When does billing begin?
You do not need to sign up for a plan—or enter a credit card—during your free trial period. After your trial ends, you must sign up for a plan to continue using Spruce, and billing will begin when you sign up. If you sign up for a plan before your free trial ends, billing will begin only after your trial expires.
Spruce's free trial provides access to all the functionality of our Basic plan, with the exception of sending SMS text messages, as this feature requires an industry-standard registration process.
If you would like to send SMS texts during your trial, you must sign up for a Spruce plan, pay the industry-imposed SMS registration fee, and complete your business registration.
If you would like to test Communicator-level features while on your free Spruce trial, please reach out to us to discuss your goals with our sales team. We're dedicated to giving you the best look at Spruce that we can!
How long is my contract? Is it easy to cancel?
Spruce offers month-to-month contracts and billing by default. For larger practices, we may require an annual commitment (with onboarding fees) to ensure a smooth and supported transition onto Spruce, and ongoing account management to help you get the most value from our platform.
We want to earn your trust every month by providing a great service, not by locking you into a long-term obligation unnecessarily. If your plan is month-to-month, you can cancel anytime directly within Spruce, and we’ll prorate your final bill. For customers on an annual contract, we’re happy to discuss options if your needs change.
If you’re considering canceling, we'll prorate the bill for your current service period. We’d also love to hear from you first—our goal is to make Spruce the easiest and most valuable choice for every practice, and we welcome any feedback on how we can improve.
How do I see my invoices?
A PDF file of your monthly invoice will be sent to your organization's billing email address every month. If you are having trouble finding these invoice records, try searching for “Spruce Health Inc” in your email client, and please make sure that you are searching the email account of your billing contact. If you are unsure of your organization's current billing email address, you can find it in the "Billing Settings" section of the Spruce web application.
Are there any additional fees?
Starting November 1st, 2025, in addition to your subscription, your monthly invoice will include applicable sales and telecommunication taxes, as well as related fees. These may comprise federal, state, and local surcharges for telecommunication services like VoIP calling, e911 services, and texting. They are pass-through charges, with no markup from Spruce, and the amount will vary based on your business address. You can learn more about these charges, including tax exemption submission, in our Help Center.
The following additional charges may also apply:
There is a one-time fee of $19.50 to enable outbound SMS text messaging for your organization on Spruce. This is the mandatory telecom industry fee for registering business SMS traffic with the major telecom carrier networks. This industry fee is not related to Spruce services and is being passed along without markup. The fee is charged only once per organization on Spruce, regardless of the number of business phone lines in use, and the fee will not be charged if your organization opts out of SMS messaging. Learn more about phone registration.
If you choose to use Spruce VoIP desk phones, we will bill the phone hardware that you choose as a one-time charge, separate from your Spruce subscription.
We may also require an onboarding fee for our larger practices, where additional setup, training, and customization are required to ensure a smooth and successful transition to Spruce. This fee helps cover the hands-on support we provide to get you up and running successfully. Feel free to contact us to learn more about this.
How is my bill determined? What counts as a user on Spruce?
Spruce is priced per user, per month. A user is any teammate you have added to your Spruce organization. Generally, this will include all clinicians, staff, and other employees (but not your patients). Spruce is not priced by number of phone lines or amount of feature usage.
All users in a single organization must be on the same billing plan.
Example: A clinic with 3 physicians, 2 nurses, 1 front-desk assistant, and 1 virtual assistant will have 7 total users on Spruce, all on the same plan and with the same cost per user.
Whenever you add or remove a teammate on Spruce, your bill will automatically increase or decrease to reflect the change.
Are there usage limits?
We've worked hard to make our monthly per-seat pricing model match the usage needs of all types of medical practices, regardless of organization size. Because of this, the vast majority of practices can (and do!) use all of Spruce's features in an effectively unlimited way, and we do not charge individually for texts, video calls, voice minutes, or other feature use. We also do not have any hard caps or automatic schedules of "overage" charges, and there will never be any surprise upcharges on your bill.
This fixed pricing works best for nearly all Spruce customers, as our goal is for you to be able to use Spruce as much and as often as possible, without having to worry about a bill that might be quietly ballooning in the background.
In the rare case that an organization's heavy use of Spruce is not compatible with the pricing of its chosen plan, we will reach out to the organization to describe the issue and to negotiate a custom price.
If you are concerned that your planned use of Spruce might be unusual, please feel free to ask our sales team ahead of time. As a general guide, extreme per-person usage of voice minutes, video minutes, SMS messages, and fax pages would be most likely to benefit from a custom pricing discussion.
How many phone and fax lines does Spruce support?
Spruce can support any number of phone and fax lines for your organization, and the system is designed to let users provision and configure new lines in a self-service manner.
By default, your subscription plan will determine the number of phone lines that your organization can provision:
• Basic: One line for each user, plus one additional line
• Communicator: Two lines for each user, plus one additional line
Fax lines work the same way. So a 3-user practice on our Basic plan could set up 4 phone lines and 4 fax lines without needing any help from our support team.
If your situation will require more lines than your subscription plan will allow for, just message our support team in the Spruce app, and we'll help you sort it out.
