Split your marketing by how the patient pays. In-network commercial insurance is usually the cheapest bucket to fill per admission. Out-of-network and cash-pay cost more. What we see running campaigns for detox and residential: about $2,000 to $5,000 per admission in-network from Google and directories, and $7,000 to $15,000 out-of-network. American Addiction Centers said the same thing in its own SEC filing: in-network beds "generally have a lower advertising and marketing expense on a per admission basis than out-of-network residential beds" (AAC 2017 10-K).
This guide covers who pays for treatment, what each bucket's keywords cost, the targeting limits, and how to set the mix. Every number links to its source or is labeled as our experience or our math.
Who pays for addiction treatment?
SAMHSA's 2024 facility survey counts which payments treatment facilities accept. Among substance use facilities that take any payment (N-SUMHSS 2024):
- 89.9% accept cash or self-payment
- 78.3% accept private insurance
- 77.8% accept Medicaid
- 52.6% accept Medicare
So almost every facility takes cash. "Cash-pay" is a positioning choice, not a payment type only luxury programs accept.
On the insurance side, all ACA Marketplace plans must cover "substance use disorder (commonly known as substance abuse) treatment," with parity protections on deductibles, visit limits and prior authorization (HealthCare.gov). Medicaid is "the nation's largest payer for substance use disorder treatment" (Milbank Memorial Fund, 2020).
What do each bucket's keywords cost?
We pulled SEMrush estimates for US searches on 2026-10-05 (2026-10-04 for the last two rows). CPC is the estimated cost per click. Your local auction will differ.
| Keyword | Bucket | Searches / mo | Est. CPC |
|---|---|---|---|
| luxury rehab | Cash-pay | 5,400 | $28.78 |
| luxury rehab centers | Cash-pay | 3,600 | $25.38 |
| executive rehab | Cash-pay | 1,000 | $32.58 |
| aetna rehab | Insurance | 720 | $46.45 |
| blue cross blue shield rehab | Insurance | 210 | $60.53 |
| does insurance cover rehab | Insurance | 1,000 | $14.69 |
| rehabs that take medicaid | Medicaid | 1,000 | No CPC reported |
| drug rehab | General | 18,100 | $37.96 |
| detox near me | General | 9,900 | $34.30 |
In this pull, carrier keywords cost more per click than luxury keywords. Plan your bids on your own account data, not on the old idea that cash-pay clicks are the most expensive.
Clicks are not the unit that matters. The unit is the VOB (verification of benefits). Our math: cost per VOB = cost per lead ÷ lead-to-VOB rate. Webserv's 2025 dataset reports a $406 cost per lead and a 15.9% lead-to-VOB rate. $406 ÷ 0.159 = $2,553 per VOB, which matches the $2,552 it reports (Webserv 2025). In our experience, cost per VOB runs from a couple hundred dollars up to about $2,000 for out-of-network programs.
Cost per admission by bucket
| Bucket | Cost per admission | Source |
|---|---|---|
| In-network, Google and directories (detox, residential) | $2,000 to $5,000 | Our experience |
| Out-of-network, Google and directories (detox, residential) | $7,000 to $15,000 | Our experience |
| SEO | A few hundred dollars to $2,000 to $5,000 | Our experience |
| Paid media, all Webserv clients, 2025 | $16,608 | Webserv (994 admits) |
PHP and IOP usually cost less per admission, but in our experience the range varies too much by region and payer to publish one number. We have no public dataset for cash-pay cost per admission, so we don't quote one.
One more data point. AAC's ad and marketing line fell from 11.8% of revenue in 2014 to 3.9% in 2017 as it added in-network beds, cut TV and leaned on its own websites (2015 10-K, 2017 10-K). AAC also said its average daily residential revenue from in-network beds "is generally lower" than from out-of-network beds. Cheaper to fill, less revenue per day. You need both numbers to pick a bucket.
Medicaid: big payer, small paid-search bucket
Medicaid pays for more addiction treatment than any other payer, and most facilities accept it. But SEMrush shows no CPC estimate for the Medicaid rehab terms we checked ("rehab that accepts medicaid," "rehabs that take medicaid").
Coverage for residential care also depends on the state. CMS runs a Section 1115 program that lets states "test flexibilities to improve the continuum of care for beneficiaries with substance use disorders" (Medicaid.gov). Check your state's rules before you build anything.
Our recommendation: if Medicaid is your main payer, put your effort into state systems, courts, hospitals and community referral partners. If it's a side payer, accept it and don't build paid campaigns around it.
Targeting limits you can't work around
- Google. Addiction treatment is a "Health" sensitive interest category. Google names "Counseling services for mental health issues like depression, anxiety, and addiction" as an example. You can't use advertiser-curated audiences: Customer Match, your data segments, lookalikes or custom segments. You can use location targeting and Google's predefined audiences (Google Ads policy).
- Google certification. US addiction treatment advertisers must be certified by LegitScript and by Google (Google healthcare policy).
- Meta. Addiction treatment ads in the US need LegitScript certification and written permission from Meta (Meta policy). Since January 19, 2022, Meta has removed detailed targeting on sensitive topics, including "Health causes" (Meta).
So you sort buckets by keyword, location and landing page, not by audience lists.
Split the keywords by bucket
Run each bucket as its own campaign with its own landing page. If one campaign buys both "luxury rehab" and "aetna rehab," you can't tell which bucket makes admits.
Cash-pay terms
- luxury rehab, luxury rehab centers
- executive rehab
- private rehab
Insurance terms
- [carrier] rehab, such as aetna rehab or blue cross blue shield rehab
- in network rehab
- does insurance cover rehab
Rule of thumb: a keyword that names a carrier goes to an insurance page. A keyword that names luxury, privacy or a profession goes to a cash-pay page. Never share one campaign and one page across both.
Careful with carrier names in ads
Carrier names are trademarks. If a trademark owner complains, Google says it will review and "may restrict use of the trademark" in ads (Google trademark policy). Only name carriers you can prove you take. LegitScript also requires ads that are "accurate, transparent, and not misleading" (LegitScript).
Landing pages for each bucket
Unbounce's 2024 data puts the median healthcare landing page conversion rate at 5.1%. Pages written at a 5th to 7th grade reading level had a 10.8% median (Unbounce). Write plainly for both buckets.
- Insurance pages: name the carrier you take in the headline, show the VOB form above the fold, and put the phone number at the top.
- Cash-pay pages: real facility photos, staff credentials, accreditation and a clear price conversation. LegitScript requires photos that "truthfully and accurately depict" your facility (LegitScript).
We don't publish a lift number for carrier-specific pages. Test it on your own traffic.
Not sure if your payer mix is right?
Free 45-minute audit. We pull your Google Ads spend by campaign, map it to VOBs and admits by payer, and show you where the money goes. No pitch, just the numbers.
Book a free auditThe phone call decides the bucket
Most of these leads call. Liine's 2024 Behavioral Health Benchmark Report found 74.9% of new behavioral health leads come by phone (as cited by CallTrackingMetrics). Invoca's 2025 healthcare data says only 59% of callers speak with a person (Invoca).
- Insurance callers want to know if you take their plan and what it costs. Run the VOB first.
- Cash-pay callers want clinical fit, privacy and credentials. Price comes up once they trust you.
Speed matters for both. Webserv says gaps from lead to VOB are "almost always a lead quality or speed-to-contact issue" (Webserv 2025). See our admissions follow-up playbook.
How should you set the mix?
There is no standard split. Set it from your own numbers, by bucket:
- Track VOBs and admits by payer bucket, not just total admits.
- Work out cost per admission for each bucket.
- Compare it with net revenue per admission for that bucket from your billing team.
- Move budget toward the bucket with the best margin per admission that you can still staff.
Our math: margin per admission = net revenue per admission − cost per admission. Run it per bucket every month.
Pay vendors for work, never for admits
Federal law (EKRA, 18 U.S.C. § 220) makes it a crime to pay anyone to induce a referral to a treatment facility. The penalty is up to $200,000, 10 years, or both, for each occurrence. Pay agencies and lead vendors a flat fee for services. Never pay per admission or an admission bonus. Tracking your own internal cost per admission is fine.
What good looks like
- Separate campaigns and landing pages for cash-pay and insurance
- Carrier pages only for carriers you can prove you take
- VOBs and admits tracked by payer bucket
- Cost per admission and net revenue per admission reviewed by bucket each month
- Separate phone scripts for insurance and cash-pay callers
- Flat-fee vendor contracts with no per-admit terms
Frequently asked questions
What's the difference between marketing to insurance patients and cash-pay patients?
Different keywords, landing pages and phone scripts. In our SEMrush pull on 2026-10-05, carrier terms cost more per click than luxury terms: aetna rehab $46.45 and blue cross blue shield rehab $60.53, against luxury rehab $28.78 and executive rehab $32.58. Insurance callers want a VOB first. Cash-pay callers want clinical fit, privacy and credentials.
Which bucket costs less per admission?
In-network insurance. What we see running campaigns for detox and residential: about $2,000 to $5,000 per admission in-network from Google and directories, and $7,000 to $15,000 out-of-network. AAC's 2017 10-K says in-network beds have lower marketing expense per admission than out-of-network beds.
Should my rehab focus on insurance or cash-pay?
There is no standard split. Track VOBs and admits by payer bucket, work out cost per admission for each, and compare it with net revenue per admission from your billing team. Move budget toward the best margin per admission you can staff.
Does Medicaid marketing work for rehabs?
Medicaid is the largest payer for addiction treatment, and 77.8% of substance use facilities that take payment accept it (SAMHSA N-SUMHSS 2024). But SEMrush shows no CPC estimate for the Medicaid rehab terms we checked, and residential coverage depends on your state. If Medicaid is your main payer, put effort into state systems, courts, hospitals and community referral partners.
Can I target ads by insurance type?
No audience list does it for you. Google treats addiction treatment as a Health sensitive interest category, so Customer Match, your data segments, lookalikes and custom segments are off. Meta removed health-related detailed targeting in January 2022. Sort buckets by keyword, location and landing page.
Can I name insurance carriers in my ads?
Carefully. Carrier names are trademarks, and Google may restrict their use in ads after a trademark owner complaint. Only name carriers you can prove you take, and keep claims accurate, as LegitScript requires.