How healthcare PPC pricing actually works
Healthcare PPC pricing splits into management fee + ad spend + setup fee. The management fee is what you pay the agency for strategy + execution; the ad spend goes directly to Google/Meta/etc.; the setup fee covers the initial 30-45 days of campaign architecture, conversion tracking, and creative production.
The percentage-of-spend model aligns incentives — agencies make more when you spend more, but only if the spend produces ROI (otherwise you cap or terminate). Flat-fee management on healthcare PPC is generally a red flag — it signals the agency is afraid to commit to performance accountability, or it's so small a fraction of large spend that the agency under-services it.
Practice tier (₹4-15L/month ad spend · 25% management)
Single specialty + single geography. Up to 3 active campaigns. Monthly reporting cadence. Includes campaign architecture across Google Search + Performance Max for the practice's top 3 procedure intents, conversion tracking with HIPAA-aligned server-side APIs (no PHI in tracking, BAA with analytics vendor), compliance-cleared creative (ASCI/FTC pre-clearance for all ad copy + imagery), bid management with weekly optimisation, landing page testing for top 2-3 high-intent procedures, and monthly reporting with cost-per-booked-patient, channel ROAS, and patient LTV breakdown.
Setup fee: ₹85K covers tracking deployment, campaign builds, creative production, and compliance pre-clearance for first 60 days of content. Outcomes typical at this tier: 3.2-4.6× ROAS at 6-month mark, cost-per-booked-patient 50-65% below industry baseline, 28-42% inquiry-to-booking conversion rate.
Group tier (₹15-50L/month ad spend · 20% management)
Multi-location + multi-specialty. Up to 12 active campaigns. Bi-weekly optimisation cadence. Includes campaign architecture across all major paid channels (Search, PMax, Meta, LSA, YouTube), multi-location bid logic with proximity-based audience definitions, restricted-category Google Ads certification (mandatory for healthcare advertisers), creative rotation testing weekly, landing page system with procedure-specific pages, financing UX, and virtual consult booking, CRM integration for closed-loop reporting (booked appointments + patient LTV), and bi-weekly strategy calls + monthly reporting.
Setup fee: ₹1.5L covers tracking architecture, multi-location campaign builds, creative production, and landing page deployment. Outcomes typical: 3.8-5.2× ROAS at 9-month mark, cost-per-booked-patient 55-70% below industry baseline, 32-48% conversion rate.
Hospital tier (₹50L+/month · 15% management · custom setup)
Hospital lines, super-specialty centres, multi-specialty chains. Unlimited campaigns. Weekly strategy reviews. Includes department-line specific campaign architecture (cardiology / oncology / neurology each as separate but integrated programmes), account-based marketing for B2B referring-doctor relationships, international medical tourism funnels (where applicable) with country-specific creative + currency handling, conversion path optimisation across procedure intent → second-opinion → first consultation, dedicated 4-person paid pod (strategy lead + 2 specialists + analytics), and weekly strategy reviews + monthly executive reporting.
Setup fee: ₹3-8L custom covers full department-line campaign architecture, international tracking infrastructure, and creative production at scale. Outcomes typical: 3.5-4.8× ROAS aggregate (varies by department line), 250-340% growth in qualified leads across all department lines, 38% increase in international patient inquiry volume.
Why management fee structure matters
Percentage-of-spend (15-25%) aligns the agency's incentives with yours. As your spend grows, our team grows; if your spend stalls or shrinks, our revenue does too. We can afford to recommend you spend less when ROAS dips because we'd rather keep you long-term than maximise short-term revenue from underperforming spend.
Flat-fee management caps agency capacity — at high spend, the agency under-services because the fee doesn't grow proportionally. We've seen this fail repeatedly: practice scales spend from ₹5L to ₹25L/month, agency stays on ₹2L flat fee, agency under-staffs the account, performance degrades, practice churns.
Performance-only pricing (paying per booked patient) sounds attractive but typically requires the agency to have visibility into your CRM and operations — most agencies under-perform on attribution and over-charge per "qualified lead" rather than per booked patient.
What's NOT included
Management fee covers strategy + execution + reporting on the paid channels. Does not include ad spend itself (you pay Google/Meta directly), landing page production beyond initial setup (typically ₹35K-1L per high-converting procedure landing page), creative production beyond standard rotations (additional video, photography typically billed separately), email + SMS nurture campaigns (separate engagement), or SEO + content marketing (separate retainer).
We're transparent about scope on the proposal. Surprise bills don't happen.
Setup fee — what it covers
The 30-45 day setup includes complete tracking architecture (server-side APIs, BAA-covered analytics, conversion tracking), campaign builds across all approved channels, restricted-category certification with Google, compliance pre-clearance for first 60 days of ad creative, landing page deployment for top procedures, and baseline reporting infrastructure. Setup is one-time; management fees are monthly thereafter.
Tiered pricing summary
Practice · 25% of spend · ₹4-15L min spend
Single specialty + single geography practices. ₹85K setup + 6-month commitment.
Included: 3 active campaigns; Google Search + PMax; HIPAA-aligned tracking; Compliance-cleared creative; Monthly reporting.
Group · 20% of spend · ₹15-50L min spend
Multi-location + multi-specialty practices. ₹1.5L setup + 12-month commitment.
Included: 12 active campaigns; Multi-channel mix; Restricted-category certified; CRM integration; Bi-weekly optimisation.
Hospital · 15% of spend · ₹50L+ min spend
Hospital lines, super-specialty centres. ₹3-8L setup + 24-month commitment.
Included: Unlimited campaigns; Department-line architecture; International funnels; 4-person dedicated pod; Weekly strategy reviews.
Frequently asked questions
Why charge a percentage of spend instead of flat fee?
Percentage of spend aligns incentives. Flat fees cap agency capacity at high spend (under-servicing), and performance-only pricing usually requires CRM visibility most agencies underdeliver on. Percentage scales with your investment without conflicting incentives.
What's the minimum useful PPC budget for healthcare?
₹4L/month ad spend is the practical floor for paid search in tier-1 markets. Below that, you can't sustain enough impressions to test bids, audiences, or creative. Sub-floor budgets should focus on organic + GBP + reviews instead.
Why is the setup fee so high?
Healthcare PPC setup includes restricted-category certification with Google (mandatory), HIPAA-aligned tracking architecture (server-side APIs, BAAs with vendors), compliance pre-clearance for ad creative, and conversion tracking that respects PHI boundaries. Setup costs roughly equal one month of management fee.
Can I run my own ads and just pay you for strategy?
Yes for practices with in-house paid expertise — strategy + monthly review at ₹65K-1.5L/month flat. For practices without in-house expertise, full management is more cost-effective because execution quality compounds.
How does ROAS get measured?
Booked-patient ROAS using closed-loop CRM data (not Google Ads conversion data alone). We integrate with your scheduling system to track which marketing-driven inquiries actually become paying patients, then calculate ROI against patient lifetime value (not first-booking revenue).
What happens if ROAS underperforms?
If 3-month ROAS is below target, we either reduce spend (preserve your capital), restructure campaigns (pivot strategy), or recommend pausing paid acquisition entirely (rare but happens for sub-floor markets). We don't continue running underperforming campaigns to keep collecting management fees.