Judge Gilbert Martinez made the ruling Thursday based on a report from the state mental hospital, where Robert Dear has been undergoing treatment since he was first deemed incompetent in May.
Doctors have been ordered to give the judge periodic updates on Dear's progress.
Dear is charged with 179 counts, including murder and attempted murder, stemming from the Nov. 27 shooting at the Colorado Springs clinic that also left nine injured.
He was found incompetent after two psychologists testified that he has a delusion disorder that made him unable to assist in his defense.
Dear told investigators he attacked the clinic because of his anti-abortion stance.