $20k captures medium-intent searches
- Additional spend enters lower-intent territory
Scaling efficiency:
- $20k/month: Efficient, good ROI
- $40k/month: Slight efficiency decrease, but more volume
- $60k+/month: Diminishing returns unless multi-location or multi-program
Don’t scale budget until current campaigns are optimized.
Common Mistakes That Waste Money
These are the problems we find in almost every treatment center PPC audit.
Mistake #1: The Drug Testing Keyword Disaster
The problem: Agencies bid on broad addiction-related keywords without understanding search intent.
Keywords that waste money:
- “drug test near me” – Employment screening
- “how to pass a drug test” – Avoiding detection
- “drug testing kits” – Product searches
- “court ordered drug testing” – Legal compliance
- “hair follicle drug test” – Screening services
- “drug test walmart” – Retail product search
Cost of this mistake: $2,000-$5,000 monthly in wasted clicks
Why agencies do it: They see high search volume and addiction-related terms. They don’t understand these searchers will never become patients.
How to fix it: Extensive negative keyword lists (200-500+ terms) and careful match type management.
Mistake #2: 24/7 Ad Scheduling Without Support
The problem: Running ads at 3am when nobody answers the phone.
The data: Conversion rates drop 60-80% outside business hours for facilities without 24/7 admissions support.
Cost of this mistake: $1,500-$3,000 monthly in wasted ad spend
Why agencies do it: Default Google Ads setting is 24/7. They never adjust it.
How to fix it:
- Ad scheduling aligned with admissions availability
- Bid adjustments by time of day
- If you don’t have 24/7 support, don’t pay for 3am clicks
Mistake #3: Inadequate Negative Keywords
The problem: Letting Google’s broad match show ads for irrelevant searches.
What we find in audits:
- Accounts with 10-20 negative keywords (should have 200-500+)
- Ads showing for job searches (“rehab jobs near me”)
- Ads showing for volunteer opportunities
- Ads showing for research purposes (“rehab statistics”)
- Ads showing for other states/countries
Cost of this mistake: $2,000-$6,000 monthly
How to spot it: Review search term report. If you see terms that make you go “why are we showing ads for THAT?” – you have a negative keyword problem.
Mistake #4: Generic Landing Pages
The problem: Sending all traffic to the homepage.
Why it matters: Someone searching for “alcohol detox” who clicks an alcohol detox ad expects an alcohol detox landing page—not a homepage about all your services.
Conversion impact: Generic landing pages convert 40-60% worse than substance-specific pages.
Cost of this mistake: Not wasted spend, but wasted opportunity. You’re getting clicks but losing conversions.
How to fix it: Substance-specific landing pages (alcohol, opioids, cocaine, etc.) with matching ad copy.
Mistake #5: Ignoring Microsoft Ads
The problem: Only running Google Ads.
The opportunity cost: Microsoft Ads typically delivers 15-20% of Google’s volume at 15-25% lower CPC.
Why agencies skip it: Lazier to manage one platform than two.
Cost of this mistake: Missing potential admissions at better economics.
Mistake #6: No Call Tracking or Poor Attribution
The problem: Can’t connect ad clicks to actual admissions.
What we see: Agencies reporting on “form submissions” and “website visitors” but can’t tell you cost per admission.
Why it matters: You can’t optimize what you can’t measure. If your agency can’t tell you which campaigns generate admissions, they’re flying blind.
How to fix it:
- HIPAA-compliant call tracking
- CRM integration
- Admission tracking by original source
- Monthly reporting on actual cost per admission
Mistake #7: Set-It-And-Forget-It Management
The problem: Agencies set up campaigns, then do minimal ongoing optimization.
What proper management looks like:
- Weekly search term review
- Bi-weekly bid adjustments
- Monthly negative keyword additions
- Quarterly campaign structure review
- Regular ad copy testing
What we often find:
- Campaigns untouched for months
- Same ad copy running for a year
- Negative keywords never expanded
Cost of this mistake: 20-40% higher cost per admission than actively managed campaigns
Mistake #8: Relying Too Heavily on Broad Match
The problem: Using broad match keywords without extensive negative keywords.
How broad match works: Google shows your ad for “related” searches it determines relevant.
The reality: Google’s definition of “related” is very loose, especially for healthcare.
Example:
- Your keyword: “drug rehab”
- Google shows ads for: “drug testing,” “drug education,” “drug statistics,” “rehab jobs,” etc.
Why agencies use it: Easier than building comprehensive exact and phrase match campaigns.
Cost of this mistake: $3,000-$7,000 monthly in irrelevant clicks
Mistake #9: Not Adjusting for Mobile Performance
The problem: Mobile ads cost the same as desktop but often convert worse.
The data: Mobile conversion rates can be lower than desktop for treatment center calls.
Why? People research on mobile, but often call from desktop or wait until they’re in a private setting. Landing pages for ads to mobile are not optimized for the situation.
How to fix it:
- Mobile-optimized landing pages
- Click-to-call functionality
- SMS text option
- Short form to get / share more info
- Form to start VOB for insurance benefits
- Checkbox for text me, email me, do not call me, etc.
Mistake #10: Competitor Name Bidding
The problem: Agencies bid on competitor facility names.
Why it’s a problem:
- Violates LegitScript policies (can lose certification)
- Often violates trademark law
- Creates retaliatory bidding wars
- Wastes budget on low-converting traffic
We’ve seen: Facilities spending $5,000+ monthly on competitor names that generate zero admissions and risk LegitScript violations.
How to fix it: Don’t do it.
Choosing PPC Management Services
Not all PPC agencies are qualified to manage addiction treatment advertising efficiently or keeping you complaint. Here’s how to evaluate options.
Required Qualifications
Healthcare Specialization:
A generalist marketing agency will waste your money. They need specific experience with:
- Addiction treatment marketing (not just general healthcare)
- HIPAA compliance requirements
- Platform healthcare advertising policies
- LegitScript certification processes
Verification questions:
- What’s your experience with LegitScript violations?
- How do you handle HIPAA-compliant tracking?
- Can you show me a sample search term report with your negative keyword strategy?
If they can’t answer these specifically, they’ll learn on your dime.
USA-Based Operations
Why this matters: HIPAA requires Business Associate Agreements with anyone handling protected health information.
Offshore contractors create compliance risks:
- No legal recourse for HIPAA violations
- Language barriers in understanding healthcare regulations
- Time zone challenges for urgent issues
- Difficulty verifying actual HIPAA expertise
Verification:
- Where is your team located?
- How many non-USA contractors or employees (what functions do they handle?)
- Can I speak directly with the person managing my account?
Contract Terms
Red flags:
- Long-term contracts (12+ months)
- Termination penalties
- Transfer fees for moving to another agency
- “You don’t own the account/campaigns” language
Green flags:
- Month-to-month or quarterly contracts
- 30-45 day termination notice
- You own all accounts, campaigns, and data from day one
- Clear handoff process if you leave
Why this matters: Agencies that deliver results don’t need to trap clients in contracts. If they’re insisting on long-term commitments, it’s because they know clients would leave after seeing poor performance.
Transparent Reporting
Minimum reporting requirements:
- Cost per admission (not just cost per click or cost per lead)
- Search term reports showing what triggered ads
- Platform-specific performance breakdown
- Budget utilization and waste identification
Red flags:
- Won’t show search term reports (“proprietary process”)
- Reports only show website visits, not admissions
- Can’t connect ad spend to actual ROI
- Defensive when asked for more detail
Ask during evaluation: “Can you show me an example monthly report for another client?” (Names redacted, obviously.)
Pricing Models
Typical structures:
Percentage of spend: 15-25% of ad budget
- Pros: Agency incentivized to increase budget (can be good or bad)
- Cons: Potential for budget inflation
- Best for: Larger budgets ($30k+/month)
Flat monthly fee: $2,500-$6,000/month
- Pros: Predictable cost, less incentive to inflate spend
- Cons: May cap agency effort
- Best for: Smaller budgets ($10k-$30k/month)
Performance-based: Base fee + bonus for admissions
- Pros: Aligned with your actual goal
- Cons: Requires very accurate tracking
- Best for: Sophisticated operations with solid attribution
Avoid: Setup fees over $2,000, “proprietary software” charges, hidden platform access fees
Questions to Ask Potential Agencies
About their experience:
- What’s the average cost per admission you’re delivering for similar facilities?
- Have any of your clients lost LegitScript certification due to advertising violations?
- How do you handle account suspensions on Meta?
About their process:
- How often do you review and optimize campaigns?
- What’s your negative keyword strategy?
- How do you handle HIPAA-compliant conversion tracking?
- Walk me through your monthly reporting process.
About transparency:
- Will I have direct access to my Google Ads account?
- Can I see everything you see in the account?
- If I leave, what’s the handoff process?
Red flag answers:
- “We can’t share specific numbers due to confidentiality” (they should share ranges)
- “Our process is proprietary” (translation: we don’t want you to see we’re not doing much)
- “You need to commit to 12 months to see results” (not true)
- “We guarantee X admissions per month” (no ethical agency guarantees admissions)
In-House vs Agency
Consider in-house if:
- You’re spending $50,000+/month on PPC
- You have someone with Google Ads certification available
- You can commit 20+ hours weekly to management
- You have HIPAA compliance expertise in-house
Stay with agency if:
- You don’t have dedicated PPC expertise
- Your team doesn’t have time for daily optimization
- You value compliance expertise and staying current with regulations
- You’re spending under $50k/month (cost-effective to outsource)
Hybrid approach: Some larger facilities use agencies for setup and strategy, with in-house team handling day-to-day optimization.
The Wingman Model
For facilities that want oversight without full agency engagement:
What it is: Expert consultant attends your current agency’s meetings, reviews their work, asks tough questions, ensures you’re getting value.
When it works:
- You’re not ready to switch agencies but suspicious of current results
- You want education and oversight
- You need help asking the right questions
Cost: Typically $1,500-$3,000/month vs $4,000-$8,000 for full management
Vetting Checklist
Before signing with any PPC agency:
□ Verified healthcare specialization (not just general marketing)
□ Confirmed USA-based operations
□ Reviewed sample reports
□ Checked contract terms (no long-term lock-in)
□ Verified direct account access
□ Confirmed HIPAA compliance expertise
□ Reviewed their LegitScript experience
□ Understood all fees and costs
□ Established clear performance expectations
Don’t skip these steps to save time. The wrong agency will cost you far more than the time spent in proper vetting.
Related Resources
- Google Ads for Healthcare: Compliance Guide [Internal link: /google-ads-healthcare-compliance/]
- LegitScript Certification: Everything Treatment Centers Need to Know [Internal link: /legitscript-certification-guide/]
- Meta Ads for Healthcare: What Works in 2025 [Internal link: /meta-ads-healthcare/]
- HIPAA-Compliant Marketing Guide [Internal link: /hipaa-compliant-marketing/]
- How to Tell If Your PPC Agency Is Scamming You [Internal link: /ppc-agency-scam-signs/]
Frequently Asked Questions
How much should a treatment center spend on PPC monthly?
Minimum effective budget is $15,000-$20,000 per month in ad spend plus management fees. Below this, you can’t cover enough keywords or get enough data for meaningful optimization. Competitive markets may require $50,000-$150,000+ monthly.
Total investment including management: $18,500-$25,000 minimum, $55,000-$155,000 for competitive positioning in some markets.
What’s a normal cost per admission from PPC?
$3,000-$8,000 per admission is typical for addiction treatment PPC. Factors affecting this:
- Geographic competition levels
- Insurance acceptance (Medicaid/Medicare vs private)
- Program type (detox, residential, outpatient, sober living)
- Average length of stay
- Follow-up speed and sales process
If you’re consistently over $12,000 per admission, something needs fixing. Under $2,000, verify tracking accuracy.
Do I need LegitScript certification?
Yes, if you want to advertise addiction treatment on Google Ads. Without LegitScript certification, your Google Ads literally will not run.
Some facilities try to avoid this by advertising “mental health” services only, but Google’s systems typically detect addiction treatment context and still require certification.
Why do addiction treatment ad accounts get banned so often?
Platform automated systems flag addiction-related content aggressively. Common ban triggers:
- Competitor names in ad copy
- Certain addiction terms flagged as negative
- Before/after imagery
- Restricted testimonial formats
- Landing page compliance issues
Even fully compliant accounts get banned and require manual review to reinstate. This is why having an agency experienced in healthcare advertising matters—they know how to navigate the reinstatement process quickly.
Can I use Google Analytics for my treatment center website?
No. Standard Google Analytics violates HIPAA because it shares patient data with Google without proper safeguards. [CITE: HHS guidance on tracking technologies]
You need HIPAA-compliant analytics solutions like Matomo, Piwik PRO, or Wp-Analytics configured properly and some will require Business Associate Agreements.
What’s the difference between broad match and exact match keywords?
Exact match: Ad shows only for that specific keyword phrase. “Drug rehab near me” triggers only for exact searches of “drug rehab near me.” (and sometimes terms very close to that – Google doing what ‘they think is best’ sigh.)
Phrase match: Ad shows for searches that include the phrase. “Drug rehab” could trigger for “inpatient drug rehab,” “outpatient drug rehab,” “drug rehab cost.”
Broad match: Ad shows for related searches Google determines relevant. “Drug rehab” could trigger for “addiction treatment,” “substance abuse help,” “drug test near me,” “rehab jobs,” etc.
For addiction treatment, heavy reliance on broad match without extensive negative keywords wastes money. Phrase and exact match give better control.
Should treatment centers use Performance Max campaigns?
Performance Max is Google’s automated campaign type that runs across all Google properties.
The problem for healthcare: You give up control over:
- Where ads appear
- What keywords trigger ads
- Ad copy variants
- Audience targeting specifics
This makes compliance harder and waste more likely. Many healthcare PPC experts avoid Performance Max or use it cautiously for some specific reasons beyond typical search to click to admit.
How long until PPC shows results?
Initial setup: 2-4 weeks for proper campaign structure, compliance verification, and LegitScript approval.
First meaningful data: 4-6 weeks to gather enough clicks and conversions to identify optimization opportunities.
Stable performance: 3-4 months to fully optimize campaigns, build conversion history, and establish consistent admission flow.
If your agency says “give it 12 months,” that’s too long. You should see improvement trajectory by month 3-4.
Can we run PPC if we don’t have LegitScript certification yet?
You can run PPC on platforms other than Google while pursuing LegitScript:
- Microsoft Ads (Bing)
- Some Meta advertising (limited)
But you cannot run Google Ads for addiction treatment without active LegitScript certification. Since Google typically provides 60-80% of treatment center PPC results, most facilities need to complete LegitScript before launching serious PPC efforts.
Should we pause PPC when beds are full?
It depends on your waitlist strategy:
Pause when: You don’t maintain waitlists and have no beds for 2+ weeks.
Don’t pause when: You maintain an active waitlist and can admit within 1-2 weeks.
Better approach: Reduce budget temporarily rather than pause completely. Pausing and restarting campaigns loses momentum and historical data value. Restarting a paused campaign can also trigger the standard auto-ban many ads, request manual review, and the delays between all of those stages
How do I know if my current PPC is working?
Ask your agency these questions:
- What’s our cost per admission, by channel?
- How many negative keywords do we have?
- What’s our search impression share?
- Can I see the search term report?
- What percentage of our clicks are from mobile vs desktop?
If they can’t answer these questions immediately with data, your campaigns aren’t being managed properly.
Red flags:
- Reports show “website visits” but not admission
- Negative keyword list has under 50 keywords
- Ads run 24/7 with no schedule adjustments
Can I do PPC myself or do I need an agency?
You can do it yourself if:
- You have 10+ hours per week to dedicate
- You understand Google Ads platform
- You know HIPAA compliance requirements
- You’re comfortable with data analysis
You need an agency if:
- You don’t have time to manage daily
- You want expert optimization
- You need compliance oversight
- You’re spending over $10,000/month (mistakes are expensive)
Warning: General marketing agencies will waste your money. Work with someone who specializes in addiction treatment marketing.
What happens if I stop running PPC?
Immediately: Leads stop (or drop to near zero).
Unlike SEO: PPC has no residual effect. The day you pause campaigns, traffic stops.
Budget planning: PPC should be a consistent line item, not on/off based on census. Stopping and restarting means losing all optimization data and starting over.
There can be delays in reactivating a campaign: as addiction treatment ads are often auto-flagged for violations and you need to go to each ad and ask for multiple manual review.
How many leads should I expect per $10,000 spent?
Conservative estimate:
- Cost per lead: $200-$300
- Expected leads: 33-50 per $10,000
Optimized campaigns:
- Cost per lead: $150-$250
- Expected leads: 40-67 per $10,000
Not all leads turn into admissions
Quality matters more than quantity. 30 qualified leads that result in 6 admissions beat 60 low-quality leads that result in 3 admissions.
Congruence of ads with custom landing pages greatly affects this, as well as your market competition, in-network insurance, etc.
See our custom landing page creation service which could increase conversions by 200%.
What platforms should we prioritize?
For most treatment centers:
- Google Ads: 60-70% of budget – Highest intent, most admissions
- Microsoft Ads: 15-20% of budget – Lower cost, good ROI supplement
- Meta: 10-15% of budget – Awareness, family targeting (with caution)
- LinkedIn: 5% of budget – Professional programs only
Don’t spread budget equally. Prioritize where you see actual admissions, not just leads.
Summary: Key Takeaways
Drug rehab PPC is fundamentally different from general PPC:
- Compliance requirements (LegitScript, HIPAA, platform policies)
- Specialized search intent knowledge required
- Account bans are common even when compliant
- Healthcare-specific tracking challenges
Budget realistically:
- $15,000-$30,000 minimum monthly ad spend
- $2,500-$6,000 monthly management fee
- Cost per admission: $3,000-$8,000 typical
- Total investment: $18,500+ monthly minimum
Common waste sources:
- Drug test keywords: $2,000-$5,000 monthly
- 24/7 scheduling without support: $1,500-$3,000 monthly
- Inadequate negative keywords: $2,000-$6,000 monthly
- Poor landing pages: reducing conversion rates significantly
Choosing management:
- Healthcare specialization required
- USA-based operations for HIPAA compliance
- No long-term contracts
- Transparent reporting on actual admissions
Platform considerations:
- Google Ads: 60-80% of results, requires LegitScript
- Meta: Restricted but viable for certain strategies
- LinkedIn: Good for professional referral development
- Microsoft: Cost-effective supplement to Google
Next Steps
If you’re spending $15,000+ monthly on PPC and don’t know if it’s working: Get an audit. We’ll show you exactly where money is being wasted and how much you could save.
If you’re being told to “give it more time” after 6+ months of poor results: Get a second opinion. Agencies use “SEO takes time” and “PPC needs data” to avoid accountability.
If you’re comparing agencies: Ask the questions in the “Choosing PPC Management” section above. Demand specific answers.
If you want to understand your current agency’s performance: Our Marketing Wingman service reviews their work, sits in on strategy meetings, and provides objective oversight.
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About Treatment Center Agency
We’ve worked with healthcare, addiction treatment, and behavioral health facilities since 2004.
Our entire team is based in the USA. No offshore contractors. No HIPAA risks. No language or time zone barriers.
We’ve audited scores of treatment center PPC accounts. We’ve seen many mistakes, many scams, tons of compliance violations. We know exactly what works and what wastes money in addiction treatment advertising.
You own everything from day one. Leave with 45 days notice. No transfer fees. No hostage situations.
Learn more about our PPC management services or get a an account audit.
Important Disclaimers
We’re marketing experts, not lawyers. This guide provides educational information based on 20+ years working with healthcare and addiction treatment facilities. However:
- This is not legal advice. Consult a qualified healthcare attorney for HIPAA, FTC, and regulatory compliance questions specific to your situation.
- Information changes rapidly. Platform policies, costs, regulations, and best practices evolve constantly. Verify current information before making decisions.
- Your results will vary. Performance benchmarks are based on aggregated data from scores of facilities. Your specific results depend on your market, budget, execution, and many other factors.
- We cite our sources. All statistics and claims include references, but you should verify important information independently.
- Double-check everything. Especially platform policies, legal requirements, and compliance guidance for your specific jurisdiction.
Found an error or have updated information? We want this guide to be accurate and helpful. [Contact us with corrections or suggestions →]
Read our full disclaimers, terms of use, and legal information →
Last updated: Dec 15 2025. Treatment Center Agency specializes in addiction treatment marketing but does not provide legal, financial, or medical advice.
ANNOTATIONS & REFERENCES:
- HHS HIPAA guidance on web tracking technologies (December 2022 / June 2024)
- Google Healthcare and Medicines Advertising Policies
- Meta Advertising Standards Drug and Alcohol Addiction Treatment
- LegitScript pricing and certification for addiction treatment requirements
- Platform market share data: https://www.statista.com/statistics/1202672/digital-ad-revenue-ad-selling-companies-worldwide/ search engines (youtube not included): https://radar.cloudflare.com/reports/search-engine-market-share-2025-q3
- General landing page conversion research