Carepatron vs Spruce (2026): which should you pick?

Pick Carepatron if

• Fits if you're a solo practitioner who wants to start on a free plan with unlimited clients
• Works for mixed practices of therapists, allied health and wellness staff under one account

Look elsewhere if

• Tight if you're staying free: 100 appointments a month, 1 GB of storage, and no reminders or calendar sync
• Watch out: claims start at 25¢ each and insurance checks cost 15¢, and neither is on the free plan
• Pricey if you grow, as every practitioner is a paid seat and ePrescribing through DoseSpot is $39 a month per user
• Not for you if you need roles and permissions, white labeling or the API, which are only on Advanced at $39 a user
• Watch out: Plus includes 150 texts a month per user, and each one past that costs 5¢

Pick Spruce if

• Fits if you want one shared inbox for calls, texts and faxes
• Works for a practice that already has an EHR and needs the phone side

Look elsewhere if

• Not for you if you want scheduling, charting or billing, as it needs a separate EHR
• Watch out: business text sending needs a one-time A2P 10DLC fee of $19.50 per organization
• Pricey if you want call flows, integrations or the API, all on Communicator at $49
• Watch out: desk phone hardware for VoIP is extra

Carepatron

• The free plan has no appointment reminders or calendar sync and stops at 100 appointments and 1 GB of storage.
• Paid plans are charged per user. Texts beyond the monthly allowance cost $0.05 each, and ePrescribing through DoseSpot is $39 a month per user.
• Electronic claims start at $0.25 each and manual insurance checks cost $0.15 each; neither is on the free plan.
• Roles and permissions, white labeling and API access are only on Advanced.

Spruce

• It does not do scheduling, charting or insurance billing; a practice still needs a separate EHR.
• Sending business SMS requires a one-time A2P 10DLC registration fee of $19.50 per organization.
• Integrations and API access are limited to the $49 Communicator plan, and VoIP desk phone hardware is an extra.
• The free trial includes Basic features but not SMS sending, which needs the registration process first.

Carepatron

Online booking and reminders

Clients book from an online page or an embed on your site. Paid plans add calendar sync, email and SMS reminders, group appointments and booking approval rules.

AI scribe and clinical notes

An AI medical scribe drafts notes from sessions, alongside a template library, customizable notes, signatures and locking, and treatment plans. Group notes need Plus.

Telehealth video

One-on-one video sessions on every plan, including the free one; group telehealth and in-call chat start on Plus.

Invoicing and insurance

Online card payments and automated invoicing on all plans. Paid plans add superbills, CMS-1500 forms, electronic claims from $0.25 each and ERA posting.

Client portal and messaging

Clients sign intake forms, message the practice securely and pay through a portal. Plus adds a HIPAA-encrypted email integration, bulk sending and a shared inbox.

Workflows and API

Custom workflows run 2,000 times a month per user on Plus and without limit on Advanced, which also opens the Carepatron API.

Spruce

Phone, text and fax in one inbox

Calls, SMS, e-fax, app-based secure messages and video visits arrive in a customizable shared inbox, with new or ported phone and fax numbers.

Secure messaging and team chat

Staff can message patients inside the Spruce app, share files, and talk to each other in internal chat on the same plan.

Automations for common replies

Auto-replies, saved and scheduled messages and bulk text broadcasts cut down repeat typing.

Call routing

Phone trees and extensions come with Spruce's phone system. Self-service call flows, urgent escalation and after-hours triage are on Communicator.

AI transcription

Voicemails are transcribed on both plans. Communicator also transcribes and summarizes call recordings and audio messages.

BAA and security claims

Spruce says every eligible organization gets a HIPAA BAA at signup with no extra fee, and describes the platform as SOC 2 Type II audited.

Carepatron

• Free$0

  Unlimited clients, telehealth, client portal, online payments and the AI scribe; 100 appointments, 1 GB of storage, no reminders or calendar sync.

• Plus$31

  per user / month, billed yearly ($39 billed monthly)

  Unlimited appointments and storage, calendar sync, reminders, group telehealth and notes, shared inbox, custom branding and 150 texts a month per user.

• Advanced$39

  per user / month, billed yearly ($49 billed monthly)

  Adds roles and permissions, white labeling, API access, Google Analytics, 90-day deleted-data retention, an onboarding manager and premium support.

Spruce

• Basic$24

  per user / month, billed monthly

  Phone, text, video, fax and team chat, a shared inbox, auto-replies and AI voicemail transcription.

• Communicator$49

  per user / month, billed monthly

  Adds call flows (IVR), urgent escalation and after-hours triage, integrations and API access, VoIP phone service and AI call summaries.

Carepatron

• Annual discount

  Save 20% with yearly billing

  Carepatron's pricing page lists 20% off for paying yearly: Plus is $31 per user a month instead of $39, and Advanced $39 instead of $49.

• Other savings

  50% off the first 6 months

  A limited offer on the pricing page halves paid plans for the first 6 months, for example Plus at $15.50 per user a month on yearly billing; no end date is given.

• Other savings

  October offer: $1 a month for 3 months

  A banner offers $1 a month for the first 3 months, or 50% off the first year, ending 30 October 2026.

Spruce

No public discounts listed.