Summary
Key Takeaways
What it is: Dragon Copilot listens to patient-clinician conversations and generates clinical notes automatically. It’s a healthcare product, unrelated to Microsoft 365 Copilot.
Three role-specific licence types: Physician Per User (flat fee), Physician Flex (subscription plus Azure consumption), and Nursing Per User (flat fee, US only). There is no Nursing Flex option.
Flex consumption charges to budget for: The main AI feature (ambient note generation) costs $3.00 per use on Flex.
Subscription prices aren’t public: Microsoft has declined to publish pricing. Contact your Microsoft representative or CSP for a quote.
Available through standard channels: Dragon Copilot is available through MCA, CSP, and Enterprise Agreement.
Limited regions: For physicians, available in the US, Canada, UK, Ireland, France, Germany, and Austria. For nurses, US only.
1. What is Dragon Copilot?
Dragon Copilot is Microsoft’s AI-powered clinical documentation assistant. It listens to patient-clinician conversations and generates clinical notes automatically, reducing the documentation burden that contributes to clinician burnout.
The product launched in March 2025, combining two Nuance technologies that Microsoft acquired in 2022:
Dragon Medical One: Speech recognition for clinical dictation
DAX Copilot: Ambient clinical intelligence that listens to encounters and drafts notes
If you’re familiar with DAX Copilot or Dragon Medical One, Dragon Copilot is their successor. Microsoft has consolidated both into a single product with unified licensing.
1.1 How It Differs from Microsoft 365 Copilot
Dragon Copilot is completely separate from Microsoft 365 Copilot, with its own licensing model and purchase channels.
Aspect | Dragon Copilot | Microsoft 365 Copilot |
|---|---|---|
Purpose | Clinical documentation | Productivity across Office apps |
Target users | Clinicians | Knowledge workers |
Pricing model | Role-specific: Physician Per User, Physician Flex, or Nursing Per User | Per-user subscription only |
Published pricing | No | Yes ($30/user/month) |
Purchase channel | MCA, CSP, EA | Enterprise Agreement, CSP, direct |
Prerequisites | Entra ID; Azure subscription (Physician Flex only) | M365 licence |
2. Licence Types
Dragon Copilot uses role-specific licensing. Microsoft’s SKU names explicitly identify the clinical role each licence supports.
SKU Name | Model | Description |
|---|---|---|
Dragon Copilot (Physician Per User) | Named user subscription | All features included for flat fee; for physician workflows |
Dragon Copilot (Physician Flex) | Per-user subscription + Azure consumption | Frontend speech included; AI features billed via Azure; for physician workflows |
Dragon Copilot (Nursing Per User) | Named user subscription | Nursing workflows including ambient flowsheet capture; US only; GA December 2025 |
Important: Per User and Flex are for physician workflows only. There is no Nursing Flex option.
2.1 Physician Per User
A Physician Per User licence assigns one licence to one named physician or other clinician working in patient-provider encounters. That clinician can use Dragon Copilot across web, desktop, mobile, and embedded interfaces.
According to Microsoft’s licensing guidance, Physician Per User “equips user to run all Dragon Copilot features (including Front-end Speech, ambient features, and GenAI features) without additional charges.”
Physician Per User offers predictability: you know exactly what you’ll pay each month, regardless of how heavily clinicians use the AI features.
2.2 Physician Flex
Physician Flex is a hybrid model for physician workflows. You still assign a licence to each named user, but the licence only covers frontend speech capabilities. Ambient recording and AI note generation are billed separately through Azure consumption.
According to Microsoft’s licensing guidance, Physician Flex “provides access to all features for the patient-provider encounter but requires an Azure subscription to run ambient and GenAI features which are charged on a consumption basis.”
If you’re unsure how heavily your physicians will use the AI features, Physician Flex lets you pay for actual AI usage rather than committing to a flat fee. The trade-off is less predictable monthly spend.
2.3 Nursing Per User
Nursing Per User is for nursing workflows, including flowsheet-based documentation. There is no Nursing Flex option – nursing licences are only available as Per User.
According to Microsoft’s licensing guidance, Nursing Per User “equips the user to run Dragon Copilot capabilities for the nursing workflow (including ambient flowsheet capture) with a single user license.”
Microsoft’s healthcare page states: “General availability in the US begins December 2025.”
3. Consumption Billing (Physician Flex Only)
Physician Per User and Nursing Per User licences include all features for a flat monthly fee. Physician Flex works differently: you pay a subscription for speech recognition, but AI features are billed through Azure consumption.
Microsoft charges $0.01 per consumption unit. Different features consume different amounts.
3.1 Unit Rates
Feature | Units | Cost at $0.01/unit |
|---|---|---|
Ambient structured notes | 300 | $3.00 |
Summarise encounter | 50 | $0.50 |
Summarise evidence | 50 | $0.50 |
Orders | 50 | $0.50 |
After visit summary | 30 | $0.30 |
Free text | 30 | $0.30 |
Get coaching | 10 | $0.10 |
Referral letter | 10 | $0.10 |
Rates effective 1 May 2025. Source: Microsoft licensing guidance
3.2 Cost Implications
The main cost driver is ambient structured notes at 300 units ($3.00) per use. To illustrate: a physician documenting 20 patient encounters daily would generate $60 per day in consumption charges, or roughly $1,200 per month on top of the Physician Flex subscription fee.
Whether that makes Physician Flex cheaper or more expensive than Physician Per User depends on the Per User price, which Microsoft hasn’t published. Without knowing both figures, you can’t do a direct comparison.
3.3 Physician Per User vs Physician Flex: Billing Comparison
Aspect | Physician Per User | Physician Flex |
|---|---|---|
Frontend speech | Included | Included |
Ambient and GenAI features | Included | Consumption billing via Azure |
Monthly cost | Predictable | Variable |
Azure subscription required | No | Yes |
Physician Per User is simpler to budget: one fee covers everything. Physician Flex requires Azure integration and usage monitoring, but may suit organisations testing adoption before committing to full Per User rollout.
4. Subscription Pricing
Microsoft hasn’t published commercial subscription prices for Dragon Copilot.
When CNBC asked about pricing at the March 2025 launch, Microsoft declined to share costs and said only that pricing would be “competitive.”
4.1 What We Found
We researched pricing across reseller websites, partner channels, and healthcare procurement sources. The results were inconsistent, spanning a wide range across different contexts: commercial versus education, UK versus US, current product versus predecessor. We chose not to publish indicative pricing because the variation would confuse rather than help.
This lack of transparency makes budgeting difficult. You’ll need to get a quote before you can build a business case.
4.2 How to Get Pricing
Contact your Microsoft representative or a Cloud Solution Provider for a quote.
5. Purchase Channels
According to Microsoft’s licensing guidance, you can acquire Dragon Copilot through: | If MCA is not an option, Dragon Copilot is also available through: |
|---|---|
Microsoft Customer Agreement (MCA) Microsoft Cloud Solution Provider (CSP), including Clinical Applications Embed | Enterprise Agreement (EA) Enterprise Agreement Subscription (EAS) Server Cloud Enrollment (SCE) Enrollment for Education Solutions (EES) |
🖐 Get clarity on complex Microsoft licence structures and AI add-ons. Learn more: Microsoft Licensing Services for Enterprises.
6. Prerequisites
According to Microsoft’s documentation, you need:
Microsoft Entra ID tenant: Dragon Copilot authenticates through Entra ID
Dragon Admin Center access: For licence and user management
Azure subscription: Required for Physician Flex licences to enable consumption billing
7. Regional Availability
According to Microsoft’s healthcare page:
For physicians: | For nurses: |
|---|---|
United States, Canada, United Kingdom, Ireland, France, Germany, and Austria. | United States only (general availability December 2025). |
8. Frequently Asked Questions
How much does Dragon Copilot cost?
Microsoft hasn’t published subscription prices. Consumption charges are published: $0.01 per unit, with ambient structured notes costing 300 units ($3.00) per use. Consumption billing applies only to Physician Flex licences.
Is Dragon Copilot the same as Microsoft 365 Copilot?
No. They’re completely separate products. Dragon Copilot is for clinical documentation in healthcare settings, while Microsoft 365 Copilot is for productivity across Office applications. They have different licensing, pricing, and purchase channels.
What’s the difference between Physician Per User and Physician Flex licences?
Physician Per User includes everything: speech recognition and all AI features for a flat monthly fee. Physician Flex covers only speech recognition; AI features are billed separately through Azure consumption. Both are assigned to named users and support physician workflows.
Can I get a Flex licence for nursing staff?
No. Nursing licences are only available as Nursing Per User. There is no Nursing Flex option.
What happened to DAX Copilot and Dragon Medical One?
Microsoft consolidated both into Dragon Copilot in March 2025. If you ’re on DAX Copilot or Dragon Medical One, Dragon Copilot is the successor product.
Why isn’t pricing published?
Microsoft has explicitly declined to share Dragon Copilot costs publicly.
Do I need Microsoft 365 to use Dragon Copilot?
No. Dragon Copilot requires Microsoft Entra ID for authentication, but it doesn’t require Microsoft 365 licences.
Is Dragon Copilot available in my country?
For physicians: US, Canada, UK, Ireland, France, Germany, and Austria. For nurses: US only.
What’s the Nursing Per User licence?
A licence type for nursing workflows, including ambient flowsheet capture. General availability in the US begins December 2025. Unlike physician licences, there is no Flex option for nursing.
9. Recent Changes
Date | Change |
|---|---|
December 2025 | Nursing licence general availability in US |
December 2025 | Clarified role-specific licence naming (Physician Per User, Physician Flex, Nursing Per User) per Microsoft’s official SKU names |
May 2025 | Consumption billing rates published ($0.01/unit) |
March 2025 | Dragon Copilot launched, consolidating Dragon Medical One and DAX Copilot |
Need Help?
Dragon Copilot’s combination of unpublished subscription prices and consumption billing makes cost forecasting harder than typical Microsoft licensing. If you’re evaluating Dragon Copilot or trying to understand how it fits alongside other Microsoft AI products, get in touch.
We don’t sell Microsoft licences or cloud services, so our advice is independent.