Reply To: tROAS or tCPA for a medical clinic that closes ~20–30 high-ticket ($20K) treatments per month?

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tCPA is worth giving a shot because it gets more complex & difficult for Google to accurately optimize for high revenue jobs in lead gen even on tROAS. It might also take trial & error to get there while campaign getting the hit.

I think you should definitely test out max conversions strategy with a custom experiment to see how it does. And as you are already importing the offline conversions, max conversions will optimize for better lead quality since has more signals & it’s overall way simpler to manage