
Your Google Ad spend might be about to go up
As of 1 October 2021, Google will “include a surcharge on your invoices or statements for ads that are purchased through Google Ads and for YouTube placements purchased on reservations basis”.
If you’re serving ads in these markets, your charges will increase as follows
- Ads served in Austria: A 5% Austria DST fee added to your invoice or statement
- Ads served in France: A 2% Regulatory Operating Cost added to your invoice or statement
- Ads served in India: A 2% Regulatory Operating Cost added to your invoice or statement
- Ads served in Italy: A 2% Regulatory Operating Cost added to your invoice or statement
- Ads served in Spain: A 2% Regulatory Operating Cost added to your invoice or statement
- Ads served in Turkey: A 5% Regulatory Operating Cost added to your invoice or statement
- Ads served in the United Kingdom: A 2% UK DST fee added to your invoice or statement
As justification for these additional charges, the Google Payments Team stated:
These surcharges are being added to cover a portion of the costs associated with complying with digital services tax legislation in these jurisdictions. Learn more about jurisdiction-specific surcharges.
What does this mean for your AD budget?
Obviously, it will go up. And if you’re a big spender, fairly significantly. What this means is that for a short timeframe you may perceive that your “normal” cost per lead from Google Ads is “going up”. In other words, if you’re using Google and Youtube ads to advertise in your markets, you will need to pay a little more for the same amount of leads (ergo, patients).
How can your avoid these extra costs?
The fact is, you can’t fight Google. However, you should ask your paid traffic partner or agency how much they’ve reduced your CPC year over year and ask them how they aim to reduce your cost per click over time.
For example, as Google Ad Partners, we manage about £50,000 a month with Google Ads on behalf of our clients. And, we’ve been able to reduce CPCs for clients in many markets over the past year alone. A few examples include:
- A 22.6% decrease in CPC year over year for a laser eye surgery client in Australia
- A 28.9% decrease in CPC year over year for a laser eye surgery client in the US
- A 10.71% decrease in CPC year over year for a cataract surgery client in the UK
- A 7.5% decrease in CPC year over year for a cataract surgery client in the UK
- A 13.26 decrease in CPC year over year for a cataract surgery client in the UK
- A 22.7% decrease in CPC year over year for a cataract surgery client in the UK
NOTE: The best way to answer that nagging question about practice growth or marketing or patient volume in the back of your mind is to book a free 15-minute compatibility call. Get some options and go away with a clear idea of what’s possible.
About the author

Rod Solar
Founder & Fractional CMO
Rod co-founded LiveseySolar and acts as a Fractional CMO for our customers. He’s on a mission to help transform the lives of 10,000 people through vision correction surgery by 2024. To achieve that, he inspires his customers to make confident decisions that will help 50,000 people take the first step towards vision correction.
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Meet our Founders

Rod Solar
Founder & Fractional CMO
Rod co-founded LiveseySolar and acts as a Fractional CMO for our customers. He’s on a mission to help transform the lives of 10,000 people with vision correction surgery by 2024. To achieve that, he inspires his customers to make confident decisions that will help 50,000 people take the first step towards vision correction.
LiveseySolar completely transformed the way we were approaching this… We’ve gone from having just the dream of having a practice to having a practice up and running with people making inquiries and booking for procedures… It’s extremely pleasing. We feel lucky we connected with LiveseySolar.
— Dr Matthew Russell, MBChB, FRANZCO, specialist ophthalmic surgeon and founder of VSON and OKKO

Laura Livesey
Founder & CEO
Laura Livesey is the co-founder & CEO of LiveseySolar. She has developed powerful refractive surgery marketing systems that increase patient volumes and profits for doctors, clinics, and hospitals, since 1997.
Rod and Laura know as much about marketing surgery to patients as I know about performing it. They are an expert in the field of laser eye surgery marketing. They know this industry inside out. I believe that they could help many companies in a variety of areas including marketing materials, sales training and marketing support for doctors.
— Prof. Dan Reinstein, MD MA FRSC DABO, founder of the London Vision Clinic, UK