Pay per appointment · US

Pay-per-appointment lead generation in the US: how it works.

Pay-per-appointment lead generation means you pay for appointments, not clicks or names. This guide explains the booked and shown versions, what should count, and what to ask a US provider before you sign.

By Femi Nwaojigba · Reviewed 10 October 2026

Short answer

Pay-per-appointment lead generation in the US means a provider runs the ads, calls and qualifies each inquiry, and books it onto your calendar, and you pay per appointment rather than per lead. Pay per shown appointment is the safer version: no-shows are not billed. Prices are in dollars; ad spend is often separate.

You pay for
Appointments, not leads
Safest version
Pay per shown
Currency
USD
Rules
TCPA, state rules

What pay-per-appointment lead generation means

In pay-per-appointment lead generation, the provider is paid for appointments rather than for clicks, enquiries or a monthly retainer. The provider runs the ads, contacts each enquiry, qualifies it and books it into your calendar.

There are two common versions. Pay per booked appointment charges when the booking is made. Pay per shown appointment charges only when the prospect actually turns up. The second puts the no-show risk on the provider, so the price per appointment is usually higher.

What should count as an appointment

A shown appointment is one where the prospect actually meets your adviser or surveyor at the booked time. Cancellations, no-answers at the door and no-shows are not shown appointments.

Agree the qualification checks in writing before launch, for example age, home ownership, whether the decision-maker will be present, and timescale. Without them, "appointment" can mean almost anything.

Questions to ask any pay-per-appointment provider

These questions separate providers who own the outcome from those reselling names.

  • Do you charge per booked or per shown appointment, and how is a no-show proven?
  • Are appointments exclusive to me, or sold to other companies in my area?
  • Who calls the enquiry, how fast, and can I hear recordings?
  • Who owns the ad account and the data?
  • Is ad spend included in the price, or paid separately?
  • How do your calls and texts comply with the TCPA and state calling rules, and how is consent captured?

What is specific to the US

US prices are quoted in dollars. Service areas are usually defined by ZIP code or county, and buyer finance, insurance and Medicaid coverage questions, and state programmes shape what can be claimed in ads.

Outbound calls and texts to enquiries must follow the TCPA, including documented consent from the landing page, plus state-level calling rules. Ask whether the provider handles consent records for you.

How Acquiri does it

Acquiri runs Meta ads for businesses whose customers are over 60, sends people to custom landing pages with no auto-fill forms, calls every enquiry within 5 minutes, qualifies on the phone and books the appointment into your calendar.

Some partners pay per shown appointment. Others choose a three-month engagement with a fee and a 90-day guarantee. Both are explained on the pricing page, and ad spend is always paid by you directly to Meta.

Frequently asked questions

A model where the provider is paid for booked or shown appointments rather than for leads or a retainer. The provider runs the ads, calls and qualifies each enquiry, and books it into your calendar.

Pay per shown is lower risk for you because no-shows are not billed. It usually costs more per appointment because the provider carries the no-show risk.

A shown appointment is one where the prospect actually meets your adviser or surveyor at the booked time. Cancellations, no-answers at the door and no-shows are not shown appointments.

It depends on the provider. With Acquiri, ad spend is always paid directly by you to Meta and is separate from the fee.

Acquiri charges a service fee for a three-month engagement, quoted on the qualification call. Ad spend is paid directly to Meta and is separate from our service fee. If the sales from our appointments haven't covered our fee by day 90, you don't pay again until they have.

Related reading

Want this running for your business?

If you would rather pay for appointments that happen than for names to chase, book a qualification call.