Google Ads location targeting decides who can see your ads based on where they are. For a practice, the goal is simple: reach people who can realistically come to your office, and nobody else. Google's default setting quietly does more than that, and it's one of the most common sources of silent waste in practice accounts. "Google ads location targeting" draws 140 US searches a month (Google Ads Keyword Planner data via DataForSEO, US, 12-month average to Sep 2026).
How far patients travel for your kind of care
Start with the patient, not the map. These are considerations, not statistics; your own records are the real answer.
| Type of care | Typical pull | Why |
|---|---|---|
| Urgent care, walk-in clinics | Short | People want the nearest open door |
| Pediatrics, family medicine | Short | Repeat visits, school runs, sick-day convenience |
| General dentistry, chiropractic, physical therapy | Short to moderate | Recurring appointments make distance a cost |
| Dermatology, specialists | Moderate | Fewer options, longer waits elsewhere |
| Implants, LASIK, plastic surgery | Longer | High-value, one-time decisions people will drive for |
To size your area, export patient ZIP codes from your practice management system and count them. You only need aggregate counts per ZIP, never names. Urgent care centers have their own considerations, covered in urgent care advertising.
Location targeting shape: radius, ZIP codes or cities
Google lets you target countries, cities, postal codes and a radius around an address (targeting steps (opens in a new tab)).
- Radius. Choose "Radius," enter your office address and a distance. Google requires at least 1 km. Best when patients come from every direction.
- ZIP codes. Paste up to 1,000 locations at once with "Add locations in bulk," one per line, including the state. Best when a river, highway or county line shapes who visits.
- Cities. Simple, but city boundaries rarely match travel patterns, and Google notes that targeting a city may also show ads "to people in nearby suburbs" (about location targeting (opens in a new tab)).
Illustrative example: a fictional pediatric practice, Northside Pediatrics, starts with a 5-mile radius. After a month, the location report shows almost no calls from across the river, so it switches to a list of nine ZIP codes on its own side.
Before you go further, a free marketing audit checks your ads alongside your Google listing and website, and flags settings worth a second look.
Presence vs interest: the setting that wastes the most money
Under location options, Google offers two choices for who you target (advanced location options (opens in a new tab), checked October 22, 2026):
| Option | Who sees your ads | For a practice |
|---|---|---|
| Presence or interest (default, recommended by Google) | People likely in or regularly in your area, plus people who have shown interest in it | Can include people hundreds of miles away researching your city |
| Presence | People likely located, or regularly located, in your target area | Usually the right choice |
Google is candid that "most campaigns will notice a decrease in impressions when switching away from the default." That's the point: the impressions you lose are mostly people who can't visit. Exceptions exist, such as a destination surgery practice that wants people researching a move or a trip, but they're rare.
Steps:
- Open the campaign's settings and the Locations panel.
- Expand location options.
- Select "Presence."
- Save, and repeat for every campaign.
Excluding areas you don't serve
Exclusions remove places inside or next to your target. The default exclusion option is "Presence": people likely located in the excluded area won't see your ads. Google adds that "people who are located outside these areas may still receive your ads," which is fine; you're only blocking the excluded area itself.
Exclude:
- Neighborhoods across a hard boundary your patients don't cross.
- An area served by your other office, if you run two separate campaigns.
- Locations that show up in the report with spend and no conversions.
Pair exclusions with negative keywords for city names in other states that share your town's name.
Location bid adjustments, and when not to bother
Bid adjustments raise or lower bids by location, from -90% to +900% (bid adjustments (opens in a new tab)). They help a manual-bidding campaign spend more where patients convert, for example +20% on the ZIP codes closest to the office.
When not to bother: if you use Smart Bidding, Google notes those strategies set bids automatically, so manual adjustments generally aren't needed. With a small budget and a tight area, adjustments split already-thin data further. Get the shape and the presence setting right first.
Checking where your clicks came from
The Locations report has two views: "Targeted locations" and "Matched locations" (geographic performance (opens in a new tab)). Matched locations "could be users' physical locations or locations of interest," so read it together with your presence setting.
- Open the Locations report after the campaign has run a few weeks.
- Look at matched locations by cost and conversions.
- Add exclusions for places with spend and no conversions.
- Expect some traffic under "Unspecified," where Google couldn't determine a location.
- Re-check monthly, alongside budget pacing.
Common mistakes
- Leaving the default "Presence or interest" on.
- Targeting a whole metro for a service people won't drive across town for.
- A town name that also exists in another state, with no state in the target.
- Targeting by city when a radius or ZIP list would be tighter.
- Never opening the Locations report.
Several offices: one campaign or several
If your practice has two offices, the simplest workable setup is one campaign per office, each with its own area, budget and ads naming that office's neighborhood. That keeps reporting clean and stops the offices competing in the same auction. If both share a budget and the areas don't overlap, one campaign with both areas can work.
Canadian clinics. Run Canadian locations in their own campaigns, and consider a separate account billed in Canadian dollars: Google says "it is not possible to change currency settings on an existing Google Ads account" (currency note (opens in a new tab)). Google forwarding numbers, used for call reporting, are available in both the United States and Canada, though features vary by country (forwarding numbers (opens in a new tab)). Location target types also vary by country, so check which postal-code targets are offered before building a list.
Medfy's Google Ads add-on optimizes inside guardrails you set, and every change is logged and reversible. It's built for a single practice account and doesn't offer multi-location features. Location also matters outside ads: see ranking on Google Maps. For the rest of the account, start with Google Ads for medical practices.
Frequently asked questions
What radius should a medical practice target in Google Ads?
Start with how far your patients actually travel, which your own address records can show in aggregate. Walk-in and pediatric care usually draw from close by, so keep the area tight; elective services like implants, LASIK or plastic surgery can justify a wider one. Check the matched locations report after a month and tighten or widen based on where calls and forms really came from.
Why are my ads showing outside my area?
Usually because the campaign uses Google's default location option, 'Presence or interest,' which reaches people in your area and people who have shown interest in it. Switch to 'Presence' to limit ads to people who are likely located, or regularly located, in your target area. Also check for city names that exist in other states, and for a radius drawn wider than you meant.
Should I target by ZIP code or radius?
Radius is quicker to set up and works when patients come from all directions. ZIP codes give more control when a river, highway or county line shapes who actually visits, or when nearby neighborhoods aren't a good fit. Many practices start with a radius, then switch to a ZIP code list once the location report shows where calls really come from.
Can I show different ads in different neighborhoods?
Yes, by splitting targeting into separate campaigns, each with its own locations and ads, for example one for the neighborhood around the office and one for the wider metro. Keep it simple: each split divides your budget and conversion data. For most single-office practices, one campaign with a well-chosen area and location-specific headlines does the job.