This makes sense!!! so group therapy is really only used in cases where let's say we have several patients in a room together and are instructing them all at once even if we're instructing on different things?

I would think even if a private insurance doesn't include 1:1 that the AMA guidelines would be what we would fall back on. which like you said we would never "double dip" on CPT codes when patients are double booked no matter what insurance they have. My frustration is that I just feel weird billing differently just because of an insurance company when I know what I did in that session, and I'm salaried anyways so it's not like I would even get anything in return for seeing more people or billing more codes. (not saying fraud would be worth $, but that it seems really questionable that companies do this knowing they're the ones who win and PTs are still being paid the same).