$47. That's what the average healthcare lead costs on Facebook right now.
Not the $0.97 per click you keep seeing in blog posts. Not the "pennies on the dollar" pitch from your Facebook rep. Forty-seven dollars, per lead, before you know if that person will ever pick up the phone.
I run Facebook Ads for home care agencies. I see the dashboards every day. And the gap between what most agencies believe about Facebook advertising and what the numbers actually show is big enough to lose thousands in.
So let me pull back the curtain.
- Boosted posts are not Facebook Ads. Most agencies waste money on the wrong button.
- Real home care CPL runs $35-75 depending on market, not the "$0.97 per click" myth.
- Facebook works best as a retargeting channel, not a cold lead generator, for home care.
- Fix your website and set up Google Ads before spending a dollar on Facebook.
The Boost Button Is Not Facebook Advertising
This is the single most expensive mistake I see home care agencies make. And I see it constantly.
An agency owner posts a photo of their team at a community event. Facebook shows that little blue "Boost Post" button. They spend $50, maybe $100. The post gets some likes. Maybe a few comments from people who already follow them. And the owner thinks they've "tried Facebook Ads."
They haven't. Not even close.
Boosted posts optimize for engagement. Likes, comments, shares. They do not optimize for phone calls. They do not optimize for form submissions. They do not optimize for the one thing that actually matters to your agency: a family member picking up the phone and booking an assessment.
A side-by-side test showed the difference plainly. A boosted post spent $90 to reach 3,473 people. An actual ad campaign through Ads Manager reached 3,609 people for $40. Same size audience. Less than half the cost. And the ad campaign tracked 72 website visits, while the boosted post had no conversion tracking at all.
The boost button is the dollar menu of Facebook advertising. Quick, easy, and you get exactly what you pay for.
Real Facebook Ads live in Meta Ads Manager. They require you to choose a campaign objective (conversions, leads, traffic), define a target audience with precision, install tracking on your website, and test multiple ad variations. It takes work. But it's the difference between scattering flyers from a rooftop and putting an ad in front of the exact daughter who just Googled "home care near Scottsdale" last Tuesday.
What Facebook Ads Actually Cost in Home Care
Every article about Facebook Ads quotes the same number: $0.97 average cost per click. That figure is a platform-wide average across all industries, all countries, all campaign types. It has nothing to do with what a home care agency in Denver will actually pay.
The real numbers look different.
Healthcare Facebook lead campaigns average $47.47 per lead. That's not per click. That's per person who actually fills out a form or takes an action. The range swings from roughly $23 in slower months to over $80 during Q4 when every advertiser floods the platform for the holidays.
For home care specifically, I typically see CPL land between $35 and $75 depending on market competition, targeting precision, and whether the agency has any retargeting data built up. A suburban agency outside a mid-size city might get leads for $30. An agency competing in South Florida or the Phoenix metro will pay closer to $65-70.
And costs keep rising. Facebook's ad prices climbed 9% year-over-year in 2025, with CPM (cost per thousand impressions) jumping 24% over the course of the year. The platform is getting more crowded and more expensive every quarter.
None of this means Facebook is a bad investment. It means you need to understand the math before you write the check.
The number that actually matters
Cost per lead tells you what you're spending. Cost per qualified lead tells you what you're buying.
A qualified lead in home care is someone who needs services, can afford them (or has coverage), is in your service area, and actually answers when you call. Out of every 10 Facebook leads, expect 3-4 to meet that bar. The rest are wrong number, wrong area, "just looking," or never respond.
So your $47 cost per lead is really $120-150 per qualified lead. If your average client is worth $11,000-$15,000 in lifetime revenue, the math still works. If your average case is 10 hours a week of Medicaid-funded care, the math gets much harder.
The Lead Quality Problem Nobody Discusses
Facebook offers two main ways to capture leads: lead forms (where users fill out a form without leaving Facebook) and website conversions (where users click to your site and take action there).
Most agencies default to lead forms because the cost per lead is lower. That's a trap.
One healthcare practice tested both approaches. Lead forms produced leads at $6 each. Website landing pages produced leads at $18 each. The lead forms looked like the obvious winner until they checked appointment bookings. Only 2% of lead form submissions became actual appointments. The landing page leads converted at 17%.
Dollar for dollar, the "expensive" leads were eight times more valuable.
The reason is friction. Facebook lead forms pre-fill your name and email. People tap "Submit" while scrolling past their neighbor's dog photos. They barely register what they signed up for. Website visitors who click through, read your landing page, and then fill out a form have demonstrated actual intent.
If an agency came to me celebrating a "great month" of 50 leads at $8 each, I'd ask one question: how many returned a phone call? Because if the answer is 3 out of 50, that's not $400 in marketing. That's $400 in busy work for your intake coordinator.
The friction principle: A lead that was easy to get is usually hard to convert. A lead that required effort to capture typically converts at a much higher rate. Optimize for quality, not quantity.
The Special Ads Category Trap
This is the part that genuinely caught me off guard when I first encountered it, and almost no one in home care marketing talks about it.
Facebook has a classification called Special Ads Category. It applies to ads related to housing, employment, and credit. If your home care ad mentions anything about in-home services, living arrangements, or caregivers coming to someone's house, Facebook can flag it.
Once flagged, your targeting options shrink dramatically. You lose age-based targeting. You lose zip code precision (replaced with a minimum 15-mile radius). You lose most interest and behavior targeting. The exact tools that make Facebook advertising powerful get taken away.
If one of my campaigns got restricted overnight because an ad mentioned "in-home care," the fix would require restructuring ad copy, adjusting targeting strategy, and sometimes rebuilding campaigns from scratch. This happens more often than you'd think.
On top of that, Meta rolled out new healthcare advertising restrictions in early 2025 that block custom conversion data from being sent back to the platform. This means if someone clicks your ad and fills out a form on your website, Facebook's algorithm can no longer "see" that conversion to optimize future ad delivery. You're forced to optimize around click-through actions instead of actual form submissions.
The agencies that don't know about this wonder why their campaigns stop improving after the first few weeks. The algorithm is flying blind.
When Facebook Ads Work for Home Care (And When They Don't)
I'll take a position here that some agencies won't like: Facebook is not the best first investment for most home care agencies looking for clients.
Google is. Someone typing "home care agency near me" at 10 PM is ready to make a decision. Someone scrolling past your Facebook ad between a recipe video and a political argument is not. Google captures intent. Facebook creates awareness.
That said, Facebook does real work in two specific scenarios.
Scenario 1: Retargeting (the real money maker)
Someone visits your website, reads your services page, maybe looks at pricing. They leave without calling. A retargeting ad follows them on Facebook for the next 7-14 days, showing a testimonial or a simple "Still looking for care? We're here when you're ready."
Retargeting campaigns deliver 3.61x return on ad spend compared to 2.11x for prospecting campaigns. And retargeted visitors convert 30-80% better than cold audiences.
This works because the hard part (getting someone to your site in the first place) already happened. Facebook just keeps you in their mind during the days or weeks it takes a daughter researching care options to make a decision.
Scenario 2: Private-pay agencies in defined markets
If your agency primarily serves private-pay clients in an affluent area, Facebook's awareness campaigns can work because the lifetime value per client justifies the acquisition cost. A $60 lead that becomes a $4,000-per-month private-pay client is a no-brainer.
If your agency handles mostly Medicaid or lower-reimbursement cases, the economics break. A $60 lead that becomes a $1,500-per-month case with 15% margins leaves almost nothing to cover acquisition costs.
The payer mix question is one that no Facebook Ads guide addresses, but it changes everything about whether the channel is profitable for your specific agency.
Not sure if Facebook Ads make sense for your agency?
We help home care agencies figure out which channels deliver actual ROI before spending a dollar. Book a free strategy call to get an honest assessment.
The $47 Question: A Readiness Test
Before you spend anything on Facebook Ads, answer these five questions honestly.
1. Does your website convert? If visitors aren't calling or filling out forms already, Facebook will just send more people to a page that doesn't work. Fix the website first.
2. Is Google Ads running? Google captures people actively searching for care. If you haven't covered that channel, you're skipping the highest-intent leads to chase lower-intent ones on Facebook.
3. Do you have call tracking? Without it, you'll never know which leads came from Facebook, which came from Google, and which came from your yard sign. You'll make decisions based on feelings instead of data.
4. Can you afford $47 per lead? Not per client. Per lead. With a 25-30% qualification rate, you'll spend $150-200 per qualified lead. If your average client LTV doesn't support that number, Facebook isn't the problem. Your unit economics are.
5. Can you commit to 90 days? Facebook's algorithm needs data to optimize. The first month is learning. The second month is stabilizing. The third month is where you start to see real results. Agencies that quit after 30 days never reach profitability.
If you answered "no" to any of the first three, stop. Those are prerequisites, not suggestions. Every dollar spent on Facebook Ads without a converting website, without Google Ads coverage, and without call tracking is a dollar you'll never be able to account for.
What a Realistic Facebook Ads Timeline Looks Like
Agencies expect leads on day one. That's not how this channel works.
Month 1: The learning phase. You're testing audiences, ad copy, and creative. Facebook's algorithm is collecting data on who engages with your ads. Expect high costs and low lead quality. This is not a failure. This is the platform calibrating. Budget $500-1,000 minimum to generate enough data.
Month 3: Stabilization. You know which audiences respond. You've killed the ad sets that waste money. Cost per lead should be trending down. Retargeting audiences from your website are starting to build. You should see your first qualified leads converting into assessments.
Month 6: Maturation. Retargeting pools are large enough to be effective. You have data on which ad creative drives the best quality leads (not just the cheapest). Cost per qualified lead should be at or near your target. This is where agencies that stuck with it start seeing real return.
The agencies that track CTR trends see healthcare click-through rates growing over time as algorithms improve at finding the right audiences. But that improvement requires patience and consistent spend.
Five Mistakes That Burn Home Care Ad Budgets
Manage enough home care Facebook campaigns and these mistakes become visible within minutes of opening an account.
Targeting "everyone aged 30-65." This is the Facebook equivalent of standing on a street corner with a megaphone. The adult daughter who needs home care for her mother is a specific person with specific behaviors. She recently researched hospital discharge, fall prevention, or dementia care. Behavior-based targeting reaches her. Age-and-gender targeting reaches everyone.
Sending traffic to the homepage. Your homepage talks about all your services, your awards, your mission statement. A Facebook ad about "24/7 home care for your aging parent" should land on a page about exactly that, with a phone number and a simple form above the fold. Every extra click between the ad and the phone call is a leak in your funnel.
Running one ad and declaring Facebook "doesn't work." Video ads are 280% cheaper per lead than static images in some tests. Short testimonial clips outperform polished brand videos. Specific offers ("Free in-home assessment this week") beat vague branding ("Compassionate care for your loved ones"). The only way to know what works for your market is to test 3-4 variations simultaneously.
Ignoring the Conversions API. After Apple's iOS privacy changes, Facebook's tracking pixel captures less data than it used to. Server-side tracking through Meta's Conversions API fills the gap. Without it, Facebook's algorithm optimizes on incomplete information, which means higher costs and worse targeting over time.
Listening to your Facebook rep. Facebook assigns reps to accounts that spend enough money. Their job is to get you to spend more. They'll recommend increasing budgets, broadening targeting, and turning on automated features. Some of that advice is fine. But their incentive is your spend, not your ROI. Good luck finding a Facebook rep who recommends that an agency pause their campaigns and fix their website first.
The Honest Take on Facebook for Home Care
Facebook advertising can work for home care agencies. It is not a magic button. It is not cheap. And it is not where most agencies should start.
If your website converts, if Google is covered, if you have tracking in place, and if your payer mix supports a $47+ cost per lead, then Facebook becomes a powerful second channel. Especially for retargeting. Especially for awareness in defined geographic areas. Especially for private-pay client acquisition in affluent markets.
If none of those conditions are met, every dollar you put into Facebook Ads is a dollar you could have spent on something with a clearer return.
The agencies I see succeed with Facebook are the ones that treat it as one part of a system, not the system itself. They run Google Ads for intent. They use Facebook for retargeting and awareness. They have a marketing partner or in-house person monitoring campaigns weekly. And they give it time.
The agencies that fail are the ones that boost a post, get frustrated after two weeks, and tell everyone at the next HCAOA meeting that "Facebook doesn't work for home care."
It does. Just not the way they tried it.
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Facebook Ads are a tool, not a strategy. The agencies that profit from them are the ones that built the system first.
Fix the website. Cover Google. Then turn on Facebook.