Tool profile
Spruce: cost, fit and limits
Spruce is a healthcare communication platform made by Spruce Health Inc that combines phone, text, fax, secure team chat and video visits in one shared inbox for medical practices, and adds AI voicemail transcription, sold per user per month.
What to know first
Spruce publishes two plans per user per month: Basic at $24 and Communicator at $49, billed monthly with taxes and fees excluded and a 14-day trial that needs no credit card. Video visits and clinical questionnaires sit alongside phone lines, two-way SMS and e-fax. AI shows up as voicemail transcription on Basic and as summaries of voicemails, call recordings and audio messages on Communicator.
Spruce at a glance
| Maker | Spruce Health Inc, Not stated on the vendor pages |
|---|---|
| Free plan | Free trial only |
| Entry price | $24 per month per user |
| API access | Yes |
| Category | Best AI Telehealth Software in 2026, rank 3 of 11 |
| Website | sprucehealth.com |
Who Spruce is best for
Practices with heavy inbound calls
Call flows, urgent escalation and after-hours triage on Communicator route callers before a person picks up, and the shared inbox lets staff assign conversations.
Clinics that mostly message patients
Two-way SMS, secure chat and e-fax live in one thread view, so staff handle patient contact without switching tools. Video visits are an extra channel.
Teams wanting an API
Communicator lists integrations and API access, which is unusual among the low-priced telehealth tools and lets a clinic connect Spruce to other systems.
Spruce plans and pricing
| Plan | Price | What it includes |
|---|---|---|
| Basic | $24 per month per user | HIPAA BAA, medical phone, text, video, fax and team chat, shared inbox, auto-replies and AI-enabled voicemail transcription. Free 14-day trial. |
| Communicator | $49 per month per user | Everything in Basic, plus call flows, urgent escalation, after-hours triage, integrations and API access, VoIP phone service and AI summaries. |
| Add-ons | $19.50 one-time for outbound SMS | Outbound SMS needs a one-time enablement fee, VoIP desk phones are a one-time hardware charge, and taxes and telecom pass-through fees are added. |
Checked November 2026.
What Spruce does
- Video visits and questionnaires
- Spruce offers video visits and clinical questionnaires for intake, so a patient can complete forms before a call. The homepage treats video as one channel, not the center of the product.
- AI voicemail transcription
- Basic includes AI-enabled transcription of voicemails. Communicator adds transcription and summarization of voicemails, call recordings and audio messages, which shortens how long staff spend listening to messages.
- Shared team inbox
- Conversations can be assigned to a person, and staff can be paged with an @ mention. Auto-replies and a customizable inbox handle common questions outside office hours.
- Phone lines and phone trees
- Professional phone lines, phone trees and call routing come with the platform. Communicator adds self-service call flows (IVR) and VoIP phone service for practices replacing a desk phone.
How Spruce handles your data
Spruce's homepage shows HIPAA, HITRUST and SOC 2 badges, and the pricing page says eligible organizations automatically receive a BAA. The vendor's policy on training AI with customer content, retention periods and hosting region was not on the pages we opened, so none of those are claimed here. Because voicemails and call recordings are processed for AI summaries on Communicator, a clinic should ask Spruce in writing what happens to the audio and the generated text before enabling the feature.
Where Spruce falls short in practice
- No scheduling on the homepage. The homepage lists communication features and does not list appointment scheduling, so a clinic that needs patient self-booking will probably pair Spruce with another tool.
- One-time fees at start. Outbound SMS needs a $19.50 enablement fee and desk phones cost a one-time hardware charge. A clinic with many seats should price these before trial ends.
- Only two published plans. Basic and Communicator are the only plans shown. Larger groups with custom needs would have to ask the vendor, as no enterprise tier is described on the opened pages.
Works with
Alternatives to Spruce
Spruce: common questions
How much does Spruce cost?
Spruce lists Basic at $24 per user per month and Communicator at $49 per user per month, billed monthly, excluding taxes and fees. A 14-day free trial needs no credit card and covers Basic except SMS texting. Outbound SMS adds a one-time $19.50 enablement fee.
What AI does Spruce include?
The pricing page names AI-enabled voicemail transcription on Basic and AI transcription and summarization of voicemails, call recordings and audio messages on Communicator. No other AI feature is named on the pages we opened, and the pages say nothing about training on customer data.
Does Spruce offer video visits?
Yes. Spruce lists video visits and clinical questionnaires for telehealth and intake inside the same communication platform as phone, text and fax. Video is part of Basic at $24, so no separate video license is described on the pricing page.
Does Spruce have an API?
Communicator at $49 per user per month lists integrations and API access. Basic does not list them. The opened pages do not name specific EHR connectors, so a practice should ask which systems Spruce already connects to before relying on it.
Is a BAA included with Spruce?
The pricing page says Basic includes a HIPAA BAA, and the site says eligible organizations automatically receive one. The homepage shows HIPAA, HITRUST and SOC 2 badges. The privacy policy was not opened in this check, so contract detail should be confirmed directly.