Ryder Scale is a medical spa marketing agency for med spas and other cash-pay clinics in the US and Canada. We run Instagram and Facebook ads for one offer. Each ad opens a DM (a direct message), and an AI receptionist books the consult. You pay per qualified booked consult, with no retainer and no setup fee.
Here is the problem. You pay an agency every month, or you pay for leads. Then you ask: what did each new patient cost? The report shows clicks and leads. Your calendar shows something else. Nobody connects the two.
How should you judge a medical spa marketing agency?
Most agency pages tell you what they do. Few tell you how to check if it worked. Before you compare anyone, including us, use three tests you can check yourself.
Test 1: cost per booked consult. Add up everything you pay in a month: the agency fee, the ad spend and any software. Divide that total by the consults booked that month. This one number puts every quote on the same scale.
Here is a hypothetical example with made-up numbers, not market rates. A clinic pays a $2,500 retainer and $3,000 to Meta. Ten consults book. That is $550 per booked consult. If 25 book, it drops to $220. Our guide to med spa marketing agency cost walks through this math with two full quotes.
Test 2: attribution. Attribution means knowing which ad brought in which patient. Without it, a report shows clicks and reach, and you still cannot tell what paid for itself.
Test 3: speed to reply. A person who taps your ad is holding their phone right now. If the first reply comes the next morning, the chat has gone cold. You still paid for the tap.
Below is how our model meets each test, and where it does not fit.
What do our medical spa marketing services include?
We do one job. We turn an ad into a booked consult.
| Step | What happens | Who does it |
|---|---|---|
| 1. One offer | We pick one front-end offer with you: the first thing a new patient books, such as a consult for one treatment. | You and us |
| 2. The ad | We create and run Instagram and Facebook ads for that offer. | Us |
| 3. The DM | A tap opens a DM with your clinic. There is no landing page and no form. | The person who taps |
| 4. The reply | The AI answers questions about the offer. It asks screening questions, simple checks that the person fits the offer. None are medical. | Our AI |
| 5. The hold | The AI offers open times. It takes a card on file or a small deposit to hold the slot. | Our AI |
| 6. The booking | The consult goes into your booking system: Boulevard, Zenoti, Vagaro, Mindbody, Aesthetic Record, Square or Fresha. | Our AI |
| 7. The consult | Your team sees the patient. Clinical decisions stay with your clinic. | You |
The AI answers only DMs that start from our ads. The rest of your inbox is untouched. Medical questions go to your team.
That is how we meet test 3. The first reply does not wait for your front desk to be free. Our guide to click-to-DM ads for med spas walks through the flow step by step.
Is this a fit for your clinic?
| A good fit | Not a fit |
|---|---|
| A cash-pay med spa or clinic in the US or Canada, such as hormone therapy, hair restoration, weight loss or IV therapy | A practice that bills insurance for the visit |
| You have open consult slots each week | Your calendar is already full |
| You can lead with one treatment | You want ads for your full menu at once |
| You are fine taking a card or deposit to hold a slot | You do not want to ask for one |
| You want to know your cost per new patient | You want SEO, a new website or someone to run your feed |
How does pricing work with no retainer?
You pay us for one thing: a qualified booked consult.
| Cost | Who pays it |
|---|---|
| Monthly retainer | Nobody. There is none. |
| Setup fee | Nobody. There is none. |
| Ad spend | You pay Meta directly |
| Our fee | You pay us per qualified booked consult |
A qualified booked consult is a date and time the person chose, held with a card on file or a deposit. That is the definition we bill on. It is not a promise that the person shows up or buys.
Meta charges for ads whether or not anyone books. So in a slow month you still pay Meta. But if nothing books, you owe us nothing. That is how we meet test 1.
Is pay per booked consult a trap?
Some agencies say pay per booking is a bad deal. They have a point about one setup. If a booking needs no card, anyone can grab a slot and never come. If the offer is a deep discount, it fills the calendar with people who never buy again.
So ask two things before you sign with anyone paid this way. What counts as a booking? Ours needs a card on file or a deposit. What is the offer? Ours is one front-end offer you choose with us, with screening questions on every DM. Our guide to building a new patient offer covers how to pick one.
What will you see for each booking?
Every booking traces back to its source. That is how you get your real cost per new patient.
| What you see | What it tells you |
|---|---|
| Ad | Which ad brought the person in |
| DM | The chat that started from that ad |
| Card or deposit | Proof the person held the slot |
| Booking | The date and time in your own booking system |
| Ad spend | What you paid Meta, from your own Meta bill |
Your team marks who came in and bought. Add what you paid Meta and what you paid us. Then divide by those new patients.
That is how we meet test 2. You do not have to trust our numbers. Every booking sits in your own calendar, and every ad dollar shows on your own Meta bill. Our guide to tracking med spa marketing ROI (return on investment) shows how to pull these numbers yourself.
How do we compare with other medical spa marketing companies?
Many medical spa marketing companies charge a monthly retainer. That is a fixed fee you pay whether 2 people book or 40.
| Question | Retainer agency | Ryder Scale |
|---|---|---|
| What you pay the agency for | Time and services each month | Each qualified booked consult |
| What you pay if nothing books | The full fee, plus ad spend | Ad spend only |
| Where the ad sends people | Often a form or a landing page | A DM with your clinic |
| Who answers new inquiries | Often your front desk, when it has time | An AI receptionist, on ad DMs only |
| What the report shows | Often clicks, reach and leads | The ad, DM and deposit behind each booking |
| Scope | Often SEO, social, website and ads | One offer, ads and DM booking |
To be fair, a retainer agency can do more kinds of work. If you need a website and SEO, that may be the right fit. A medical spa marketing agency paid per booking fits a clinic that wants to pay only when a slot is held. For the full side by side, read pay per lead vs pay per booked consult.
What happens in the first 30 days?
- Audit. A free 20-minute call with Alex Ryder, our founder. We look at your offers, open slots and booking system, and check if the model fits.
- Offer. We pick one offer with you and write approved answers to common questions.
- Ads. We create the ads and set them up with Meta. Meta reviews each ad before it runs.
- AI setup. We load the offer, screening questions, open times and your deposit rule. We connect your booking system. Your team agrees who takes medical questions.
- Launch. The ads go live. DMs from those ads get answered, and consults get booked.
- Review. We go over bookings, spend and cost per booked consult with you. Then we change one thing at a time.
What do we not do?
We keep the job narrow on purpose, so it is easy to measure.
- No SEO and no work on your Google rankings.
- No websites or landing pages.
- No social media management, posting or comment replies.
- No other DMs. The AI only touches DMs from our ads.
- No medical advice. Clinical decisions stay with your clinic.
Frequently asked questions
Who is the best med spa marketing company?
No single company is right for every clinic. The right one is paid on the result you want and passes the three tests above. It shows a clear cost per booked consult. It traces each booking to an ad. It replies fast to new inquiries. Pick the one whose numbers you can check yourself. Our guide to choosing a med spa marketing agency lists the questions to ask.
How much does a medical spa marketing agency cost?
It depends on the fee model. Agencies charge a monthly retainer, a share of ad spend, or a fee per result. In every model, you also pay Meta for the ads. Ryder Scale has no retainer and no setup fee. You pay us per qualified booked consult, and you pay Meta directly. To set your ad budget, see how much a med spa should spend on marketing.
What happens if a booked patient does not show up?
The consult still counts as booked. Our fee is tied to a date and time held with a card on file or a deposit, not to the visit. That card or deposit gives your own no-show policy real weight. Our guide to med spa no-shows and card on file shows how to set a fair policy.
Will the AI receptionist give medical advice?
No. It answers questions about the one offer, such as what is included and when there are open times. Its screening questions are not medical. Any medical question goes to your team. Clinical decisions stay with your clinic. Our guide to the AI receptionist for med spas shows where the handoff happens.
Which booking systems does the AI receptionist work with?
It books into Boulevard, Zenoti, Vagaro, Mindbody, Aesthetic Record, Square and Fresha. The consult lands in your own booking system, so your team sees it next to every other booking. Each one traces back to the ad, the DM and the card or deposit behind it. Bring the name of your system to the audit, and we will check the fit.
Get your free 20-minute audit
Start with the three tests. Work out last month's cost per booked consult. Then bring it to a free 20-minute audit. Alex Ryder will go through the numbers with you and tell you plainly if this model fits your medical spa.
There is no retainer and no setup fee. You pay only per qualified booked consult, and you pay Meta directly for the ads.
Page updated October 2026.
