Spruce Health review

Spruce Health is a different kind of telehealth pick: a HIPAA-compliant communication platform where video is one channel among several. The Basic plan at $24 per user per month includes a BAA, medical phone, text, video, fax and internal team chat, a customizable shared inbox, auto-replies and AI voicemail transcription. Communicator at $49 per user adds self-service call flows, urgent escalation and after-hours triage, integrations and API access, VoIP phone service and AI transcription and summaries for call recordings. For a practice that already uses an EHR, this means video visits, reminder texts and faxed records all sit in the same patient thread rather than in three tools. Spruce notes that prices exclude taxes and fees, and outbound SMS needs a one-time $19.50 registration fee. It ranks lower on features for telehealth because it has no charting, intake forms or billing of its own.

Who it is for

Practices that want video visits as part of one compliant inbox for phone, texting and fax.

Price

Basic $24 per user per month; Communicator $49 per user per month; taxes and fees extra.

$24/month * per user
Quoted from the vendor pricing page on November 9, 2026.

Key features

• HIPAA BAA on every plan
• Medical phone, text, video, fax and internal team chat on Basic
• Customizable shared inbox and auto-replies
• Self-service call flows (IVR), urgent escalation and after-hours triage on Communicator
• AI-enabled transcription and summarization for voicemails, call recordings and audio messages

Strengths and weaknesses

• Strength: Video sits next to phone, text and fax in one patient thread
• Strength: Low per-user price for a full communication stack
• Strength: Number porting for existing phone and fax lines
• Weakness: Not an EHR, so charting and billing happen elsewhere
• Weakness: A one-time $19.50 fee applies to enable outbound SMS
• Weakness: Phone trees and integrations require the $49 Communicator plan

Key facts

• Basic: $24 per user per month
• Communicator: $49 per user per month
• SMS registration: $19.50 one-time fee
• Users: 50,000+ healthcare professionals (vendor figure)

Where it ranks

Spruce Health is No. 7 in our Best Telehealth Platforms for Providers verdict.