Does this look the same in every market?

No. Across the 6 markets measured, the share of businesses no AI engine named ranged from 80% to 85.2%. Google rank counts for more in some markets than others. Every market's own numbers are published on its own page rather than folded into the average.

The Local AI Visibility Index

Behavioral Health Clinics across 6 US markets

We measured every Behavioral Health Clinics practice Google Maps returns in 6 markets — 300 businesses in total — then asked 5 AI answer engines the same 10 patient questions in each one and recorded who got named.

Practices: 300
Markets: 6
Questions: 10 per market
Engines: 5
Measured: July 2026

74.8%

of the best-reviewed Behavioral Health Clinics practices across 6 markets were named by no AI answer engine at all.

Finding 01

How often do the best-ranked local businesses show up in AI answers?

The businesses ranked highest on Google Maps still show up in only 15.3% of AI answers. Measured across 300 mental health clinics in 6 markets: across the best-ranked 10% by map position, an AI engine named them in 15.3% of the answers about their own category.

Ranking well clearly helps. It is also clearly not the thing that decides it — most of the best-ranked businesses across these 6 markets still never came up. And this is an average of markets that do not agree with each other: rank counted for more in the smaller markets we measured than in the larger ones.

Google Maps rank vs getting named — all 6 markets combined
Where they rank on Google Maps	Named by AI	Share
The 1st third — best ranked on Maps	31 of 100	31%
The middle third	13 of 100	13%
The bottom third	4 of 100	4%

Finding 02

How much of the AI answers do a handful of businesses take?

In the average local market, three businesses take 75.3% of everything AI answer engines say. Measured across 300 mental health clinics in 6 markets: the three most-named businesses in each market got 75.3% of all the mentions, and everyone else split what was left.

Finding 03

Are the best-reviewed local businesses named by AI answer engines?

74.8% of the best-reviewed local businesses are never named by an AI answer engine. Measured across 300 mental health clinics in 6 markets: among the top half by Google rank, star rating and review count combined, 74.8% show up in Google Maps but were named in none of the AI answers about their own category.

Finding 04

Do Google reviews decide whether AI names a business?

Google reviews do not decide whether AI answer engines name a business. Measured across 300 mental health clinics in 6 markets: neither the number of reviews nor the star rating tracked with getting named — both came out close enough to zero to mean nothing (review count +0.187, star rating -0.171, on a scale where 1.0 would be a perfect match).

Finding 05

Do different AI answer engines recommend the same businesses?

No two AI answer engines recommend the same local businesses. Measured across 300 mental health clinics in 6 markets: asked the same questions, any two engines agreed on somewhere between 26.2% and 50.6% of the businesses they named — so being named by one is no guarantee of being named by the others.

Across every market combined, each engine named a different share of the businesses measured: Gemini named 78, Perplexity named 54, Google AI Overview named 50, ChatGPT named 32, Claude named 29.

Of the 95 practices named by any of the three, all three agreed on 15.

How often two engines named the same business
Engine pair	Agreed on
Gemini & Google AI Overview	50.6%
Perplexity & Google AI Overview	48.6%
Claude & Google AI Overview	46.3%
Gemini & Perplexity	45.1%
Claude & Perplexity	33.9%
ChatGPT & Gemini	29.4%
Claude & Gemini	28.9%
ChatGPT & Claude	27.1%
ChatGPT & Perplexity	26.5%
ChatGPT & Google AI Overview	26.2%

How much does this vary between markets?

Substantially. The share of practices no engine named ranged from 80% to 85.2% across the 6 markets measured. Every market’s own figures are published on its own page, computed from that market alone.

Per-market results — 300 businesses across 6 markets
Market	Practices	Never named	Top 3 took
Abilene, TX	65	83.1%	59.8%
Duluth, MN	61	85.2%	71.5%
Little Rock, AR	54	85.2%	84.8%
Cape Girardeau, MO	47	85.1%	78.9%
Syracuse, NY	38	84.2%	83.3%
Staunton, VA	35	80%	73.2%

How we measured it

In each of 6 markets we pulled every Behavioral Health Clinics practice Google Maps returns, then asked 5 AI answer engines the same 10 patient questions and recorded which ones each engine named.

Sample: 300 practices across 6 markets: Abilene, TX; Cape Girardeau, MO; Duluth, MN; Little Rock, AR; Staunton, VA; Syracuse, NY. A practice with more than one listing is counted once per market. 163 listings that share the websites of 39 organizations are counted as those organizations, because AI engines cite an organization's site rather than any individual listing.
Market selection: The 6 markets were picked before any measuring started — deliberately spread across large, medium and small cities and across the country — and every market we opened is reported here, including the ones that came back less interesting.
Collection: 10 patient questions per market, held identical across ChatGPT, Claude, Gemini, Perplexity and Google's AI Overview. 50 answers per market, July 2026.
Visibility: Share of answers naming or citing a practice, weighted by the reach of the engine that named it.
What we will and will not publish: A combined number only goes up when it covers at least 3 markets and 150 practices, with a usable reading for at least half of them. Where markets disagree with each other, we publish the range as well as the average rather than hiding it.
Scope: One category, 6 US markets. Practices are never named. Answer engines change over time; these figures describe July 2026.

For anyone who wants the statistics

The findings above are counts, which is how most people want to read them. Here are the same relationships as correlations, across all 300 businesses.

Reputation signals vs getting named — 300 practices
What we measured	How closely it tracked	What that means
Google Maps rank	−0.317	A slight connection
Review count	+0.187	No real connection
Star rating	−0.171	No real connection

Reading the middle column: 0.0 means the two things had nothing to do with each other. 1.0 would mean they moved together perfectly. A minus sign means they moved in opposite directions. Anything under about 0.2 either way is noise.