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TREATMENT OR TESTING BY AUTHORIZED MEDICAL PROVIDER WC-205

TREATMENT OR TESTING BY AUTHORIZED MEDICAL PROVIDER WC-205 2026

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The document WC-205 is a form from the Georgia State Board of Workers' Compensation that outlines the process for authorized medical providers to request pre-authorization for treatment or testing of injured employees. While advance authorization is not required for payment, providers can submit this form to insurers/self-insurers, who must respond within 5 business days. If there is no response, the treatment is automatically approved. The document also details the necessary sections to be filled out by both the medical provider and the insurer.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out Section 1, which includes identifying information such as the patient's last name, first name, employer name, and diagnosis. Ensure all fields are completed accurately.
Proceed to Section 2 to request treatment or testing authorization. Enter the ICD-10 and CPT/DRG codes, specify who will provide the treatment, and detail the requested treatment or testing along with the reason for it.
In this section, also include your contact information as the requesting authorized medical provider. Make sure to certify that you have faxed or emailed this form to the insurer/self-insurer.
Finally, review Section 3 where the insurer will respond. This section is not for you to fill out but is crucial for understanding how your request will be processed.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (76 Votes)
2013	4.4 Satisfied (32 Votes)

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TREATMENT OR TESTING BY AUTHORIZED MEDICAL PROVIDER WC-205 2026

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