diff --git a/borgmatic/config/schema.yaml b/borgmatic/config/schema.yaml
index dacc4105..7ca317a2 100644
--- a/borgmatic/config/schema.yaml
+++ b/borgmatic/config/schema.yaml
@@ -1662,6 +1662,13 @@ properties:
                     states.
                 example:
                     - finish
+            create_slug:
+                type: boolean
+                description: |
+                    Create the check if it does not exist. Only works with
+                    the slug URL scheme (https://hc-ping.com/<ping-key>/<slug>
+                    as opposed to https://hc-ping.com/<uuid>). Defaults to false.
+                example: true
         description: |
             Configuration for a monitoring integration with Healthchecks. Create
             an account at https://healthchecks.io (or self-host Healthchecks) if
diff --git a/borgmatic/hooks/healthchecks.py b/borgmatic/hooks/healthchecks.py
index 8c63f217..c36143d2 100644
--- a/borgmatic/hooks/healthchecks.py
+++ b/borgmatic/hooks/healthchecks.py
@@ -1,4 +1,5 @@
 import logging
+import re
 
 import requests
 
@@ -59,10 +60,15 @@ def ping_monitor(hook_config, config, config_filename, state, monitoring_log_lev
         )
         return
 
+    ping_url_is_uuid = re.match(r'(\w{4}-?){4}$', hook_config['ping_url'])
+
     healthchecks_state = MONITOR_STATE_TO_HEALTHCHECKS.get(state)
     if healthchecks_state:
         ping_url = f'{ping_url}/{healthchecks_state}'
 
+    if hook_config.get('create_slug') and not ping_url_is_uuid:
+        ping_url = f'{ping_url}?create=1'
+
     logger.info(f'{config_filename}: Pinging Healthchecks {state.name.lower()}{dry_run_label}')
     logger.debug(f'{config_filename}: Using Healthchecks ping URL {ping_url}')
 
diff --git a/tests/unit/hooks/test_healthchecks.py b/tests/unit/hooks/test_healthchecks.py
index 479b0e34..f53c0f59 100644
--- a/tests/unit/hooks/test_healthchecks.py
+++ b/tests/unit/hooks/test_healthchecks.py
@@ -264,6 +264,58 @@ def test_ping_monitor_hits_ping_url_when_states_matching():
     )
 
 
+def test_ping_monitor_adds_create_query_parameter_when_create_slug_true():
+    flexmock(module.borgmatic.hooks.logs).should_receive('Forgetful_buffering_handler').never()
+    hook_config = {'ping_url': 'https://example.com', 'create_slug': True}
+    flexmock(module.requests).should_receive('post').with_args(
+        'https://example.com/start?create=1', data=''.encode('utf-8'), verify=True
+    ).and_return(flexmock(ok=True))
+
+    module.ping_monitor(
+        hook_config,
+        {},
+        'config.yaml',
+        state=module.monitor.State.START,
+        monitoring_log_level=1,
+        dry_run=False,
+    )
+
+
+def test_ping_monitor_does_not_add_create_query_parameter_when_create_slug_false():
+    flexmock(module.borgmatic.hooks.logs).should_receive('Forgetful_buffering_handler').never()
+    hook_config = {'ping_url': 'https://example.com', 'create_slug': False}
+    flexmock(module.requests).should_receive('post').with_args(
+        'https://example.com/start', data=''.encode('utf-8'), verify=True
+    ).and_return(flexmock(ok=True))
+
+    module.ping_monitor(
+        hook_config,
+        {},
+        'config.yaml',
+        state=module.monitor.State.START,
+        monitoring_log_level=1,
+        dry_run=False,
+    )
+
+
+def test_ping_monitor_does_not_add_create_query_parameter_when_ping_url_is_uuid():
+    hook_config = {'ping_url': 'abcd-efgh-ijkl-mnop', 'create_slug': True}
+    flexmock(module.requests).should_receive('post').with_args(
+        f"https://hc-ping.com/{hook_config['ping_url']}",
+        data=''.encode('utf-8'),
+        verify=True,
+    ).and_return(flexmock(ok=True))
+
+    module.ping_monitor(
+        hook_config,
+        {},
+        'config.yaml',
+        state=module.monitor.State.FINISH,
+        monitoring_log_level=1,
+        dry_run=False,
+    )
+
+
 def test_ping_monitor_with_connection_error_logs_warning():
     flexmock(module.borgmatic.hooks.logs).should_receive('Forgetful_buffering_handler').never()
     hook_config = {'ping_url': 'https://example.com'}