Chiropractic marketing

The exam is the start, not the sale. A lot of chiropractor marketing is judged on new patient exams, but in many practices the exam is only visit one. The care plan comes at visit two, the report of findings, as a number of visits over a number of weeks with a price on it, and a wellness membership may follow when the plan ends. A chiropractic marketing plan that counts exams and stops there can’t tell you whether visit two ever happened. We run the ads, put both visits on the calendar and count each care plan visit by visit, as one system.

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From the first exam to a care plan ad or map listing exam the days between findings visit care plan membership Visit one is the exam. The plan is heard at visit two, so visit two is booked before visit one ends.

Fill The Lobby is a chiropractic marketing agency for cash-based and membership chiropractic practices of every size in the US, from a solo chiropractor to a large group practice. Medicare draws the line a cash chiropractic practice works around: Part B “only covers adjustments of the spine by a chiropractor to correct a subluxation”, not the X-rays, massage therapy or acupuncture a chiropractor orders (Medicare.gov, checked 3 November 2026), and CMS treats chiropractic maintenance therapy as not payable (Medicare Benefit Policy Manual, chapter 15, checked 3 November 2026). So the pages say which visits Medicare may pay toward and what every visit, care plan and membership costs. Fill The Lobby writes the campaigns to that line and runs them inside the practice’s own ad accounts, where the ad spend goes directly to Google and Meta. Work starts with a 30-day Proof Pilot at one flat fee of $2,500. After the pilot, plans are priced per practice by clinician count.

What actually turns an exam into a care plan.

The first visit is two visits

In many chiropractic practices the first visit is two appointments. Visit one is the history and the exam, with imaging if the chiropractor orders it. Visit two, often the next day or later that week, is the report of findings, where the chiropractor explains what they found and presents the care plan. The leak sits between the two: a patient who leaves visit one without visit two on the calendar may never hear the plan at all. So the page explains both visits before anyone books: what happens at each, how long each takes, what each costs and what visit two is for. The booking holds the exam slot and, where your practice works this way, the findings visit too, and visit two is on the calendar before the patient walks out of visit one. Findings visits held are reported weekly beside exams held. If your chiropractors present their findings on day one, the page follows that path instead.

A care plan is a schedule with a price on it

Many new patients come to the report of findings with the worry chiropractic is best known for: that once they start, they’ll be coming forever. The care plan answers it on paper, as a number of visits over a number of weeks, often more of them at the start, with a re-exam on a set date and a price per visit, as a prepaid package or monthly. For uninsured and self-pay patients, the federal good faith estimate rule asks for the same terms: one estimate can cover recurring services if it states “the expected scope of the recurring primary items or services (such as timeframes, frequency, and total number of recurring items or services)”, and that scope “must not exceed 12 months” (45 CFR 149.610(b)(1)(x), checked 3 November 2026; our good faith estimate guide covers the rest of the rule). So the plan page, the written care plan and the estimate use the same three terms, timeframe, frequency and total visits, and a patient can see where the plan ends before saying yes to it. A package price in an ad says how it is paid, because Google’s dishonest pricing practices policy says advertisers “must clearly and conspicuously disclose the payment model or full expense that a user will bear” (checked 3 November 2026). And for the patient who doesn’t want to prepay before seeing how care goes, the page says what happens to prepaid visits that go unused, in your practice’s own terms.

Medicare draws its line at maintenance

Medicare Part B pays for one chiropractic service, the adjustment of the spine to correct a subluxation, and not for the X-rays, massage therapy or acupuncture a chiropractor orders (Medicare.gov, checked 3 November 2026). It also draws a line through the adjustments themselves. CMS’s manual says chiropractic maintenance therapy “is not considered to be medically reasonable or necessary, and is therefore not payable”, and defines it as “a treatment plan that seeks to prevent disease, promote health, and prolong and enhance the quality of life”, or care that has become “supportive rather than corrective in nature” (Medicare Benefit Policy Manual, chapter 15, section 30.5.B, checked 3 November 2026). That reads very like the description of a wellness membership. So for Medicare patients, the pages and the phone script say which visits Medicare may pay toward at your practice and which it won’t, and nothing says “covered by Medicare” across the board. The membership sign-up page says the same to a patient over 65, so nobody joins believing Medicare pays part of the fee.

A membership sold online is a negative option

A wellness membership is often offered when the care plan ends or at the re-exam, to a patient who by then knows the chiropractor. If it can be bought on your website and bills until it is cancelled, the federal law on negative option marketing online applies. The seller must provide text that “clearly and conspicuously discloses all material terms of the transaction before obtaining the consumer’s billing information”, get the consumer’s “express informed consent” before charging, and provide “simple mechanisms for a consumer to stop recurring charges” (15 U.S.C. 8403, checked 3 November 2026). So the sign-up page states the monthly fee, the billing date, any minimum term, how it renews and exactly how to cancel, all before the card details. An ad that offers a free or discounted first month says the charge then starts automatically, because Google’s pricing policy disallows “a free trial without clearly stating the trial period or that the user will be automatically charged” (checked 3 November 2026). Our guide to membership pricing covers the same law from the functional medicine side.

Every ad says chiropractor

State chiropractic boards decide which titles a chiropractor may advertise under, and some are strict. Georgia’s rule lets chiropractors use only the terms chiropractor, doctor of chiropractic and D.C., and says “The use of the term Chiropractic Physicians is not authorized” (Ga. Rule 100-4-.01(3), checked 3 November 2026). The other half is what the ad claims. In August 2020 the FTC sent warning letters to businesses promoting treatments against COVID-19, chiropractic offices among them, some of which had offered adjustments as protection, restating that it is unlawful to advertise that a service can “prevent, treat, or cure human disease” without “competent and reliable scientific evidence” (FTC, checked 3 November 2026). Georgia’s same rule also lists “Advertising that contains any guarantee of the results of any services” among the advertising it prohibits. So every ad, profile and page title carries the designation your state allows, the copy describes the visit, the chiropractor and the techniques used, and we draft to your state board’s text for your chiropractors to confirm.

Count the plans, not the specials.

New patient exams, findings visits held, care plans started, and memberships started or cancelled, each by source, visible weekly. BAA signed before any data moves.

The only agency that is also the customer.

We built and run our own clinical platforms (200+ clinicians, patients in 20+ countries), and every part of this system, from the ads to the answered call and the follow-up, runs there first, on our own money. Fill The Lobby is that engine, pointed at your practice.

We do this in other specialties too.

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The findings visit nobody booked

A new patient comes in on a Tuesday evening with a stiff neck after a month at a new desk. The exam goes well. At the end the chiropractor says they’ll go over everything next time, and the front desk, with two people waiting, says someone will call to set it up. Nobody sets a time. By Thursday her week has filled, the neck seems less urgent, and the text she gets on Friday reads like a reminder for something she never booked. The care plan the chiropractor drafted is never presented, and the month’s report counts her as a new patient.

So visit two is booked before visit one ends, in the exam room or at the desk on the way out, and the reminder says what visit two is for: the findings, the plan, what it costs and how long it takes. A findings visit that is missed gets a call from the practice the same day, at the number the patient agreed to be contacted on. Exams held and findings visits held are reported side by side every week, so the gap between them is a number you can see rather than a feeling.

The plan that stops at visit six

A patient starts a twelve-visit plan, prepaid as a package. By visit six he has decided he’s doing fine, a busy week comes, and he skips a visit, then another. Nobody calls, because his next visit was never on the calendar. Six weeks later the first word from him is an email asking for a refund on the visits he didn’t use, and the chiropractor hears about it from the front desk.

So each next visit is booked before the patient leaves the current one, a missed visit gets a call from your front desk the same day, and the re-exam is on the calendar from the start of the plan. A patient who wants to stop hears the options your practice has set, such as finishing the plan, pausing it or the refund terms on the package, and the chiropractor hears about it while there is still a conversation to have. That call says what is left on the plan and leaves the decision with the patient. Plans started are reported against plans completed, with the visit at which each one stopped.

Where the rest of it leaks

Nothing here is judged on clicks. The chiropractic advertising we run reports exams held, findings visits held and care plans started, kept apart for acute pain searches and for wellness and membership searches, so a busy week of one-off exams never passes for a week of new plans. A chiropractor in the middle of an adjustment can’t pick up the phone, and in many practices one person runs the front desk, so missed call recovery returns the calls that come in while both are busy. The two-visit booking and the membership sign-up both live on the page, and the website and booking pages we build hold both visits on your real calendar and put the membership terms in front of the card details. Patient follow-up picks up the exam inquiries that never booked and the care plans patients took home from the findings visit to think over, and stays with each until the patient starts or says no. Local SEO for chiropractors builds the map listing and the pages that answer what visits one and two involve. Members who let a membership lapse can be invited back by name through patient reactivation, once the practice moves to a higher-tier plan after the pilot. The full eight, and how they hand off to each other, are laid out under what we do, and the patient retention calculator works out churn before care ends and what missed visits add up to in a year. All of it maps onto the seven leaks we look for in week one.

Questions

Chiropractic marketing: what practice owners ask.

Yes, as long as every page, ad and phone call gives the same plain account of what Medicare covers and how your practice handles it. Chiropractors are on the CMS list headed “Providers NOT Eligible to Opt Out” (CMS, checked 3 November 2026), so “we don’t take Medicare” can’t mean for a chiropractor what it means for a doctor who has opted out. The line between corrective and maintenance care shows up on the claim too. CMS’s manual says a chiropractor must put an AT modifier on a claim for active or corrective treatment, that “Claims without the AT modifier will be considered as maintenance therapy and denied”, and that chiropractors who give a patient an advance beneficiary notice follow the claims manual and add a GA modifier (Medicare Benefit Policy Manual, chapter 15, section 240.1.3, checked 3 November 2026). That notice is where a Medicare patient learns in writing that a visit may be theirs to pay for, so the page and the phone script tell a Medicare patient the same thing before the visit. How your practice handles Medicare is its decision, made with its billing adviser. We write the pages, the ads and the phone script to match it, and nothing in them says or implies that Medicare pays for a visit it doesn’t.

Keep it if it is written to your state’s rules and judged on care plans rather than exams. Some states regulate free and discounted chiropractic offers in detail. Georgia requires the patient to receive and sign a written account of the advertised service stating “ANY FURTHER TREATMENT WILL BE PROVIDED AT RATES REGULARLY CHARGED BY THIS OFFICE”, and bars a separate charge for evaluating tests given free or at a discount, “whether such professional evaluation is made at the time of the initial office visit or at a later date” (Ga. Rule 100-4-.01(4), checked 3 November 2026). So in Georgia, if the special includes discounted X-rays, the findings visit that explains them can’t carry a separate charge for that evaluation. Florida’s capital-letter notice for free or discounted services, which gives the patient a right to refuse to pay for any other service performed as a result of, and within 72 hours of, responding to the ad, covers chiropractors licensed under chapter 460 (Fla. Stat. 456.062, checked 3 November 2026). Whatever the state, the price in the ad is the one the patient pays, and the ad says what the exam includes, X-rays or not. Chiropractic new patient marketing built on a special is reported on findings visits held and care plans started, because a low-priced exam can fill the calendar with people who never hear a plan.

Our side of it is fixed: the Proof Pilot is thirty days at one flat fee of $2,500. Ad spend sits on top and goes from your own accounts straight to Google and Meta, so on the pilot we never touch it and never mark it up. In chiropractic the budget follows the adjustment schedule rather than the exam book. A new care plan often puts its visits closest together in the first weeks, so the spend is paced to the adjustment slots your chiropractors have free over the coming weeks, not to the exam slots open this week. Acute pain searches and wellness or membership searches run as separate campaigns with their own pages, because one person wants to be seen this week and the other is choosing a practice to stay with. Campaigns for long-standing back or neck pain are planned as if they sit inside Google’s health category for personalized ads, which covers treatments for “chronic health conditions” and doesn’t support Customer Match or your data segments (Google, checked 3 November 2026), so their reach comes from search, the map listing and Google’s predefined audiences. The week-one audit checks who already bids on chiropractic Google ads near you, and what their new patient specials say, before a budget is set.

It is, when the pages answer the two things people want to know before booking a chiropractor: what happens at the first visit, and what it costs to keep coming. So the pages say what visit one and visit two involve and how long each takes, give the per-visit, care plan and membership prices, and say whether you give superbills to patients who want to claim out-of-network benefits themselves (our superbill guide explains what one contains). Each chiropractor’s page and profile text carry the designation your state allows, as the ads do. Review requests go out at the re-exam, when a patient has a whole plan to describe, to every patient who reaches it rather than the ones the front desk picks, and in the way your state board allows. Map rankings move over months, so paid search carries the exam calendar while the listing and the pages build, and the weekly report shows findings visits held and care plans started from the map beside those from ads.

The searches change first. People looking for a chiropractor who takes their plan stop being yours, so the campaigns move to the visit, the care plan and the price, and the pages say what a visit costs before anyone books. Then come the patients you already have, in writing and before the date. Patients partway through a care plan hear what the visits left on it will cost from that date, per visit or as a package, so nobody finds out at the desk on visit nine. Patients who came in every month or so for wellness visits are offered the membership, with its fee, minimum term and way to cancel set out in the letter. Each letter says whether superbills are available for patients who claim out-of-network benefits themselves. Medicare doesn’t move with the networks: chiropractors can’t opt out, so Medicare patients still get the answer from the first question above. The terms for leaving each network are between your practice and the plan, and we write the pages, the letters and the phone script so the change reads the same everywhere.

Ask what it reports. Marketing for chiropractors is often sold on new patient exams, so ask whether the weekly report shows findings visits held, care plans started and memberships kept, by source, because a full exam book can sit beside an empty plan schedule. Ask to see a new patient special page it has written, and check it against your state chiropractic board’s rules and the title your state allows. Ask whether the same site template and the same special are running for other chiropractors near you. The same goes for a chiropractic SEO company: ask whether the pages it writes explain the findings visit and what a care plan costs, or only the exam special. And ask who would keep the ad accounts, the call tracking line and the membership list if you parted ways. Here is what we commit to: an audit in week one, a roadmap before anything is built, every booking reported with its source and cost, and every account in your practice’s name.

Updated November 2026.

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