I audit Google Ads accounts for med spa owners almost every week. The same mistakes show up in 80% of them. These aren't strategic errors. They're settings errors. Configuration choices that Google makes easy to get wrong because the default options favor Google's revenue, not yours.
Here are the specific settings I fix first, every time, and what a properly configured med spa Google Ads campaign actually looks like.
Broad Match Keywords Are Bleeding Your Budget
Google's default keyword match type is broad match. This means if you bid on "Botox," Google will show your ad to people searching for "Botox side effects," "Botox gone wrong," "Botox at home," and "is Botox safe for my cat." I wish I were exaggerating about that last one.
Broad match was designed for large e-commerce brands spending $100K+ per month who want maximum reach and have the budget to absorb waste. It was not designed for a med spa spending $3K to $5K per month that needs every dollar to generate a qualified lead.
What I switch to: phrase match and exact match only. Phrase match (keyword in quotes) means your ad shows when someone searches for your keyword phrase in order, with words before or after. Exact match (keyword in brackets) means your ad shows only for that specific search or very close variants.
Example: instead of broad match Botox, I run phrase match "Botox near me" and exact match [Botox injections Weehawken]. The search volume is lower. The conversion rate is 3x to 5x higher. You stop paying for clicks from people who were never going to book.
I've seen this single change cut cost-per-lead from $90 to $35 in the first month. Not over time. In the first 30 days.
Your Negative Keywords List Is Empty (or Doesn't Exist)
Negative keywords tell Google which searches should NOT trigger your ads. Without them, you're paying for clicks from job seekers, students, and people researching complications. Your campaign needs a negative keywords list on day one, and it needs to grow every week.
Here's the starter negative keywords list I add to every med spa campaign:
- Job-related: jobs, hiring, salary, career, training, certification, school, course, classes, how to become
- DIY/at-home: at home, DIY, homemade, self, how to do
- Complications: gone wrong, side effects, dangers, risks, lawsuit, death, bad results
- Price shopping: free, cheap, cheapest, discount, coupon, groupon, deal
- Information-only: what is, definition, wiki, wikipedia, reddit, before and after only
- Competitors: (add specific competitor names you don't want to bid on)
That list blocks hundreds of irrelevant clicks per month. At $5 to $15 per click, that's $500 to $2,000 in monthly waste eliminated. Every week, pull your search terms report and add any irrelevant searches that slipped through. This is a 10-minute weekly task that directly protects your budget.
Location Targeting: The Radius Problem
Most med spa Google Ads campaigns target a radius around the practice. Usually 25 to 50 miles. That sounds reasonable until you look at the data. The vast majority of med spa patients drive 15 minutes or less. Outside of that, your conversion rate drops off a cliff.
But the bigger problem is a setting most people never check. Google's default location option is "Presence or interest: People in, regularly in, or who've shown interest in your targeted locations." Read that again. "Shown interest in." That means someone in Miami who once searched for something related to your city can see your ad. You're paying for clicks from people 1,000 miles away.
Change this setting to "Presence: People in or regularly in your targeted locations." This one toggle eliminates out-of-area clicks immediately. I've seen it reduce wasted spend by 15% to 25% in metro-area campaigns.
Then tighten your radius. Start at 10 to 15 miles. Review your conversion data after 30 days. If 90% of your bookings come from within 8 miles, shrink to 8 miles and increase your bids. Concentrate your budget where your patients actually are.
Call Tracking: If You're Not Measuring, You're Guessing
This is the one that makes me want to flip a table. I see practices spending $4,000 per month on Google Ads with no call tracking. They have no idea which keywords generate phone calls. They have no idea which ads produce bookings. They're making spending decisions based on clicks and impressions, which tell you almost nothing about revenue.
Med spa patients book by phone. Yes, some use online booking. But 60% to 70% of new patient leads come through phone calls. If you're not tracking which Google Ads keyword generated which phone call, you're flying blind with your budget.
Minimum setup: Google Ads call extensions plus a call tracking platform (CallRail, WhatConverts, or similar) with dynamic number insertion on your landing pages. This gives you keyword-level call attribution. You'll know that "Botox near me" generated 12 calls last month and "lip filler consultation" generated 3. Now you can move budget from the underperformer to the producer.
Cost for call tracking: $45 to $150 per month. The insight it provides saves 10x to 20x that amount in wasted ad spend. There's no legitimate reason to run Google Ads for a med spa without call tracking. None.
Landing Page Mistakes: Where Good Clicks Go to Die
You've got the keywords right. Your ads are showing to the right people. They click. Then they land on your homepage. Or worse, your "Services" page with 15 treatment options and no clear call to action.
Every Google Ads campaign needs dedicated landing pages. One page per treatment category, minimum. A "Botox" ad sends to a Botox landing page. A "body contouring" ad sends to a body contouring landing page. The page has one goal: get the visitor to call or book. One phone number. One booking button. One form. Testimonials, pricing guidance, provider photos, and a clear next step. If building dedicated landing pages feels like a separate project, it is. That's what a proper lead capture system looks like.
Practices that switch from homepage landing to dedicated treatment pages see conversion rates jump from 3% to 5% up to 12% to 18%. At 500 clicks per month, that's the difference between 15 leads and 75 leads. Same ad spend. Same clicks. Different page.
What a Properly Built Campaign Looks Like
Budget: $3,000 to $5,000 per month minimum. Below $3,000, you won't get enough data to refine. Above $5,000 makes sense once your conversion infrastructure (call tracking, landing pages, front desk training) is solid.
Structure: one campaign per treatment category. Botox/toxins, filler, body contouring, skin resurfacing, facials. Each campaign has its own budget, keywords, ads, and landing page. This lets you see which treatments produce the best cost-per-lead and shift budget accordingly.
Expected benchmarks for a well-configured med spa campaign:
- Cost per click: $5 to $20 depending on market and treatment
- Click-through rate: 4% to 8% on search ads
- Conversion rate: 10% to 18% on dedicated landing pages
- Cost per lead: $25 to $60 per qualified lead
- Phone call rate: 60% to 70% of conversions should be phone calls
If your numbers are outside these ranges, one of the settings above is probably the reason. Start with match types and negative keywords. Those two fixes alone will move your cost-per-lead by 30% to 50% in the first month.
Stop Paying for Google's Defaults
Google Ads works for med spas. I've helped practices build $50K to $80K per month in new patient revenue from Google Ads alone. But it only works when the settings are configured for your business, not left on Google's defaults that maximize their revenue at your expense.
Every one of these fixes takes less than an hour. If you're currently running Google Ads, open your account today and check your match types, negative keywords, and location targeting settings. Those three alone are probably costing you $500 to $1,500 per month in wasted spend.
Our marketing strategy service includes a full Google Ads audit as part of the engagement. We also walk through live audits at every Practice Empowered course. Bring your laptop and I'll look at your account with you. No pitch. Just fixes you can make that afternoon.
