At the outset of the COVID-19 pandemic, many health systems transitioned to mandatory telehealth visits and then slowly reintroduced in-person visits as safety improved. This study describes patient safety, patient satisfaction, and financial savings for patients receiving radiation therapy who attended weekly management visits with their physician via telehealth instead of in-person. Safety event rates were similar for patients receiving telehealth and in-person care. Nearly all telehealth patients reported high satisfaction and cost savings.