Oncologists can miss up to half of their patients’ symptoms during treatment. When there is a gap between what patients feel at home and what the care team notices at the next visit, a manageable side effect can turn into an emergency room visit.

A randomized trial at Memorial Sloan Kettering split patients receiving chemotherapy for metastatic cancer into two groups. One group reported twelve common symptoms electronically between visits, and care teams were notified if a symptom was severe or getting worse. The other group received standard care. Patients who reported symptoms had better quality of life at six months, fewer emergency room visits, and stayed on chemotherapy longer. After a median of seven years, the reporting group lived more than five months longer, 31.2 months compared to 26.0 (p = 0.03).

Why Cancer Symptoms Slip Through Between Visits

Between infusion appointments, a patient might feel worse for days without telling anyone. They may not want to bother the care team or may think nausea or a mild fever is just part of treatment. By the time they call or go to the emergency room, the problem is bigger and more expensive to treat. Care teams want to catch these issues earlier but cannot help if they do not know what is happening.

Electronic symptom monitoring helps close this gap. Patients answer a short set of questions on their phone. If any answer is above a set threshold, the monitoring team is alerted while there is still time to help.

How Remote Therapeutic Monitoring (RTM) Works in Oncology

An effective oncology remote therapeutic monitoring plan is based on the patient’s treatment and its side effects. Most plans run daily during active treatment. Patients report their pain score, nausea and fatigue levels, temperature, a brief mood check for depression and anxiety, and whether they took oral chemotherapy and supportive medications. For example, an assessment may ask:

1. On a scale from 0 to 10, how would you rate your pain today?

2. Have you felt more tired or fatigued than usual? (Not at all, A little, Quite a bit, Very much)

3. Have you experienced any nausea in the past 24 hours? (None, Mild, Moderate, Severe)

4. What is your current body temperature?

5. In the past week, have you felt down, depressed, or hopeless? (Not at all, Several days, More than half the days, Nearly every day)

6. Did you take your oral chemotherapy medication today? (Yes/No)

Once a week, patients complete a quality-of-life survey and record any weight changes. The questions use simple language based on the same criteria oncologists use, so patients can describe their symptoms without needing to know medical terms.

Providers can customize each assessment to match the specific treatment plan and patient population, so clinics can add or adjust questions for certain therapies, cancer types, or individual patient needs. This flexibility helps capture both common and unique symptoms for more personalized monitoring.

Care teams often worry that monitoring will add to their workload. Actuvi is designed to make things easier instead.

If a reading goes above the threshold set by the care team, such as a fever, high pain score, or worsening nausea, the Actuvi platform flags it for the monitoring team.  For critical alerts, the assigned staff member quickly reviews the context and recent patient history, then follows set response protocols. Depending on the alert’s severity and type, the team member may message the patient directly, escalate to the oncologist, move up an appointment, adjust medication, or arrange an in-person or telehealth visit.

Patients can also send messages directly to their oncology care team using the Actuvi patient app.

Where Remote Therapeutic Monitoring (RTM) Billing Fits in Oncology

Remote Therapeutic Monitoring (RTM) allows providers to bill for monitoring patient-reported, non-physiological data between visits, such as therapy and treatment compliance, depression and anxiety levels, medication adherence, and more. RTM covers three categories: respiratory, musculoskeletal, and behavioral health, all of which are relevant in oncology. These are the 2026 RTM codes along with their reimbursement figure:

*2026 national averages; actual amounts vary by locality and MAC.

Musculoskeletal RTM covers cancer-related pain and loss of physical function that patients work to regain during and after treatment. Respiratory RTM is for patients whose disease or treatment affects their breathing. Behavioral health codes are used when there is a behavioral health monitoring plan, which fits the distress, anxiety, and depression that often come with a cancer diagnosis.

RTM and value-based care go hand in hand. RTM reimburses monitoring that fits its categories, and all the patient-reported data you collect also supports value-based programs that reward keeping patients healthy. Every symptom you track can either support a billable RTM service, improve your value-based performance, or both. For how this data drives your performance under the Enhancing Oncology Model, see our guide to value-based care in oncology.

Clinics using Actuvi usually see reimbursement of up to $180 per patient per month for RTM. For example, a program with 500 patients can bring in $90,000 in monthly RTM revenue, plus savings from fewer emergency and inpatient visits.

Keeping Patients Reporting and Teams Responding

Benefits from a remote therapeutic monitoring program can only be achieved if two things happen: patients report their data, and the care team responds to alerts. Actuvi is built to support both.

Reporting needs to be easy, or patients will not do it. Actuvi includes several patient engagement features to help patients report consistently:

1. Assessments are sent in plain language through a simple, modern app, allowing patients to answer in a few seconds

2. Assessments are available in multiple languages, and the content is designed in a way that most people can understand and respond easily

3. Conditional logic keeps each assessment short, so patients only see follow-up questions based on their answers

4. Scheduled notifications, reminders, and streaks help make monitoring part of the routine

The easier the process is for patients, the more consistent the data will be. Consistent data makes everything else possible.

Some patients may still stop reporting, and some will not use an app at all. For these patients, Actuvi’s AI agents follow up by text and deliver the assessment in the conversation, turning a missed monitoring into a quick reply.

If a patient cannot report on their own, Guardian/Caregiver Access allows a family member or caregiver to submit on their behalf. In oncology, this often helps frail patients stay in the program instead of dropping out.

Actuvi integrates with leading EHRs, and all patient communications and data storage are HIPAA-compliant.

We set up your program for long-term success. Our team builds the assessments, sets thresholds, trains your staff, and stays involved to help keep patient compliance high.

Getting Started with Oncology Remote Therapeutic Monitoring (RTM)

Getting started with RTM does not have to be a big project for your team. Actuvi takes care of the setup and builds your program. These programs can help many oncology patients, but some groups may benefit even more. High-value patient groups for regular symptom monitoring include:

1. Patients with advanced or metastatic disease

2. Patients undergoing chemotherapy or immunotherapy

3. Patients with complex symptom burdens

4. Patients with frequent hospital visits

5. Patients at higher risk of complications

6. Patients with limited ability to report symptoms in person

Focusing on these groups can help clinics get the most clinical and operational benefits from RTM and ePROs.

Here is what onboarding usually looks like:

1. Kickoff and Planning: We meet with your team to understand your workflows, review your patient population, and confirm your priorities.

2. Assessment Design: Our team customizes assessment questions based on your treatment protocols, using plain language that matches your clinic needs.

3. Thresholds and Alerts Configuration: We set up alert thresholds in consultation with your clinical leads, so the right people are notified at the right time.

4. Staff Training: We train your team on using Actuvi, interpreting reports, and responding to alerts efficiently, with hands-on sessions and support materials.

5. Go-Live: We launch your program, monitor early reports together, and provide real-time support to ensure everything runs smoothly.

6. Ongoing Support: After launch, we continue to monitor engagement and performance, make updates as your needs evolve, and help maintain patient compliance and reporting on track as your volume grows.

We usually complete the implementation within two weeks of kickoff.

Talk to our digital care expert. We will match the program to your patient population, show you how it works for reimbursement and outcomes, and provide a revenue breakdown for your clinic.