Physical machines are disappearing from offices, but the fax service industry is not shrinking. The global fax services market was valued at $3.31 billion in 2024 and is on track to reach $4.47 billion by 2030. These statistics tell a story that surprises most people: while traditional fax machines are declining, online and cloud-based fax services are growing at a compound annual growth rate between 5% and 10%.
For healthcare organizations, firms offering legal services, and government departments that use fax to send documents containing protected health information every day, the shift is not away from this technology — it is toward a new form built for digital communication.
Key Takeaways
Over 17 billion pages were sent by fax service providers in the U.S. in 2019, with 9 billion of those in healthcare alone. The fax industry continues to grow through online fax and cloud-based solutions, even as physical fax machines decline.
89% of healthcare organizations still use fax, driven by interoperability gaps among electronic health record systems that force providers to rely on it as the default for referral letters and medical records.
The global fax services market is projected to reach $7.22 billion by 2035, with a CAGR of 9.5%. North America accounts for roughly 38% of all fax service revenue.
Copper telephone lines are being retired across the U.S. and U.K. by 2027–2029. Organizations still running machines on analog phone line connections face forced migration to cloud-hosted alternatives or ATA-bridged fax solutions.
How Many Pages Are Sent by Fax Each Year?
The most widely cited figure comes from a report cited in Communications of the ACM: more than 17 billion individual faxed documents were sent in the United States in 2019. Healthcare alone accounted for over 9 billion of those fax transmissions, according to estimates from Konica Minolta.
Other volume benchmarks worth noting:
200 billion pages — the number of pages fax machines consumed annually across the U.S., including paper-based processes, according to IDC's 2017 survey
6,000 pages per second — the estimated rate of fax transmissions in the U.S. at peak volume
82% of large enterprises surveyed by IDC in 2017 said fax usage had increased or stayed the same year over year
Globally, estimates range from 17 billion to over 100 billion pages per year, depending on the source and how digital faxing through modern online fax services is counted. What is not in dispute: organizations that use fax in healthcare, legal services, finance, and government still rely on this channel at high volume.
Fax Usage by Industry
Fax technology is not evenly distributed across the economy. A handful of regulated industries account for the overwhelming majority of fax service demand.
Healthcare
Healthcare is the single largest driver of demand. The numbers speak for themselves:
89% of healthcare organizations reported using fax machines in a 2019 poll of 1,581 healthcare leaders (MGMA)
70% of all healthcare communication happens via fax — rising to 90% when you include fax transmissions flowing into and out of EHR applications (Altera Digital Health)
9+ billion fax pages are exchanged annually in U.S. healthcare alone
56% of referrals continue to be faxed despite the availability of electronic referral tools within EHR systems
Why does fax, as a method of document transmission, remain so dominant?
The root cause is a failure of EHR interoperability. According to ONC data cited by TechTarget, 64% of hospitals reported health information exchange challenges in 2021 because their systems could not communicate with exchange partners. When two providers at different organizations use different EHR platforms, a fax service is often the only way to send documents like medical records and lab results reliably — those tools cannot handle email attachments or structured data across different vendor platforms.
The consequences are measurable. According to Konica Minolta, 30% of medical tests are unnecessarily re-ordered because transmissions are lost, arrive at busy signals, or go missing. For providers managing patient information under HIPAA compliance requirements, every misdirected page is a potential violation. HIPAA penalties for fax-related breaches can range from $137 to over $2 million per violation annually, depending on the level of negligence, according to the HHS Office for Civil Rights penalty tier structure.
Legal and Financial Services
Law firms use fax to securely transmit legally binding documents, including contracts, court filings, pleadings, and motions. Faxed signatures have been legally recognized since the late 1980s, and courts accept these transmissions as admissible evidence with automatic timestamp verification. For many organizations in the legal sector, the combination of a legally binding audit trail and secure transmission makes a dedicated fax service the default for sending critical, legal, and sensitive documents.
The financial services sector accounts for approximately 19% of the global fax services market, according to Arizton. Common use cases include:
Business associate agreements and compliance forms
Loan documents requiring wet or faxed signatures
Regulatory filings between branches and international partners
Sensitive information shared with insurers and underwriters
Banks, insurance companies, and mortgage lenders use fax solutions because they provide a verifiable, secure channel for records retention and compliance.
Government
Government departments at the federal, state, and municipal levels continue to use fax for official communications. Agencies, including the IRS and the Social Security Administration, still require fax service for certain filings. Regulatory requirements for record retention and secure delivery drive continued adoption across public-sector offices.
Fax Market Size and Growth Projections
The fax market tells two different stories depending on whether you are looking at hardware or services.
Metric | Value | Source |
|---|---|---|
Fax machine hardware market (2025) | ~$325 million, declining at -5% CAGR | |
Global fax services market (2024) | $3.31 billion | |
Global fax services market (2030 forecast) | $4.47 billion, 5.15% CAGR | Arizton |
Online fax service market (2035 forecast) | $7.22 billion, 9.5% CAGR | |
North America share of global fax services market | ~38% | Business Research Insights |
Hardware is declining. Manufacturers have slowed or stopped producing replacement parts for traditional fax machines, making it harder to maintain aging equipment. The global market for fax machines is projected to shrink at a compound annual growth rate of -5% through 2033.
The fax services market is growing. Cloud-based fax services dominate new implementations. According to IDC's research, only 36% of pages in 2017 were sent from standalone fax machines. Cloud-hosted and email-based fax solutions had already overtaken physical fax machines for new deployments. An IDG MarketPulse survey cited by OpenText found that paper-based usage dropped from 60% to 44% of enterprise volume in just two years. The shift from traditional approaches to digital faxing accelerates as large enterprises adopt cloud fax services for their workflows and document management systems.
Why Fax Persists: Four Structural Drivers
1. EHR Interoperability Gaps
Healthcare providers cannot abandon this channel because the digital alternatives do not work reliably across organizations. According to the 2018 CAQH Index:
182 million prior authorization transactions occur annually in the U.S. commercial medical market
51% are processed manually — by phone or fax
Only 12% use the HIPAA electronic transaction standard (5010 X12 278)
Until EHR systems can reliably send and receive electronic documents, this fax service remains the universal fallback.
2. Legal Admissibility and Compliance
Transmissions produce a legally binding confirmation page that includes a timestamp, the recipient's fax number, and the page count. Courts accept faxed documents as evidence. Business users in regulated industries rely on the comprehensive audit trails that fax technology provides. Many organizations maintain these workflows specifically because regulatory requirements demand verifiable, secure transmission with audit trails — something email cannot match without additional tooling.
3. Security Perception
A connection over analog lines establishes a point-to-point link that is harder to intercept than email, which routes through multiple servers and is vulnerable to phishing. Modern online fax services use TLS encryption for secure transmission in transit and at rest, making faxing one of the more secure methods for sending documents containing sensitive information. For business users handling patient information or financial records, a dedicated fax service provides a secure channel that meets HIPAA requirements when paired with appropriate safeguards.
4. Network Effects
Individual organizations cannot stop using fax if their counterparts — hospitals, courts, insurance companies, international partners — still require it. The network effect locks in adoption across entire industries. When a provider needs to send a referral to a specialist who uses a different EHR, the only guaranteed path is to use fax and dial that provider's fax number. This dynamic sustains reliance on the fax service even when organizations would prefer purely digital communication.
The Copper Retirement and What It Means
One of the most underreported developments in fax technology is the accelerating retirement of PSTN copper infrastructure — the analog phone line infrastructure that traditional fax machines depend on.
Key milestones:
U.K.: BT Openreach will permanently switch off the PSTN by January 31, 2027. Fax machines, landline phones, alarm systems, and payment terminals are directly affected.
U.S.: AT&T is retiring copper networks in phases — non-fiber areas between 2025 and 2027, fiber build-out areas between 2027 and 2029.
This does not mean the end of fax. It means organizations still running physical fax machines on POTS lines need to migrate. Two technologies address this:
Cloud-hosted fax solutions — eliminate the need for physical hardware entirely
ATA (Analog Telephone Adapter) devices — bridge existing machines to an encrypted cloud infrastructure
Either path removes the dependency on copper lines while preserving the ability to send fax and receive faxes through existing workflows. For organizations evaluating their posture, the copper retirement is a forcing function. Waiting until lines are decommissioned risks losing service with no replacement in place.
FaxSIPit's SecureFax-ATA — a proprietary hardware device that connects existing fax machines to FaxSIPit's encrypted cloud — was designed for exactly this scenario. It preserves fax number assignments, routing rules, and document workflows while moving secure document transmission to a dedicated network with TLS encryption and comprehensive audit trails. For organizations that need to instantly send and receive faxes from a smart device or desktop without hardware, our cloud fax service handles incoming faxes and outgoing transmissions through browser, email, or desktop app. Both options support HIPAA-compliant operation with business associate agreements, configurable retention up to 7 years, and full delivery records — making faxing a reliable, compliant process even after analog infrastructure goes dark.
The Real Cost of Running Fax Machines
Most organizations underestimate what traditional fax machines actually cost. The purchase price ($200–$500 for a basic machine) is the smallest part.
Hidden costs of traditional fax:
Dedicated phone line: ~$40/month per machine
Paper and toner: ~5,000 sheets per year per machine
On premises fax servers: up to $1,200/month for a Windows Server, plus 20% annual maintenance on license costs
Transmission failure rate: ~5% of analog fax transmissions fail to reach their destination, driving up the true cost of paper fax
Staff time: 8–15 seconds per trip to a fax machine, compounding to hours of lost productivity weekly at scale
Energy consumption: ~321 kWh per year per machine running in standby
Cloud-based fax eliminates most of these costs. There is no dedicated landline, no on-premises servers, no paper, and no hardware maintenance. Pricing for modern online fax services typically starts in the range of $10–$15 per month for basic plans, scaling with volume. For organizations moving away from fax machines but needing to preserve cover sheets, fax number assignments, and document management capabilities, cloud-hosted fax solutions provide a direct replacement at a fraction of the cost.
Cloud Adoption Trends
The transition to digital faxing is well underway:
2017: Cloud-hosted fax services accounted for 31% of total activity among companies that had adopted them, with that share projected to grow to 71% within three years (IDC)
2019: Paper-based processes dropped below 50% of enterprise volume for the first time (IDG MarketPulse)
2025 and beyond: Cloud-first is the default for new fax service deployments across the fax services market
The fax industry continues to evolve in new forms. Integration with document management systems, EHR platforms, and unified communications tools (Microsoft Teams, Zoom, Google Workspace) is accelerating adoption among large enterprises. API-driven fax solutions allow organizations to embed send fax and receive faxes capabilities directly into existing workflows, eliminating the need for standalone applications. For the Japanese government, which attempted to phase out this technology in 2021 and was forced to reverse course because of widespread institutional resistance, the shift is slower — but even Japan is gradually moving toward digital faxing and online fax as two technologies converge.
Frequently Asked Questions
Is fax still used in healthcare?
Yes. According to the MGMA, 89% of healthcare organizations reported using this technology as of 2019. Approximately 70% of all healthcare communication happens via this channel, rising to 90% when you include transmissions flowing through EHR systems. The U.S. healthcare sector alone exchanges over 9 billion pages per year. EHR interoperability gaps — not preference — keep this method embedded in clinical workflows for referrals and prior authorizations.
How many businesses still use fax?
Globally, approximately 17% of businesses still rely on this method for critical operations, according to a 2024 Statista report. Usage is far higher in regulated industries: 89% in healthcare, an estimated 85% in government, and roughly 19% of the fax services market is driven by financial services. In Germany, 82% of companies with 20 or more employees still use fax.
What is replacing physical fax machines?
Cloud-hosted and online fax services are replacing physical hardware, not the capability itself. The machine hardware market is declining at -5% CAGR, but the fax services market is growing at 5–10% CAGR. Cloud-hosted services eliminate the need for dedicated phone lines, paper, and on-premises servers while preserving fax number assignments and the ability to send and receive from any device. ATA devices can also bridge existing equipment to cloud infrastructure for organizations that want to keep their physical machines.
How Do These Statistics Affect Your Organization?
If your organization still depends on fax machines and analog telephone lines, the data points in one direction: the infrastructure under those machines is going away, but the need for fax is not. Organizations in healthcare, finance, and government will continue to use fax for secure transmission of critical documents, legally binding fax filings, and compliance-driven processes for the foreseeable future.
The question is not whether to keep your fax service. It is whether your infrastructure can survive the copper retirement, meet HIPAA compliance and audit trail requirements, and scale without the hidden costs of on-premises servers and aging hardware.
See how FaxSIPit handles HIPAA-compliant fax for regulated industries.
