Updated November 10, 2026 · Prices checked on each vendor's own site
Spruce Review and Pricing
Spruce is the phone and texting tool most DPC clinics end up on. Here's what each plan includes and what a typical team pays.
The verdict
Spruce is the best phone and texting system for most DPC clinics. Calls, texts, faxes, video and team chat land in one shared inbox, every plan includes a BAA, and it syncs with Elation and Hint. Per-user pricing means the bill grows with your team, so count everyone who needs access.
Spruce pricing
| Plan | Price | Adds |
|---|---|---|
| Basic | $24/user/mo | Phone, text, video, fax, team chat, shared inbox, auto-replies |
| Communicator | $49/user/mo | Custom call flows, urgent escalation, after-hours triage, integrations and API |
Every teammate counts as a user, and everyone in an organization shares one plan. Outbound texting has a one-time $19.50 registration fee, CSV data export is $100 a month, and prices exclude telecom taxes. There's a 14-day free trial with no credit card. Prices checked November 4, 2026.
What Spruce does well
One inbox for every patient conversation, internal team chat beside it, voicemail transcription, and a BAA on every trial and plan. Spruce syncs texts and voicemails into the Elation chart and reads Hint's provider, membership and plan tags.
Things to watch
Call flows and after-hours triage need Communicator, which doubles the per-user price. Larger practices may be asked for an annual commitment with onboarding fees.
Who Spruce is best for
DPC clinics that promise direct access by phone and text and want the whole team working from one inbox.
Spruce alternatives
OhMD to text-enable your existing office line, and Weave for phones plus reviews and text-to-pay.
The part most comparisons skip
Every tool on this page is good at its own job, and none of them were built to talk to each other. So a patient text turns into a refill in the chart, which needs a review, which needs a reply, and the follow-up lives in someone's head. That isn't anyone's fault. The tools just don't share a to-do list.
That's the job Tabflows does. Tabflows is a dedicated tech team for DPC clinics. We connect the tools you already chose and give your team one place for chat, tasks and patient context, with managed workflows for the repeat work like refills, lab follow-ups and onboarding. We set it up around the way your clinic already runs, and you keep every tool you picked.
Works alongside the tools on this page. No switching required.
Frequently asked questions
How much does Spruce cost?
Spruce Basic is $24 per user a month and Communicator is $49 per user a month. A four-person team on Basic pays about $96 a month.
Is Spruce HIPAA compliant?
Yes. Every Spruce trial and paid plan includes a BAA.
Does Spruce integrate with Elation or Hint?
Yes. Spruce syncs texts and voicemails into the Elation chart and uses Hint's provider, membership and plan tags.