# Spruce review (2026): is it worth $24 a month per user? > HIPAA-focused phone, text and fax for healthcare practices Checked Nov 12, 2026 ยท graded Nov 12, 2026 by ToolGPA. Spruce is a communications platform for healthcare practices that puts phone, text, fax, video visits, secure messaging and team chat in one shared inbox. It is not an electronic health record or a scheduling tool. Billing is per user per month, and the vendor says every organization gets a signed BAA. - **Category:** Therapy & Clinic Software - **Made by:** Spruce Health (since 2013) - **Website:** https://sprucehealth.com - **Runs on:** Web, iOS, Android - **Who should skip it:** Not for you if you want scheduling, charting or billing, as it needs a separate EHR. - **Facts last checked:** Nov 12, 2026 ## Pricing As of Nov 12, 2026, Spruce is a paid product with a free trial, starting at $24 per user / month, billed monthly. - **Pricing model:** Free trial - **Free plan:** None. - **Free trial:** 14-day free trial, no credit card required. | Plan | Price | What you get | | --- | --- | --- | | 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. | Read from https://sprucehealth.com/plans on Nov 12, 2026. Prices change, so confirm with Spruce before buying. ## Key features - **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. ## Good for - Therapy and medical practices that need compliant texting and a business phone line - Small teams that want a shared inbox for calls, texts and faxes - Practices that already have an EHR and only need communications ## Worth knowing - 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. ## ToolGPA grades **GPA: 2.4 out of 4**, graded Nov 12, 2026. Spruce gives a practice one inbox for phone, text, video, fax and team chat, with a signed BAA. It does none of scheduling, charting or insurance billing, so you still need an EHR. Integrations and the API are on the $49 plan, and sending texts needs a one-time $19.50 registration. - **Value for money: B.** Basic is $24 a user a month billed monthly, just inside the cheaper quarter of $25. Communicator is $49. - **Free plan and trial: C.** A 14-day trial with no card, and no free plan. The trial does not include sending texts until registration is done. - **Features: C.** Phone, text, fax, chat, call flows and AI transcription do the communication job fully. It is a smaller job than an EHR. - **Ease of use: C.** No store rating on record. You set up numbers, call flows and text registration first. - **Platforms and integrations: B.** Web, iPhone and Android with athenahealth and an API from Communicator. No desktop app listed. These are ToolGPA's own grades. Graded from this listing, whose facts were read from Spruce's own pages on 12 November 2026. Not based on using the product, and shorter than our full reviews. ## Where it stands among therapy and clinic software - Spruce's GPA of 2.4 is higher than 25 of the 38 other therapy and clinic software we grade, and level with 8. - It stands best on value for money (B, above 32 of 38) and worst on features (C, above 0). - Its paid plans start at $24 a month for each person, against a middle price of $39 for the category: 6 of the 26 others that charge start lower. - On features, ease of use and platforms it scores 2.3 out of 4. 4 tools score higher and cost less. The category's chart of price against score: https://toolgpa.com/charts/therapy-clinics ## Keep it, or make your own? **Keep it.** To replace Spruce you would be making phone numbers and calls carried over the phone network. That is not a weekend's work, with an AI app builder or without one. It costs $288 a year. - You could not: Phone numbers and calls carried over the phone network. - You could not: Fax numbers connected to the phone network. - You could not: Video sessions that meet health privacy rules. - You could not: One mailbox that several people work at once. - You could not: Texts from a business number, registered with the carriers. - You could not: A real app for iOS and Android. Something home-made would be a web page. - You could not: It is priced for each person, which means accounts and billing for a team. - You could not: What a company asks for before it lets staff use something: SOC 2 and HIPAA. A judgement by ToolGPA from this listing, by rules that are the same for every tool. Nothing was built to test it. ## Works with athenahealth **Tags:** Business phone line, Business texting, Online fax, Telehealth, Shared inbox ## Alternatives - [Quo](https://toolgpa.com/tools/quo): Business phone app for calls and texts on shared team numbers. [Compare](https://toolgpa.com/compare/quo-vs-spruce) - [Dialpad](https://toolgpa.com/tools/dialpad): AI business phone with live call transcripts and call summaries. [Compare](https://toolgpa.com/compare/dialpad-vs-spruce) - [RingCentral](https://toolgpa.com/tools/ringcentral): Cloud phone system with texting, fax, video meetings and team chat. [Compare](https://toolgpa.com/compare/ringcentral-vs-spruce) - [Healthie](https://toolgpa.com/tools/healthie): EHR, telehealth and client programs for wellness and care practices. [Compare](https://toolgpa.com/compare/healthie-vs-spruce) - [Carepatron](https://toolgpa.com/tools/carepatron): Practice management with a free plan, AI scribe and telehealth. [Compare](https://toolgpa.com/compare/carepatron-vs-spruce) ## Sources The prices, plans, platforms and features above were read from these pages on Nov 12, 2026: - https://sprucehealth.com/plans - https://sprucehealth.com/about - https://sprucehealth.com/mental-health - https://sprucehealth.com/spruce-api Page: https://toolgpa.com/tools/spruce Listed by ToolGPA (toolgpa.com).