What Are Local Service Ads?
Local Service Ads (LSAs) are a Google ad format that appears at the very top of search results — above traditional pay-per-click ads and above the Maps Pack. They feature your business name, rating, hours, and a “Google Screened” or “Google Guaranteed” badge.
The critical difference from standard Google Ads: you pay per lead, not per click. A lead is defined as a phone call or message from a prospective patient that lasts more than a minimum duration. If someone calls your office and immediately hangs up, you don’t pay. If a call is spam or clearly irrelevant, you can dispute the charge.
This pay-per-lead model makes LSAs particularly attractive for healthcare practices that want predictable acquisition costs.
Healthcare Specialties Currently Eligible for LSAs
Google has expanded LSA eligibility to include a growing list of healthcare categories. As of 2025, eligible categories include:
- Dentistry (general, cosmetic, orthodontics, oral surgery)
- Optometry
- Audiology
- Mental health and therapy (therapists, counselors, psychologists)
- Physical therapy
- Chiropractic care
- Acupuncture
- Dermatology
- Primary care and family medicine (in select markets)
- OB/GYN
- Urgent care
Availability varies by market. Google continues to expand eligible categories, so if your specialty isn’t listed here, check the current Google LSA eligibility page.
The Google Screened Badge
Healthcare LSA listings earn the “Google Screened” badge (other industries get “Google Guaranteed”). To earn Google Screened status, your practice must pass a verification process that includes:
License verification — Google verifies that the licensed professionals at your practice hold current, valid licenses in your state. This requires submitting license numbers which Google cross-references with state licensing databases.
Insurance verification — Your practice must carry appropriate professional liability insurance.
Background checks — For most healthcare categories, background checks on key staff are required.
GBP connection — Your Google Business Profile must be claimed, verified, and in good standing.
The verification process typically takes 2-4 weeks. During this time, your profile is under review and ads don’t run.
How LSA Ranking Works
Unlike traditional Google Ads where budget and Quality Score determine placement, LSA ranking is primarily determined by:
- Proximity — How close your practice is to the searcher
- Review score and volume — Your GBP star rating and number of reviews
- Responsiveness — How quickly you respond to LSA leads
- Bid — What you’re willing to pay per lead (less dominant than in standard PPC)
The review signal is particularly important: practices with higher ratings and more reviews rank better in LSAs, which creates a virtuous cycle between review management and LSA performance.
When LSAs Make Sense for Healthcare Practices
LSAs are a strong fit when:
You serve high-value, high-intent local searches. Searches like “dentist near me,” “therapist accepting new patients,” and “chiropractor open today” are exactly what LSAs are designed for.
Your front desk is ready to answer calls quickly. Responsiveness is a ranking signal. If leads go to voicemail regularly, your LSA ranking will suffer.
You have a solid review profile. Reviews are a core ranking factor. If you have fewer than 30 Google reviews or a rating below 4.0, invest in review generation before activating LSAs.
You want cost predictability. Pay-per-lead is easier to forecast than pay-per-click. If you know that 20% of leads become patients and each patient is worth $X, you can calculate your max allowable cost per lead.
LSAs Versus Standard Google Ads: How to Think About the Combination
LSAs and standard Google Ads solve different problems. They work best in combination:
LSAs: Appear at the very top of results, pay per lead, cover broad “near me” and high-intent local searches. Less granular control but strong for volume.
Standard Google Ads: More control over keywords, ads, and landing pages. Better for targeting specific service terms, running promotions, or covering searches that LSAs don’t capture.
Maps/GBP organic: Your Google Business Profile appearing in the Maps Pack costs nothing per click and should be the foundation. LSAs and standard ads supplement your organic Maps visibility.
A well-structured patient acquisition strategy uses all three, with budget allocation based on cost per acquisition data across each channel.
Getting Started with LSAs
- Go to ads.google.com/local-services-ads
- Select your business category
- Complete the Google Screened verification process
- Set your weekly budget (Google suggests a minimum; we recommend starting at $300-500/month to gather meaningful data)
- Connect your Google Business Profile
- Set your service areas and job types
Once live, monitor your leads closely. Dispute any leads that are spam, wrong number, or outside your service area — Google’s LSA support is responsive and proper dispute management improves your cost efficiency.
Want help setting up and managing your Local Service Ads? We include LSA management in our Patient Growth System for eligible healthcare practices.