Affordable HIPAA fax for counseling and group practices that grow

A counseling or group practice of 3 people at 500 pages a month pays $9.99 a month billed annually on Fax Pigeon Standard, with a signed BAA and unlimited people, against $13.65 at SRFax and $33.33 at eFax, billed annually, and $39.95 month to month at WestFax Team; at 10 people and 2,000 pages, Fax Pigeon Pro is $29.99.

What does an affordable HIPAA fax cost a counseling or group practice?

An affordable HIPAA fax for a counseling or group practice costs $9.99 a month billed annually on Fax Pigeon Standard for 500 pages, or $29.99 on Pro for 2,000 pages, with a signed BAA and any number of clinicians. Fax Pigeon has no team plans: every plan includes unlimited people. Among the providers in the table, the next lowest price for 3 people at 500 pages is SRFax Healthcare Basic at $13.65, with the BAA by request.

For a 3-person counseling practice, the table prices each provider's cheapest plan with a BAA by the month at 500 and at 2,000 pages sent and received.

At 2,000 pages, SRFax costs $58.60 and eFax Business $95.83 a month billed annually, against $29.99 for Fax Pigeon Pro. Over a year, Fax Pigeon Pro costs $359.88, which is $343.32 less than SRFax at the same pages. WestFax bills month to month only, and its Team plan reaches $54.95 at 2,000 pages.

What do counseling and group practices fax, and to whom?

Counseling and group practices fax records to other treating clinicians, referral letters and prior authorization requests to insurers, and records that attorneys and employers request with a signed authorization. Recipients include primary care offices, psychiatrists, hospitals, residential programs and the utilization review teams at insurers. Hospitals and crisis units fax discharge summaries back, so the outpatient clinician has them before the first visit.

Payer programs set their own fax lines and clocks. Humana Military's TRICARE East tip sheet has facilities without internet access fax non-urgent mental health requests to (877) 378-2316. Its TRICARE ABA page lets providers request ongoing treatment up to 60 days in advance and warns that a request less than 30 days before the current authorization expires may go unreimbursed.

Intensive outpatient programs recertify Medicare patients no less often than every 60 days under 42 CFR 424.24(d)(3)(ii).

How does the price change as the practice adds clinicians and pages?

On Fax Pigeon the price changes only with pages: a practice moves from Standard at $9.99 to Plus at $16.99 and Pro at $29.99 a month billed annually as it grows from 500 to 2,000 pages, and each added clinician costs nothing. Pages sent and received count together, and everyone shares one page allowance. Fax Pigeon serves counseling practices of any size, from a solo clinician to a team of 100 or more.

The table shows Fax Pigeon's six plans as a practice grows, and every plan includes a signed BAA and unlimited people.

A move up takes effect right away for the prorated difference, and a move down waits for the next renewal. At three rivals the bill grows with people as well as pages: WestFax moves from Solo with 1 user to Team with 5 and to its 3,000-page Team tier with 25, eFax adds $10 a month for each user past five, and iFax adds a team license for each person past the first, on Pro.

The 10-person table gives the monthly price of every provider's cheapest BAA plan at 500 and 2,000 pages sent and received.

At 10 people and 2,000 pages, a year costs $359.88 on Fax Pigeon Pro, $1,650.00 on eFax Business and $3,029.28 on iFax, each billed annually. SRFax, Sfax and Fax.Plus keep the same prices from 3 people to 10.

Which fax services charge per user, and which include everyone?

eFax, iFax and WestFax charge for people, while Fax Pigeon, Sfax and Fax.Plus Enterprise include unlimited users and SRFax prices no user on a shared number.

The table shows what each provider charges for people, from each provider's own pages.

Fax.Plus's help center says that when a number is assigned to several users, each incoming page counts against the quota once per assigned user, so a 1-page fax on a number shared by 5 users uses 5 pages. Once a BAA is signed on Fax.Plus Enterprise, the account cannot be downgraded to Premium. SRFax's FAQ says added users with their own number pay a small fee and see only their own faxes.

Can the whole team share one fax number and inbox?

A whole counseling team can share one Fax Pigeon number, one inbox and one page allowance, and adding people costs nothing. Owner, Manager and Member roles control who handles billing and invitations. Incoming faxes can be assigned to a colleague and marked reviewed, so a records request reaches the clinician it names. More on sharing one fax inbox in a small office and on HIPAA fax with unlimited users.

Which HIPAA rules apply to a group practice's faxes?

A group practice's faxes fall under HIPAA's psychotherapy notes rule, the minimum necessary standard and the Security Rule's login and audit controls, and under 42 CFR Part 2 when the practice provides substance use disorder care and holds itself out as doing so. Under 45 CFR 164.501, psychotherapy notes include notes from a group, joint or family counseling session kept apart from the rest of the record. 45 CFR 164.508(a)(2) requires an authorization for any use or disclosure of them, apart from listed exceptions such as the originator's own use for treatment, and 164.508(b)(3)(ii) lets that authorization be combined only with another psychotherapy notes authorization.

Part 2 reaches private practitioners who hold themselves out as providing, and provide, substance use disorder diagnosis, treatment or referral (42 CFR 2.12(e)(1)). A Part 2 disclosure made with written consent goes out with a copy of the consent or a clear explanation of its scope, and 42 CFR 2.32(a)(2) offers the one-line notice "42 CFR part 2 prohibits unauthorized use or disclosure of these records." The 2024 final rule set a compliance date of February 16, 2026.

On a payer's request, 45 CFR 164.502(b) requires reasonable efforts to limit the pages to the minimum necessary, while 164.506(c)(2) lets a group send records to another treating clinician. The Security Rule requires a unique login for each person under 45 CFR 164.312(a)(2)(i) and audit controls under 45 CFR 164.312(b), and 164.308(a)(3)(ii)(C), an addressable specification, calls for ending access when a clinician leaves.

Which group practices should switch, and to what?

A counseling or group practice that pays for each person, or pays more than $9.99 a month for 500 pages with a BAA, should switch to Fax Pigeon Standard, or to Pro at $29.99 for 2,000 pages. The same holds for group therapy practices, ABA providers, intensive outpatient programs and practices adding a second location; a practice enrolled in Medicare reports a new location to its Medicare contractor within 30 days under 42 CFR 424.516(d).

The current number ports free on every paid plan, starting at sign-up or from Settings, and the old provider keeps it live until the move completes, 5 to 15 business days for most transfers. eFax's Customer Agreement lists an administrative fee of $40 per number to port out.

A solo clinician weighing the same choice can read HIPAA fax for therapists in private practice. On month-to-month billing at 10 people and 500 pages, WestFax costs $839.88 a year and Fax Pigeon Standard $143.88.

* Prices last verified October 19, 2026, at each provider's own site. Fax Pigeon is not affiliated with SRFax, eFax, iFax, Fax.Plus, WestFax or Sfax.