Spruce Health Pricing, Plans & Alternatives (2026)

Overview

Spruce Health is a patient-communication platform for medical practices that combines a medical phone line, secure text messaging, video visits, fax and internal team chat in one application.^[11] Its premise is that a clinic’s communication with patients is spread across many channels, and that putting them in a shared inbox makes it easier for staff to manage.

Pricing is per user per month. The Basic plan costs US$24 and includes a BAA, medical phone, text, video, fax, team chat, a shared inbox, auto-replies and AI voicemail transcription. The Communicator plan costs US$49 and adds IVR call flows, urgent escalation and after-hours triage, integrations and API access, VoIP phone service, and AI transcription and summaries for voicemails, call recordings and audio messages.^[11] There is a free 14-day trial with no credit card; texting needs a one-time US$19.50 SMS registration fee. Billing is month to month by default, although larger practices may be asked to sign an annual contract with onboarding fees.^[11] Spruce states that all trials and paid plans automatically include a BAA, accepted electronically when the organisation is created.^[11]

The limitations relate to scope and cost transparency. Spruce is not an EHR, so documentation and billing require another system. Since 1 November 2025 its invoices also include sales and telecom taxes and pass-through fees that vary by business address, and VoIP desk phones are charged separately.^[11]

Spruce Health features

Medical phone line with VoIP option
Secure text messaging with patients
Video visits included in Basic
E-fax and team chat
IVR and after-hours triage on Communicator
BAA included in all plans

Spruce Health pricing

Basic: US$24 per user/month. Communicator: US$49 per user/month. Month-to-month by default; 14-day free trial; one-time US$19.50 SMS registration fee; taxes, telecom fees and desk-phone hardware extra.