The Spruce Insider’s Guide
Everything we know about Spruce in one document: what it costs, its grades, getting a refund, getting help and what else to look at. Read it here, or keep a copy.
Spruce
The Insider’s Guide
HIPAA-focused phone, text and fax for healthcare practices
Every plan, grade, refund rule and rival among therapy and clinic software, read from Spruce’s own pages.
Made by Spruce Health · checked Nov 12, 2026 · toolgpa.com
Contents
- 01WelcomeWhat it is, who it suits, its grades and the ten things to know first
- 02What it costsEvery plan, the free plan, ways to pay less and how prices have moved
- 03What it doesIts main features, where it runs, what it works with and who makes it
- 04Where it standsIts grades against its category, and whether to keep it or make your own
- 05The alternativesThe tools it is most often weighed against, side by side
- 06Quick answersThe questions people ask about it, each answered in a line or two
- 07About ToolGPAWho made this guide, what else is on the site, and how to cite it
ToolGPA put this guide together from Spruce’s own pages, its app-store listings and our grades. Every fact in it is on Spruce’s page too, where it is kept up to date. Checked Nov 12, 2026.
Part 01 · Overview
Welcome
What it is, who it suits, its grades and the ten things to know first
2.4
GPA, above 25 of the 38 other therapy and clinic software we grade
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.
To get you started, here are 9 things to know about Spruce, taken from its own pages and our grades.
It does none of scheduling, charting or insurance billing, so you still need an EHR.
- 1
Best for phone, text and fax for healthcare practices
Spruce gives a practice one inbox for phone, text, video, fax and team chat, with a signed BAA.
- 2
Paid plans start at $24 a month for each person
As its pricing page puts it: $24 per user / month, billed monthly.
- 3
You can try it first
14-day free trial, no credit card required
- 4
It runs on 3 platforms
Web, iOS and Android.
- 5
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.
- 6
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.
- 7
Automations for common replies
Auto-replies, saved and scheduled messages and bulk text broadcasts cut down repeat typing.
- 8
A 2.4 GPA, above 25 of 38
That is against the other therapy and clinic software we grade, on value, the free plan, features, ease of use and platforms.
- 9
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.
Spruce at a glance
- Pricing
- Free trial, from $24 per user / month, billed monthly
- Free plan
- No
- Free trial
- 14-day free trial, no credit card required
- Runs on
- Web, iOS, Android
- Made by
- Spruce Health, since 2013
- Category
- Therapy & Clinic Software
- Our grade
- 2.4 GPA, fair
The report card
Best for phone, text and fax for healthcare practices
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.
| Subject | Grade | Comment |
|---|---|---|
| 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. |
An A is worth 4 points, a B 3, a C 2, a D 1 and an F nothing. The GPA is the average of the five.
Who Spruce is for
- 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
Who it is not for
- 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
Good to know
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.
Part 02 · Pricing
What it costs
Every plan, the free plan, ways to pay less and how prices have moved
$24
A month to start, for each person
Spruce is a paid product with a free trial, starting at $24 per user / month, billed monthly.
The trial does not include sending texts until registration is done.
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.
Trying it first
14-day free trial, no credit card required
Read from sprucehealth.com on Nov 12, 2026.
Part 03 · Features
What it does
Its main features, where it runs, what it works with and who makes it
3
Places it runs: Web, iOS and Android
HIPAA-focused phone, text and fax for healthcare practices. Here is what it does, as its own site describes it, and what it covers: shared inbox, business phone line, business texting, online fax, telehealth.
Phone, text, fax, chat, call flows and AI transcription do the communication job fully.
- 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.
Where it runs
- Web
- iOS
- Android
What it works with
- athenahealth
Spruce is made by Spruce Health, and has been around since 2013.
Part 04 · Standing
Where it stands
Its grades against its category, and whether to keep it or make your own
25/38
Other therapy and clinic software it is graded above
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.
Each grade against the category
Every bar is all 39 therapy and clinic software we grade, cut by the letter each got. Spruce’s own letter is outlined.
- BValue for moneyAbove 32 of 38
- CFree plan and trialAbove 11 of 38
- CFeaturesAbove 0 of 38
- CEase of useAbove 0 of 38
- BPlatforms and integrationsAbove 14 of 38
Price against what you get
Each dot is one of 27 therapy and clinic software. Further left costs less; higher up scores better on features, ease of use and platforms. Spruce is the marked dot.
What paid plans start at, a month (each step along is roughly double) →
Keep it, or make your own?
Whether this is something you could build for yourself with an AI app builder, and what you would give up.
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.
What you could not
- Phone numbers and calls carried over the phone network.
- Fax numbers connected to the phone network.
- Video sessions that meet health privacy rules.
- One mailbox that several people work at once.
- Texts from a business number, registered with the carriers.
- A real app for iOS and Android. Something home-made would be a web page.
- It is priced for each person, which means accounts and billing for a team.
- What a company asks for before it lets staff use something: SOC 2 and HIPAA.
What this rests on. Spruce’s listing: what it does, where it runs, what it plugs into and what it costs. It is a judgement about the kind of software this is. We have not built a replacement for it, and making your own means looking after it too. How we decide, and every tool’s verdict.
Part 05 · Alternatives
The alternatives
The tools it is most often weighed against, side by side
Quo, Dialpad, RingCentral, Healthie and Carepatron
The 5 tools Spruce is most often weighed against, with where each one differs from it.
- 2.8GPA
Quo
Free trial · from $15/mo
Business phone app for calls and texts on shared team numbers.
- Only Quo lists macOS and Windows apps.
- Spruce also covers online fax and telehealth.
- Quo also covers transcription and AI support agent.
- 2.8GPA
Dialpad
Free trial · from $15/mo
AI business phone with live call transcripts and call summaries.
- Only Dialpad lists macOS and Windows apps.
- Only Dialpad lists a browser extension.
- Spruce also covers shared inbox, online fax and telehealth.
- 3.0GPA
RingCentral
Free trial · from $20/mo
Cloud phone system with texting, fax, video meetings and team chat.
- Only RingCentral lists macOS and Windows apps.
- Spruce also covers shared inbox, online fax and telehealth.
- RingCentral also covers transcription, team chat and video calls.
- 2.4GPA
Healthie
Free trial · from $18/mo
EHR, telehealth and client programs for wellness and care practices.
- Spruce also covers shared inbox, business phone line and business texting.
- Healthie also covers clinical notes, insurance billing and appointment booking.
- 2.6GPA
Carepatron
Free plan · from $31/mo
Practice management with a free plan, AI scribe and telehealth.
- Carepatron has a free plan. Spruce does not, though it has a free trial.
- Spruce also covers shared inbox, business phone line, business texting and online fax.
- Carepatron also covers transcription, clinical notes, insurance billing and appointment booking.
Part 06 · Questions
Quick answers
The questions people ask about it, each answered in a line or two
12
Questions, each answered in a line or two
The short version of everything above, for when you only need the answer. Each one is told in full in its part of the guide.
Is Spruce free?
No, Spruce is a paid product, but you can try it first. 14-day free trial, no credit card required.
How much does Spruce cost?
Spruce lists 2 plans. Basic: $24 per user / month, billed monthly.
What platforms does Spruce work on?
Spruce is available on Web, iOS and Android.
Does Spruce have a Windows app?
No Windows app was listed when its pages were read on Nov 12, 2026. Spruce is listed for Web, iOS and Android.
Does Spruce have a macOS app?
No macOS app was listed when its pages were read on Nov 12, 2026. Spruce is listed for Web, iOS and Android.
Is Spruce open source?
Spruce is not described as open source on its own site, as read on Nov 12, 2026.
What does Spruce integrate with?
Spruce's listing names athenahealth. A listing names up to eight integrations, so it may connect to more.
Who makes Spruce?
Spruce is made by Spruce Health. It dates from 2013.
What are the alternatives to Spruce?
The closest alternatives to Spruce in our directory are Quo, Dialpad, RingCentral, Healthie and Carepatron.
How does Spruce compare with other 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.
Is Spruce good value for money?
ToolGPA grades Spruce B for value for money. 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.
Could I make my own version of Spruce?
To replace Spruce you would be making phone numbers and calls carried over the phone network.
Where this guide comes from
The prices, plans, platforms and features were read from Spruce’s own pages on Nov 12, 2026, and the grades were given on Nov 12, 2026. 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.
Every tool we list gets five grades, A to F, each with its reason, and a GPA that averages them. How each is decided is at toolgpa.com/grades. This guide is ToolGPA’s own work; it is not made, paid for or approved by Spruce Health. Prices change, so check sprucehealth.com before you buy.
Part 07 · About
About ToolGPA
Who made this guide, what else is on the site, and how to cite it
5,038
Tools graded, in 95 categories
ToolGPA grades software the way a school report grades a pupil: five subjects, a letter for each with the reason written beside it, and a GPA that averages them. Prices, plans and platforms are read from each maker’s own pages and dated, so you always know how fresh a figure is.
Every grade, review and ranking on ToolGPA is our own judgement. No company can pay for a grade or change one. Every tool on the site has a guide like this one, free to download and pass on. It all lives at toolgpa.com.
5,038
tools graded
95
categories
739
price changes on record
579
apps priced in 12 countries
What else is on toolgpa.com
- Spruce, kept up to dateEverything in this guide, with prices and grades as they are todaytoolgpa.com/tools/spruce
- How grades are givenThe rules behind every letter and every GPAtoolgpa.com/grades
- Value chartsWhat each tool costs against what it scores, for every categorytoolgpa.com/charts
- CompareAny two tools side by side, plan by plantoolgpa.com/compare
- Price changesEvery price rise and cut on record, each with its sourcetoolgpa.com/price-changes
- Prices by countryWhat apps cost on the App Store in 12 countriestoolgpa.com/prices-by-country
- Pay lessEvery public discount: yearly billing, students, nonprofitstoolgpa.com/save
- Keep or makeWhich tools are worth paying for, and which you could build yourselftoolgpa.com/keep-or-make
Scan for the live page
Prices and grades as they are today
Quoting this guide?
Please name ToolGPA and link to the live page, so readers can check the figures for themselves:
ToolGPA, "Spruce: The Insider's Guide", checked Nov 12, 2026. https://toolgpa.com/tools/spruce
Know someone choosing between therapy and clinic software?
Send them this guide: toolgpa.com/tools/spruce/guide
ToolGPA elsewhere: youtube.com/@toolgpa
See our other guides
The best-graded therapy and clinic software after Spruce, each with an Insider's Guide of its own.
- Therapy & Clinic Software Insider's GuideEvery one of the 39 therapy and clinic software we grade, compared
- Halaxy Insider's GuideFree practice management software for health practitioners3.0 GPA
- SimplePractice Insider's GuidePractice management and EHR for private-practice therapists2.8 GPA
- Upheal Insider's GuideAI therapy notes, with an optional full practice EHR2.8 GPA
Choosing software? Every tool graded, every price dated.
Compare tools at toolgpa.com ›Everything in this guide is ToolGPA’s own summary of what Spruce’s pages, its app-store listings and public reviews said on the dates shown. Grades are our judgement under the rules at toolgpa.com/grades. Every grade, review and ranking on ToolGPA is our own judgement. No company can pay for a grade or change one. Spruce is a trademark of its owner, and this guide is not made, paid for or approved by Spruce Health. Prices and plans change: check sprucehealth.com before you buy.